20 April 2026
South Africa’s healthcare financing system is unsustainable, too expensive, and failing workers. This is no longer a matter of contestation. At the recent Section 77 hearing at NEDLAC, the Minister of Health Aaron Motsoaledi confirmed that the current model is inappropriate and cannot be sustained, while affirming that escalating medical aid costs constitute a matter of clear social and economic importance.
For COSATU and FEDUSA, this confirmation reinforces a shared position across organised labour. Workers are facing relentless increases in medical aid contributions, including the recent 9.5% adjustment by GEMS, at a time when wages remain under
pressure and the broader cost of living continues to rise. What was once considered a basic layer of social protection is increasingly becoming unaffordable and a luxury for many working households.
The crisis, however, extends beyond any single medical scheme. The Minister has made it clear that the problem lies within the broader structure of healthcare financing in South Africa. Despite significant national expenditure on health, the system
continues to produce unequal outcomes, with a disproportionate share of resources benefiting a minority while the majority face constrained access and rising costs.
Importantly, the main drivers of escalating healthcare costs are located within the private healthcare sector, particularly in the pricing practices of private hospitals and specialists. Medical schemes, including GEMS, are responding to these pressures by
increasing premiums to remain viable, with the burden ultimately unfairly and unnecessarily falling on workers.
This is the core injustice confronting the working class. They are being asked to carry the cost of a system that is structurally flawed and increasingly detached from affordability and reality.
COSATU and FEDUSA therefore reiterate that this campaign is not limited to one scheme, GEMS. It reflects a broader struggle to address the rising cost of healthcare in South Africa and to confront the systemic failures that continue to undermine
access, equity, and sustainability.
At the same time, GEMS, as a scheme established to serve public servants, must take seriously the impact of its decisions on members and must actively engage in efforts to contain costs, reverse the 9.5% increase and protect beneficiaries within the
constraints of the current system.
COSATU and FEDUSA will continue to advance this joint campaign through all available platforms, including Section 77 processes currently underway at NEDLAC, ongoing engagements within the PSCBC, coordinated mass action, strategic litigation, political interventions and sustained public advocacy. These interventions reflect the growing consensus across organised labour and the broader public that escalating healthcare costs require urgent national intervention and cannot be left to market forces alone.
Government must now move beyond acknowledgement toward decisive action. Regulatory intervention to address the pricing of private healthcare providers must be accelerated, alongside broader reforms to ensure that healthcare in South Africa is affordable, accessible, and equitable.
Workers cannot be expected to carry this burden indefinitely.
For media enquiries:
Zanele Sabela (COSATU Spokesperson)
079 287 5788 / 077 600 6639
zaneles@cosatu.org.za
Betty Moleya (FEDUSA Media)
063 736 5533
communications@fedusa.org.za
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