For decades, a vicious cycle held our healthcare system hostage: treat illness when it appears, then manage complications as they worsen. But with chronic diseases such as diabetes, hypertension, heart disease, asthma, and HIV now among the leading causes of death and disability, this approach is not only outdated – it is unsustainable.
The reality is that chronic diseases account for a disproportionate share of healthcare costs, straining both households and the national healthcare system. What's worse, they not only affect health, but they also erode productivity, family stability, and national development. The challenge, then, is to develop effective, sustainable programmes that reduce long-term expenses while improving the quality of life for millions of South Africans.
Why chronic diseases weigh so heavily
Unlike acute illnesses, which typically resolve after short-term treatment, chronic conditions persist for years and often for the remainder of one's life. Their costs accumulate steadily: consultations, diagnostic tests, medications, monitoring devices, specialist referrals, and, in many cases, hospital admissions when conditions spiral out of control.
Take diabetes as an example. Left unmanaged, it leads to costly complications such as kidney failure, blindness, or amputations. Hypertension, if untreated, contributes to strokes, heart attacks, and heart failure – conditions that require intensive, expensive hospital care. Beyond direct medical costs, there are also indirect losses: absenteeism, early retirement, and reduced earning capacity.
The World Health Organisation (WHO) estimates that the economic burden of chronic disease in low- and middle-income countries is rising faster than GDP growth: "Chronic diseases inflict an enormous direct and indirect economic burden on the poor, and push many people and their families into poverty. Existing knowledge underestimates the implications of chronic diseases for poverty and the potential that chronic disease prevention and health promotion have for alleviating poverty in low and middle-income countries."
South Africa is no exception. Without systemic intervention, chronic diseases will continue to consume a larger share of both household and scheme healthcare budgets.
Effective management with a human element
It's important not to reduce this conversation to numbers alone. Behind every chronic disease is a person navigating daily struggles: a breadwinner skipping medication because it's too expensive, a parent juggling work and endless clinic visits, a young adult too embarrassed to disclose their HIV status, or an elderly grandparent feeling isolated while managing multiple conditions.
These stories matter. Chronic disease management is not just about clinical protocols; it's about dignity, empowerment, and helping people live whole, productive lives despite their diagnoses. An effective chronic disease management programme should be:
- Proactive through early screening for conditions like diabetes and hypertension.
- The treatment is tailored to each patient's medical history and lifestyle.
- Coordinated across care teams, i.e. GPs, specialists, dietitians, mental health professionals.
- Digitally enabled, using telemedicine and monitoring tools to improve adherence and reduce unnecessary visits.
- Educational, ensuring patients understand their condition and treatment.
- Supported by the community, reducing isolation and stigma through shared experiences.
Medshield's approach: turning intent into impact
At Medshield Medical Scheme, we have built chronic disease management into the heart of our benefit design. We recognise that successful interventions start with prevention and extend across a member's health journey. That's why our benefits are structured not only to treat conditions, but also to anticipate and manage them. Our chronic disease benefit covers the Prescribed Minimum Benefits (PMBs) for a wide range of conditions, ensuring members have access to essential treatment.
- Members across all Medshield plans are covered for chronic conditions on the Chronic Disease List (CDL) – everything from hypertension, diabetes (Type 1 and 2), and asthma, to more complex illnesses like multiple sclerosis, Parkinson's disease, and Crohn's disease.
- The higher-end options provides access to an expanded list of chronic conditions, totalling up to 48, including less obvious issues such as acne, allergic rhinitis, Alzheimer's disease, and calcium supplementation.
Significantly, these benefits are complemented by our preventative and wellness benefits – screenings, vaccinations, and health risk assessments (HRAs) that help identify conditions before they escalate. By combining preventative care with long-term chronic management, we help our members achieve better health outcomes while protecting their financial stability.
Why this matters now
South Africa's healthcare costs are rising faster than the rate of inflation. Chronic diseases are among the leading contributors to this trend. If left unmanaged, they will continue to drive up scheme contributions and out-of-pocket expenses, putting effective healthcare further out of reach for many. However, when managed effectively, chronic conditions become predictable, controllable, and significantly less costly. Early intervention means fewer emergencies, fewer hospital admissions, and fewer families derailed by unexpected medical crises.
Healthcare cannot remain reactive. Every player in the system must adopt a preventive, proactive mindset. Chronic disease management programmes must be designed not only to save costs, but to enhance lives. We encourage every medical scheme member to understand the benefits available to them and take an active role in their health journey. Don't wait for symptoms. Don't wait for crises. Chronic diseases may be lifelong, but with the proper support, they don't have to be life-defining.
