The Educators Union of South Africa (Eusa) was the first to raise concerns about discrepancies with the scheme, and now the union’s call has been strengthened by the involvement of the National Healthcare Professionals Association (NHCPA) and the South African Private Ambulance & Emergency Services Association (Sapaesa).
The bone of contention is that medical aid claims are not being paid timeously, and members’ funds are exhausted within two months, without explanation.
On Thursday Eusa members held a national picket outside Gems offices and, following this, private doctors and ambulance services joined the action.
Eusa president Scelo Bhengu said they wanted government employees to be allowed their constitutional right to choose which medical aid they wished to belong to.
Bhengu said when they met Gems officials during the picketing, they were told that the scheme was not immune to problems experienced by private schemes.
Bhengu said they had tabled a number of concerns ranging from exclusion by doctors who were experiencing payment issues with the scheme, to members’ funds “disappearing” and being exhausted within two months.
In the six-hour meeting with Gems principals, the union demanded answers regarding delays in the payment of service providers and shortfalls, with some members forced to pay a portion of their medical bills.
The Daily News recently spoke to doctors who were refusing to see patients on Gems because of the problems they experienced with the scheme.
Some doctors said they asked Gems members to pay cash upfront.
Oliver Wright, Sapaesa chief executive, said the association supported Eusa’s move.
“Gems is extremely disorganised in paying claims. This has put many small and emerging businesses in the private sector out of business due to unpaid claims which dated back four years. Basically, Gems is not fit to provide the service and to assist in this problem,” he said.
Gems remained mum about what issues were tabled by the union.
Dr Guni Goolab, the scheme’s principal officer, could only confirm that the union had raised member-related concerns within the ambit of the services provided by the scheme.
Dr Donald Gumede, NHCPA chairperson, said they had taken all medical aids to court for unpaid bills. He said Gems was the worst of them all.
“Why have medical aid if it cannot fulfil its obligation? Medical aids are abusing their powers.
“We support efforts to take Gems to task,” Gumede said.