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Newsletter for members of the MSP/Sizwe Medical Fund Volume 3, 2001

VOICE
(such as being hospitalised after an accident, or heart attack). If you still want the top-range benefits at a reasonable contribution level consider the Super 100. If you were on Full Budget and it has become too expensive, consider moving to the Affordable option or from Affordable to Primary. When choosing a medical aid option, first look at the benefits it provides for life-threatening conditions. Then, like your monthly shopping, look at the option that you can afford. REMEMBER: The higher the benefit value, the higher the cost of your contribution. If you are currently paying for a top-ofthe-range option, look at what you have claimed for over the past year and then ask yourself: Do I really need all this cover? Like household insurance, one can over-provide. This year has been a very difficult one. MSP/Sizwe, like most other medical schemes, has felt the effect of higher medicine costs and an increasing number of chronic conditions related to stress, and has had to introduce its new contribution increases in November to meet the shortfall created by these demands. Its administrator, SMS, also experienced a short hiccup with the postal strike in April that resulted in many duplicate claims being Continued on page 2 …

Medical aid –

CAN YOU AFFORD IT?

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hat is health? The World Health Organisation describes it as “the absence of disease”. Medical aid members may regard health as “the absence of money”. Let’s face it, medical aid cover is becoming very expensive for many of us. What has driven up the costs to the extent that they are far above the inflation rate? Firstly, medical science has become more sophisticated and doctors can now do many things to make people live longer and better lives: for example, heart bypass surgery or hip replacement. Medicines have also evolved, with constant research producing improved (and more expensive) drugs. The fact that most of these medicines are made in the United States, and that the Rand is so weak against the dollar, adds to our economic burden. So, will you still be able to afford medical aid cover next year? Most definitely ... but only if you carefully review your needs. The reality is that most of us would love to drive a luxury 4 x 4 but cannot afford it. So, what do we do? We buy a smaller car, or a motor-bike, or catch the taxi. You’ll have to adopt the same strategy with your medical aid. Ask yourself: What option can I really afford? Don’t look at all the nice-to-have list of benefits, but look at an option that gives you reasonable benefits for everyday treatment, but covers the life-threatening situations

We would all love to drive a fancy car, but sometimes taking the bus is all we can afford. Let’s consider your options ...

The MSP/Sizwe Benefit Guide for 2002 is enclosed with this mailing. After reading it carefully, please complete the Option Selection Form to indicate which of the six options you wish to belong to for the next year. The form must reach your payroll office, or be faxed to your nearest branch, by 1 December 2001.

Food for

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… continued from cover story received. In addition, the new computer system that was introduced in January compounded the temporary backlog. Fortunately, the new year will start with a clean slate: the options within MSP/Sizwe have been rationalised, the administration is on track and your Trustees are confident that the Fund is well run and financially sound and service levels are improving. Now, all we ask is that our members join us in keeping MSP/Sizwe healthy for years to come.

What can you do to

STRETCH
your benefits?
Medicines account for more than 30% of your Fund’s claims, so by reducing medicine usage you can help the Fund reduce its expenses. Here are some ways to do so responsibly: Ask your doctor if there is a generic equivalent to the medicine he/she has prescribed. Generics can be as much as 40% cheaper than branded medicines. Ask if you need all the tablets prescribed, or if you can reduce the dosage (from one a day to half a day) without any side-effects. Often, patients feel better after a few days and do not complete the course (just look inside your medicine chest at all those

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half-full containers, many of which have expired!). At the same time, it is important to complete the full course of any antibiotic that is prescribed (normally three to five days’ worth of tablets). Do not “doctor-hop”. Your doctor can refer to your file to see what medicines have been prescribed and ensure that you are not on any other medication. Some medicines can counteract the effects of others or cause very serious side-effects when combined. If you move from doctor to doctor and get different medicines from each of them, you could very well be damaging your health.

o you suffer from a lack of energy, irritability or sleep problems? Are you overweight or underweight? It could be that you are suffering from these symptoms because your liver is not coping with your diet. The liver supplies the body with energy in the form of a steady supply of glucose, for brain, nerve and muscle function. However, in order to function optimally, the liver needs a steady supply of the three basic food types: G starches and sugars; G proteins and fats; and G vitamins and minerals. On the other hand, the highly refined starches and sugars that are commonly found in the modern diet, do not really supply the liver with the nutrients it requires to function properly. If left unchecked, bad diet could lead to liver malfunction and could lead to conditions such as obesity, late onset diabetes and indirectly to the development of abnormal fat levels that cause blood vessels to become clogged resulting in a stroke. In the last issue of Healthvoice, we discussed how you can go about getting the nutrients you need from the foods that you buy. In this issue we look at how you should combine these foods in your diet, in order to get the most out of your meals. Some of these eating suggestions are adapted from schedules provided by the Research Institute for Nutritional Diseases of the Medical Research Council: SUGGESTED DAILY ALLOWANCES PER PERSON G Two big cups of low-fat or skim milk or one cup whole milk (eg, Buttermilk or low fat yoghurt). G One egg (don’t exceed 3-5 a week). G Two slices sweetmilk, cheddar cheese or one tablespoon cottage cheese. G An average portion (170gsm/the size of your palm) lean meat (beef, lamb, chicken, lean pork or fish). G 2-4 potatoes boiled or baked in jackets. G 2-4 portions of green vegetables and tomatoes, one or more eaten raw. G One portion of root vegetables (turnips, beetroots, carrots, pumpkin, butternut or squash) G Two portions fruit of choice. G 2-3 slices of wholewheat (may be toasted) or rye bread or substitute (see box: Bread substitutes). G Two tablespoons sunflower, maize, canola or olive oil for preparation of foods like fish, eggs, meat or salad dressing.

IMPORTANT: Your Fund pays 100% of BHF rates for most treatments and procedures, so ensure that your doctor or dentist charges BHF rates. If he or she charges private rates, you will be responsible for the difference.

The three R’s of good health
Of course, another way to save money is to stay healthy. So, don’t forget the importance of the three R’s: 1. Reasonable exercise; 2. Right eating habits; and 3. Relaxation. See the article opposite for some suggestions on the type of meals or foods that we should be eating for good health.

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One tablespoon butter or unsaturated margarine spreads. PLUS: + honey, used sparingly (rather in evening). + garlic and all herbs can be used freely. + salt and pepper sparingly to taste. + Two glasses of dry wine or one low calorie can of beer, weekly. FOODS TO BE AVOIDED OR TAKEN OCCASIONALLY G Fried food unless daily ration of oil is used. G Fatty meats (sausage, polony, bacon) or beef marrow, thickened gravy or soup. G Crumbed foods and foods in a batter (eg, fish and chicken bought at fast food outlets). G Brain, kidney and liver. G Cream, ice-cream or puddings (unless fat-free). G Wholemilk, unless from ration. G Sweets, preserves/jam and sugars (white or brown). G Canned fruits (unless in own juice). G Cakes, pies, pastries and cookies. G Nuts, except almonds. G Cold drinks: ginger beer, colas, lemonade (diet drinks are allowed). G Chocolate and chocolate beverages. G Filter or instant coffee in excess (more than three cups a day). A MEAL PLAN Breakfast (7-8 am) ALWAYS 1-2 portions of fruit (eg, grapefruit, apple or banana) OR one small glass of orange or unsweetened carton juices. PLUS: G One egg boiled or poached, or fried kipper or haddock (use two teaspoons oil for preparation) OR G One cup cooked coarse maize, masela or oats porridge with 50ml milk from your daily ration. OR G Four tablespoons of All Bran with raisins and milk. PLUS: G One slice (10mm thick) wholewheat or brown bread (toasted) with spread from ration and one teaspoon honey if desired. PLUS: Tea or coffee with milk from ration. Snack (10-11 am) G Two tablespoons of raisins. OR G Two wholewheat biscuits (eg. Provitas) and 2 tablespoons of low fat cheese.
G

VEGETABLE LIST
Group A: Eat as many from this group as you wish: Asparagus G Broccoli G Brussel sprouts G Cabbage G Cauliflower G Celery G Cucumber G Egg fruit G Gem squash G Green beans G Lettuce G Marrow G Mushrooms G Parsley G Radishes G Rhubarb G Spinach G Spring onion
G

Sweet green peppers G Sweet red peppers G Tomatoes G Watercress

Group B: Eat in moderation: Beetroot G Butternut G Carrots G Green peas G Hubbard squash G Leeks G Onions G Pumpkin G Turnips G Tomato juice

BREAD SUBSTITUTES
G G G G G G G

120g (125ml, half a cup) mashed potato One potato, 90g or 60x50mm 60g (125ml) cooked rice 70g (125ml) sweetcorn One green mielie, 125x45mm (130g) 20g crackers (two or more, depending on type) One and a half portions fruit

G G G G G G G

110g (125ml) wholemeal porridge 20g ready-to-eat cereal (200ml or more, depending on type) 60g (60ml) sweet potato 70g (125ml) Lima beans (frozen/cooked) 70g (125ml) dried beans (cooked) 70g (125ml) dried peas (cooked) 100g (150ml) parsnips

Lunch (12-1 pm) G Bread roll or toasted sandwich (wholegrain) G Thin soup with noodles. OR G Pasta salad/savoury rice with oil-free tuna or sardines. OR G Mixed bean salad/baked beans. ADD: a slice of cheese, meat or sardines. OR G A small tub or yoghurt. ADD: salad vegetables like small cherry tomatoes, cucumber, grated cabbage, carrot and herb salad, sprouts. G One item of fruit. Snack (3-4 pm) G Portion of fruit or juice. Dinner (7 pm) G A portion (90gm) lean meat (beef/chicken/pork grilled or casseroled with onion/garlic and potato) or grilled or steamed

fish. Gravy must be unthickened and fat-free. OR G A grilled lamb chop (fat removed) and stuffed tomato. PLUS G Two to three potatoes cooked in jackets or mashed; or as salad with one tablespoon mayonnaise. PLUS G Tossed salad with lettuce, celery, peppers, cucumber and beansprouts. Gem squash and spinach with a teaspoon of oil (or alternatives: see box: Vegetable list). Bedtime G One tablespoon raisins and one cup milk from ration, or dried fruit ± three portions.

DENIS takes the menace out of dental claims

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SP/Sizwe Medical Fund considers the dental health of its members to be an important aspect of their overall well-being. In order to take the pain out of dental claims, the Fund has therefore joined forces with a dental claims management system known as DENIS (Dental Information Systems), which has successfully been protecting and managing your dental benefits. By using clinically intelligent software (designed by South African dentists), the system is able to keep track of your family’s dental history and assist MSP/Sizwe’s advisors in evaluating clinical data. In effect, it evaluates the treatment information on each claim and picks up irregularities or possible mistakes, which lead to increased costs, and ultimately to increases in your contributions. DENIS keeps an eye on any dental bills being sent through to MSP/Sizwe (to ensure that none of these claims are fraudulent) and will also be able to track members who do not go for their annual check-up.

YOUR DENTAL HEALTH The dental profession has long been telling its patients that to minimise the risk of tooth decay and gum disease, proper oral hygiene and annual visits to the dentist are essential. MSP/Sizwe supports this view and encourages all its members with access to our website (www.mspsizwe.co.za) to link to the dental treatment information page (or go directly to www.dentaltreatmentinformation.com). Here members can submit any dental-related questions to an independent dental advisor, who will be able to give them advice on almost any dental query they may have. PUTTING THE LID ON BOTTLE MOUTH – BY DR GARETH HAYTON A common problem that is emerging these days, is that there is an increase in the number of children and babies suffering from tooth decay. This phenomenon is often attributed to a condition called “Bottle Feeding Syndrome” or “Bottle Mouth”. Babies often fall asleep when drinking their bottles and this means that the bottle liquid is pooling in their mouths because they

For more information visit www.dentaltreatmentinformation.com

are not swallowing as quickly as they would when they are awake. If their drink contains sugar, tooth decay will begin to set in. Sugar is essential for the growth of plaque (germs), and the more sugar they have, the more tooth decay will occur. Tooth decay leads to abscesses and this means pain for your child and sleepless nights for you. This decay can be treated but it means that your child will have to go to hospital and as a parent, you would clearly want to avoid such a drastic step. To avoid bottle mouth, take the following precautions: G Do not add sugar to the bottle drink. G Do not use fruit juice or fizzy drinks in the bottle – they are very acidic. G Try not to let the baby lie for hours with the bottle in his/her mouth. G Do not dip the dummy in syrup – this is a recipe for disaster. G Make sure you brush your baby’s teeth twice a day from the moment that first tooth appears in the mouth.

Our latest Project Reward winners are ...
The Project Reward Incentive programme continues to reward members for good health management. Winners who submitted low claims during February and March are: G FEBRUARY: Magdalena Botha, a direct paying member and Paulus Tshabalala, of Haggi Rand in the East Rand. G MARCH: Lillian Nomthelo, of Sun Courier in Centurion and Mr K.L. Burgess of Nestlé in East London. A hundred other low claimers won a free Lotto ticket each.

WE HAVE MOVED!
A number of our branches, including our head office in Johannesburg, have moved recently. Here are the new address details: JOHANNESBURG (HEAD OFFICE): Street address: Fourth Floor 56 Von Wielligh Street Cnr Market and Von Wielligh streets Jhb 2001 Postal address (for claims): PO Box 260709 Doornfontein, 2028 Fax: (011) 353-0317 WITBANK: Street address: Sixth Floor, Gensec Building Sanlam Centre, Arras Street, 1035 CAPE TOWN: Street address: 22nd Floor, Golden Acre Adderley Street, Cape Town, 8000 Note: Unless included above, no other changes have been made to address or contact details.

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