Introduction

Did you know that only 1 in 10 people in need have access to medical appliance across the globe (WHO, 2018)?

In South Africa, one of the major barriers to accessing medical appliances is medical funding and excessive cost of private health care. With, South African medical aid members reported to be paying 55% more out of own pockets than 5 years ago (Business Insider 2020)? Of that, Allied Health Care Services contributing the second largest, at 14%, behind dispensed medicine at 33% (Business Insider 2022).

The significant increase in out-of-pocket has left medical aid members disgruntled and unsatisfied.

Questioning whether medical aid schemes are offering enough medical funding to begin with. Suggesting that an increase in medical funding would reduce exhaustion of medical benefits and out-of-pocket payment. However, this article argues that no amount of medical funding would be sufficient for a leaky business model.

To support this position, the article will present 3 top linear economy signs of leaking medical appliance benefits to waste.

Through a concept of oversupply. Oversupply is when the supply exceeds the demand. In the medical appliance context, oversupply is when the supply of a medical appliance exceeds the recovery period. Below is the number 1 sign of medical appliance oversupply that exhaust limited medical aid benefits.benefits.

 

Linear Economy Sign #1: Underutilization of medical appliance

The first sign of medical appliance oversupply is the underutilization of medical appliances.

According to Collins’ dictionary, underutilization refers to a condition when not used as much as it could or should be. The concept of underutilization in the medical appliances industry is a consequence of the adopted linear economy business model. That advocates for a single use and discard of medical appliance to waste.

However, underutilization is at its peak among precautionary and temporary medical appliances.

 

a. Precautionary Medical Appliances

Precautionary medical appliances refer to supportive braces prescribed as a safety precaution when doctors are suspecting a potential injury in an emergency care unit.

In addition, Doctors also administer precautionary medical appliances when referring a patient to an orthopaedic specialist for comprehensive care. Although the motive behind precautionary medical appliances is clinically sound. They have become the most underutilised, expensive, and wasted medical appliances.

For example, on average, the patient may use the medical appliance for an hour (s) while waiting for medical examination.

Alternatively, a patient could also use it for a day (s) when a patient is precautionary treated and referred to an orthopaedic specialist. Overall, patients hardly use precautionary medical devices for more than a week. However, the device will cost a full medical aid rate for that device, yet use it once and discard it to waste.

I have a device at home that I used for a day, and it is still in an excellent condition. Reported a patient during our medical appliance buyback program.

 

b. Temporary Medical Appliances

Temporary medical appliances refer to supportive braces prescribed to immobilise physical impairment under emergency care.

Although the treating motive behind temporary medical appliances is clinically sound. They are second most underutilised, expensive, and wasted medical appliances. These temporary medical appliances comes in two categories namely mobility aid (s) and Orthotic supportive braces.

i. Mobility Aid and Wheelchairs

Mobility aids are one of the topmost prescribed medical appliances during emergency care .

Their purpose is to offload weight from the affected body part while promoting mobility at the same time. Although the treating motive behind mobility aids is clinically and functionally sound. They are one of the topmost underutilised devices.

On average, a temporarily impaired patient may use at least two different mobility aids until recovery.

For example, a critically injured patient would begin with a wheelchair for mobility. However, with multi-disciplinary care, the patient may improve and upgrade to the next mobility aid in a walker within day (s) or week (s). The patient can improve further and upgrade to another mobility aid in elbow crutches before discharge from hospital.

Unfortunately, with the linear economy business model, the patient ought to buy every walking aid they use.

Regardless of whether they will use it for a day (s) or week (s) before they upgrade. As a result, patients have a potential to go home with at least 2 mobility aids that they may not need in due course. I have 3 devices at home that I don’t know what to do with them, reported one patient during our device buyback program.

 

ii. Orthotic supportive braces

Orthotic supportive braces are among the most prescribed medical appliances for temporarily impaired patients during emergency care.

Their purpose is to immobilise and support the injured body part to promote healing. Although the treating motive behind supportive braces is clinically sound. They are also one of the underutilized, expensive, and wasted devices. For example, a temporary impaired patient with an ankle fracture may need a moon boot appliance for at least 6-8 weeks.

However, with the linear economy business model, the patients ought to buy to own the moon boot at full medical aid rate, yet discard it to waste after single use.

 

 

Linear Economy Sign #2: In house collection of medical appliances

The second sign of medical appliance oversupply is the accumulation of medical appliances at home.

Qualitatively, patients realise that precautionary and temporary medical appliances have a massive untapped capacity left post recovery. Whereas quantitatively, a patient might go home with at least 2 medical appliances or 4 medical appliances at most. As a result, patients are accumulating medical appliances home post discharge from hospital or post recovery.

I have 3 other devices at home, that I don’t know what to do with them, reported one patient during our medical appliance buyback program.

 

 

Linear Economy Sign #3: Second-hand medical appliance market

The third sign of medical appliance oversupply is the open second hand market of medical appliances.

Having households with medical appliances that are in good condition has created an opportunity for patients to sell or either donate their second hand medical appliances. Patients sell devices directly to each other via non-traditional medical sourcing channels in social media, gumtree, and second-hand stores. In our circular economy buyback program, about 40 patients returned their medical appliances for financial gains. Whereas twenty returned them for charity purpose.

 

Conclusion

The purpose of this article was to argue that increasing medical funding only would not resolve the premature exhaustion of medical appliance benefits and the subsequent out-of-pocket payments.

Arguing that medical funding only cannot fix a leaky business model, at least not in the medical appliance industry. To support this argument, the article has outlined 3 signs of oversupply leaking limited medical aid benefits to waste.

The first sign is the significant amount of medical appliance underutilisation. Associated with a linear economy business model that advocates for a single use and discard of medical appliances. The subsequent second sign is the conscious collection and keeping of underutilised medical appliances at home by the patients. The last subsequent sign is the open market of unregulated second-hand medical appliances.

We can therefore conclude that our medical industry business model does not align with the responsible production and consumption recommended by Sustainable Development Goal 12. Seeking to transition businesses towards sustainable practices that prevent development of waste output to the environment. Therefore, sealing the holes in our business model seems to be the obvious first step before increasing funding.