ASK THE
DOCT R
Have a question for the doctor? Email us at magazine @ afrocentricds. com and your question could feature in the next issue of B-Living.
Hi Dr
Could you please provide more information on bipolar depression together with the latest developments and treatment?
S. Soodeyal
Dear Mr Soodeyal
According to the South African Anxiety and Depression Group, bipolar disorder affects approximately 4 million South Africans. Depression is usually the predominant phase in bipolar disorder and the management and treatment thereof continue to pose significant challenges for clinicians. Today, mood stabilising drugs are a mainstay treatment for bipolar disorder. Doctors may prescribe an anti-manic drug, anti-psychotic drug or a combination of both in order to alleviate symptoms of depression without triggering a manic episode.
For many years, psychiatrists have traditionally added an antidepressant to a mood stabiliser if a mood stabiliser alone seemed ineffective; however, research shows that antidepressants are often not effective for bipolar depression. Mood-stabilising medication works on improving social interactions, mood and behaviour and is recommended for both treatment and prevention of bipolar mood states that swing from the lows of depression to the highs of hypomania or mania. In some patients with bipolar disorder, a mood stabiliser may be all that’ s needed to modulate the depressed mood. However, in bipolar patients who do not respond to one mood stabiliser, another mood stabiliser or an atypical antipsychotic is sometimes added to the treatment regimen. Because each case of bipolar depression is patient-specific, the best course of action is to consult closely with your doctor to ensure that the treatment prescribed will meet your individual needs.
Good morning Doctor
At the end of 2016, I was advised that Bonitas members will have to pay a 30 % co-payment at certain hospitals. I’ m on BonSave which doesn’ t have a hospital network so I’ m a bit confused as to how this works.
William Dear William
We negotiate rates with hospitals to ensure our members benefits stretch as far as possible to prevent out-of-pocket expenses. Last year we negotiated with the three largest hospital groups in South Africa with a view to creating a network of designated service providers to ensure the lowest possible increases, to keep costs down while maintaining the sustainability of the Scheme.
The negotiation process included agreeing on the tariffs charged for all hospital services used by members, as well as assessing the quality of service. Bonitas used its increased size, due to the amalgamation with LMS, to its advantage and was able to negotiate more favourable hospital tariffs for the 2017 benefit year and beyond.
However, we were unable to strike a favourable deal across all of Life Healthcare’ s facilities. For this reason we excluded 14 Life Hospitals from being DSPs. This meant that members could go to other network hospitals in their area or pay a 30 % co-payment if admitted to one of the 14 excluded Life Hospitals.
Please note: Life has since waived the co-payment and it will no longer apply.
Disclaimer: The advice included above is for information purposes only. It is not intended to replace the advice of a doctor or medical practitioner. We strongly urge you to consult with your family practitioner before embarking on any health treatment or programme. All information has been checked by Bonitas Clinical advisor.
Page 87 Bonitas Member B-Living Magazine Issue 20161, Issue 20173