Growing state scheme

Gems has grown its membership from 0 to 100 000 in just 14 months by giving government employees incentives to join the scheme.
 
As of July last year, the government has been paying 75 percent of the contributions, to a maximum of R1 900 a month, for employees earning more than R60 000 a year who join Gems. Employees earning less than R60 000 can receive a 100 percent subsidy if they join Gems's lowest-cost option.
 
The government is paying only two-thirds of the contributions up to a maximum of R1 014 a month in 2006 for employees who remain on their existing medical schemes.
 
The government has chosen to offer incentives rather than force its existing employees to join Gems, but new government employees can access the government subsidy only if they join Gems. As a result of this, more than 800 members are signing up every day.
 
Dr Eugene Watson, the principal officer of the medical scheme, says the process to elect Gems's first board of trustees has begun. In line with the Medical Schemes Act, members will elect 50 percent of the trustees on the board of trustees, at an annual general meeting that will be held later this year. 
 
Gems is currently governed by Watson and an interim board of trustees (also known as the steering committee) of 11 government employees who were appointed by Geraldine Fraser-Moleketi, the Minister of Public Service and Administration.
 
These trustees will remain on the board as the employer-elected trustees, and the members will elect a further 11 trustees.
 
"Providing more South Africans with quality, yet affordable, healthcare is still a challenge for both Gems and the entire healthcare industry. The sector needs to attract new lives, increasing both the size of the risk pool, as well as the inherent clinical risk profile," Watson says.
 
"Enlarging the risk pool will also increase the total revenue generated, which, in turn, will create additional opportunities for all service providers. This will then create business and employment opportunities," he says.
 
When Gems launched late in 2005 existing medical schemes had about 550 000 government employee members and as many as 488 000 of these members (according to membership data for 2005 from Global Credit Ratings) were in open schemes (those that admit anyone and are not restricted to employer groups). Government employees then made up more than 26 percent of the membership of open schemes.