The Government Employees Medical Scheme (GEMS) revealed a funding shortfall this week of roughly R2bn after healthcare claims outpaced member contributions in 2025, adding to existing pressure from disgruntled unions who are fiercely rejecting proposed premium increases, reports The Mercury.
Last year, the scheme paid out more than R67bn in claims, but received only R65bn in contributions, with GEMS board of trustees chairperson Dr Nomzamo Tutu saying this reflects broader pressures in the healthcare sector, where inflation is rising significantly faster than consumer inflation.
“GEMS has consciously leveraged its robust financial reserves for the past several years, generating more than R10bn in direct savings for members – thus shielding them from the full impact of healthcare inflation,” she said.
The shortfall admission comes amid protests by labour unions over the medical aid’s contribution hike for 2026, originally pegged at 9.8% but subsequently cut to 9.5% after backlash.
However, this increase has also been rejected by unions, which have called it unjustifiable and threatened to protest.
The scheme confirmed it had reviewed a memorandum of demands submitted by organised labour in February and has committed to further engagement. It has also acknowledged the financial strain facing public servants and affirmed the right of members to protest within the legal framework.
Urgent bilateral talks with union representatives have been proposed for the final week of March to seek mutually workable solutions.
In response to member concerns, GEMS has also opened a special option selection window for those on the Tanzanite One plan. Until 9 April, members on this option, designed for employees in salary levels 1 to 5, may switch to alternative benefit options.
GEMS has highlighted its governance track record, noting 18 consecutive unqualified audits since inception and a zero-tolerance stance on fraud and corruption. Non-healthcare expenditure remains low at 5.2%, among the lowest in the industry.
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