Government employees medical aid has become unaffordable, claims PSA

Union says many workers are contemplating cancelling their Gems membership

The Public Servants Association (PSA) says it has been inundated with calls from union members after the Government Employees Medical Scheme (Gems) membership subscription increased by 13.4% for 2025. 

The union said in a recent Public Service Co-ordinating Bargaining Council (PSCBC) meeting with Gems, the PSA and other unions rejected the proposed increase, which Gems is now unilaterally implementing.

“This major increase will cause a salary decrease for many public servants, making medical aid unaffordable. Owing to conflicting needs, scores of members are contemplating cancelling their Gems membership,” the union said. 

The PSA said when unions concluded a collective agreement that established Gems nearly 20 years ago, the founding principles of providing affordable medical cover and ensuring cost-effective medical cover for members over the long term, were agreed upon.

“Parties endeavoured to promote the enrolment of employees to Gems. The Gems subsidy was thus higher than for other medical aid schemes to persuade employees to opt for Gems membership.” 

The union alleged this protection and preference of Gems over other medical aid schemes, however, allowed Gems to take advantage of its monopoly and use the opportunity to exploit members. In response, Gems said there was no truth to this allegation.

“Gems membership has become unaffordable. Many members are contemplating cancelling membership to allow them to cope with increasing cost-of-living expenses, which will expose them to risks associated with not belonging to a medical aid scheme,” the PSA said.

The union said it never envisaged a situation where employees would have to choose between buying food for their families and paying for medical aid.

It said it would continue efforts to secure affordable medical aid for public servants.

Gems principal officer Dr Stanley Moloabi said the contribution increase had been carefully determined based on anticipated healthcare funding needs of Gems beneficiaries for 2025.

“The Gems subsidy is in accordance with the agreement entered into between employer and majority of unions at the PSCBC as expressed in PSCBC Resolution 1 of 2006.” 

He said the average increase per member was dependent on several factors such as the number of beneficiaries they were paying for, the salary band they were on, the cover option they chose and the subsidy. 

Moloabi said the actual increase might vary slightly and was influenced by these factors.

“It is for this reason that the 2025 contribution was communicated to members individually as there may be slight variations.” 

Moloabi said the contribution increase, among others, accounted for inflation, increased utilisation — usually due to ageing and increased burden of disease but could be due to other factors like fraud, waste and abuse — benefit enhancements, increased healthcare costs and some allowance to maintain reserves. 

He said the increase was determined with the help of scheme actuaries to ensure that the envisaged healthcare costs of scheme beneficiaries for the next year are covered.

“Failure to make adequate provision can lead to the regulator intervening,” Moloabi said.

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