gems_logo_original

Towards universal cover, GEMS is working hard to broaden healthcare access

South Africa is making great strides towards the realisation of universal access to healthcare, with preparations for the introduction of National Health Insurance (NHI) well underway. The progress that Government Employees Medical Scheme (GEMS) has made, and continues to make, in broadening access to healthcare surely ranks among the significant milestones achieved in the journey towards this goal.

“In the decade since its inception, GEMS has opened the doors of healthcare provision to a great segment of society who had never before enjoyed access. With more than 684 266 principal members and 1.803 million beneficiariesunder our care, we continually aim to extend meaningful and proactive health benefits to members of the public service and their families,” says Dr GuniGoolab, Principal Officer of GEMS.
While GEMS is a restricted medical scheme, the Council for Medical Schemes has repeatedly acknowledged the Scheme’s contribution to widening the proportion of South Africans who have healthcare cover.

“The health subsidy Government provides for its employees has helped significantly to grow healthcare access in the country, helping us to boost the productivity of members of the public service, which in turn benefits South Africa’s overall development,” Dr Goolab observes.

According to GEMS Executive LiziweNkonyana, the Scheme will be concluding its current three-year strategic plan cycle at the end of the year, and is now evaluating the impact it has had on the South African healthcare environment.

“We are looking to build on our experiences, the service partnerships we have developed, and the understanding we have attained towards making quality medical care more affordable, in order to stretch healthcare rands while providing the best possible benefits,” she explains.

“GEMS accounts for approximately 10% of healthcare expenditure in the country, with roughly R1 in every R5 spent on private healthcare being spent by GEMS. We are constantly looking to refine our approach to healthcare funding to ensure that are on track with supporting the nationalgoal of providing universal, quality healthcare to all South Africans.”

Dr Goolabobserves that GEMS’s experience, as a leading player in the healthcare funding industry, has achieved tighter management of non-healthcare expenditure, while providing access to medical and wellness services on a massive scale across the country.

“Our rigorous tender process and agreements with best-of-breed service providers have established the appropriate infrastructure and skills to help realise the goals of universal cover. We are extremely supportive of Government’s efforts towards establishing access to quality healthcare for all, and recognise that we have a role to play in its realisation.

“In the interests of our members and the country as a whole, the Scheme views its work in improving efficiency and service to members as a matter of national importance, with profound implications for achieving other goals in the broader development agenda,” Dr Goolab concluded.