Taking the first steps to a successful new universal healthcare dispensation

    GEMS Principal Officer talks NHI ahead of annual Symposium

    Friday, 6 October 2017 The implementation of universal healthcare, through National Health Insurance (NHI), is one of the most important priorities facing South Africa over the next decade and it is critical that a detailed roadmap is developed to support its successful implementation.

    This is the view of Dr Gunvant Goolab, Principal Officer of the Government Employees Medical Scheme (GEMS), who was speaking ahead of the tenth annual GEMS Symposium, which is this year being held under the theme “The first steps towards universal health coverage”, and takes place from 12-13 October 2017 at the Cape Town International Convention Centre.

    “There are a number of aspects that need to be discussed as we enter these vital initial phases of the implementation of the NHI. One of the key questions that needs to be considered is how we as a country optimise our finite healthcare resources and this will be a focus of this year’s Symposium,” observed Dr Goolab.

    “It is critical that we consider all experiences both local and international to ensure that the new health system South Africa is able to reduce or eliminate wasteful practices. Cost-containment and the application of managed care within the NHI framework will become increasingly important as we go forward in our efforts to provide all South Africans with access to quality healthcare.”

    More than 200 leaders and stakeholders from across the healthcare sector, including from government departments and academia, as well as health professionals and policymakers, are expected to attend the Symposium in Cape Town to discuss the first steps for the implementation of National Health Insurance in South Africa.

    Dr Goolab said that since its inception GEMS had worked hard alongside its extensive healthcare practitioner and provider networks and other stakeholders to develop solutions that are sustainable while at the same time providing meaningful benefits to its members.

    As GEMS has from the outset focused on providing members with access to quality healthcare that is affordable and administratively efficient, Dr Goolab says that its mandate is closely aligned to the objectives of the NHI.

    “GEMS continues to make significant inroads through providing medical cover to first-time medical aid members. In addition, GEMS membership comprises members from a wide range of income bands, including members from an entry-level salary bracket to members in the middle to high-end salary brackets.

    “As such GEMS’ membership is reflective of the demographic and socio-economic profile of the country. It also has the broadest definition of a beneficiary, which allows for more inclusive cover with the extended family structure, not found in a typical medical scheme.

    “The GEMS Sapphire Option could be considered as a reference product to achieve alignment to the NHI basic benefit package. In addition, GEMS has long recognised that primary healthcare is central to achieving better patient health outcomes, where members who return to the same doctor each time frequently enjoy better health.

    “Looking back on the essence of our existence as a Scheme and the journey thus far, we are proud that we have contributed to transformation in the healthcare sector. Going forward we will continue to secure the best possible value