As salaries stagnate and the cost of living rises, South Africans are starting to question why mandatory medical aid is a condition of employment. The cost of Mandatory Medical AidIn 2008, the average age of a policyholder was 32; today it’s 38. This argument, alongside disputes that the National Health Insurance prevents voluntary association, has put a spotlight on mandatory medical aid policies. Should employers no longer require mandatory medical aid membership, membership could decline rapidly, placing South Africa’s ageing population at risk. Some medical aid members can’t afford comprehensive cover and still pay out of pocket for hospital care and other healthcare needs.