‘Joining late': exploring the impact of the Late Joiner Penalty (LJP) imposed by South African medical aid schemes

This study explores how black women in paid employment experience the Late Joiner Penalty (LJP) that has been imposed on them by the Medical Schemes Act of 1998. Using various theories of citizenship, this research explores ways in which women are still excluded from obtaining full citizenship rights. The researcher applied a qualitative approach and conducted one-on-one in-depth interviews to generate meaningful data. The findings of the study reveal that women experience work precarity in various forms, which has been heightened by the COVID-19 pandemic. Women are subject to periods of “waithood” with delays that may impact their economic stability and growth. In addition, strong themes of control exerted by medical aids, healthcare practitioners and male partners reinforce the ways in which women are denied full access to citizenship. Furthermore, medical aid is gendered and forces women to organise their productive lives around their reproductive obligations. The LJP revealed no risk for the scheme but appears only to endeavour to exploit those who have been historically marginalised. Moreover, the lack of knowledge of the LJP, the finer details and the long-term implications of joining a medical aid scheme for poorer working-class families are problematic and consistent with current hegemonic practices that reward citizens for fitting into the ideal mould. These findings were then discussed within the theoretical framework of citizenship using Barchiesi's (2007) Theory of Social Citizenship and Brown's (2016) Theory of Sacrificial Citizenship as analytical tools. The research demonstrates that neoliberal policies and legislation punish the poor through a form of poverty tax (LJP) and decrease the ability to generate financial and health security through medical aid scheme subscription. Additionally, the LJP undermines the constitutional promise of equal citizenship by effectively discriminating against citizens on the basis of age, gender and historical disadvantage.

Grantor

Department of Sociology

Year dc:date.issued

2021

Author dc:creator

• Moodaley, Natasha

Advisor dc:contributor.advisor

• Paremoer, Lauren

• sociology

Handle dc:identifier.uri

http://hdl.handle.net/11427/35913

OAI identifier oai:identifier

oai:open.uct.ac.za:11427/35913