Botswana has a population that is slightly over two (2) million with about 17% covered by private health insurance. 80% of patients on private health insurance are covered by the major three provider companies. Botswana is challenged by a double-disease burden state of Human-Immunidodeficiency Virus (HIV)/Acquired Immunodeficiency Syndrome (AIDS) and other infectious diseases as well as non-communicable diseases. This has affected health insurance leading to managed care more especially provider reimbursement type of discounted fee-for service through preferred provider organisations (PPOs) to control healthcare expenditure. Q P - A S M - 0 0 1 | R e v 0 0 6 E f f D a t e : 1 8 - 0 3 - 2 0 2 1 Page 3 of 3

(a) Discuss five (5) factors that are responsible for increased healthcare costs in Botswana. [10]

(b) Discuss ways of controlling healthcare costs. [10]

(c) If the Schedule of Benefits for a policy option stipulates a deductible of R500.00/person and a premium of R500.00/month. If a person covered under this option goes for a treatment that cost R3000.00, explain how this amount will be paid if the person has not yet met his/her deductible. State any assumptions you make, and also use amounts (figures) where possible. [5]