Low wage public servants are screening for cancer at significantly lower rates than better-paid colleagues despite being provided with equal cover for these benefits, data from the Government Employees Medical Scheme (GEMS) shows. A similar trend is seen in the take-up of tests for diabetes.
The findings highlight the extent to which the circumstances in which people live affects their health seeking behaviour and access to services, said GEMS chief research officer Selaelo Mametja. GEMS is the biggest medical scheme for civil servants, and had more than 2.1-million beneficiaries at the end of 2022.
State employees on salary levels one to five are eligible for generous state subsidies that enable them to join GEMS’ Tanzanite One option for R115 per family per month. Tanzanite One beneficiaries include cleaners, gardeners and administrative staff, many of whom live in rural areas, said Mametja. She presented the data at a symposium hosted by GEMS on Thursday.
“We know breast cancer screening units are not available in our townships and rural areas, so access is a determinant of health. But low incomes are also associated with low education levels and low health literacy,” she said, suggesting healthcare professionals and medical schemes could do more to raise awareness of the importance of preventative healthcare measures such as cancer screening.
Public servants on salary level five are paid on average R283,000 a year.
Medical schemes are obliged by the Medical Schemes Act to fully cover screening tests for certain cancers, including of the breast, cervix, colon and prostate cancers. These tests are routinely used for early detection of cancers that are generally asymptomatic in their early stages. Early detection improves not only prognosis but lowers the cost of treatment, an important consideration for medical schemes.
Members of Tanzanite One had lower utilisation rates for mammograms, pap smears and PSA tests than those who belong to other options. These tests are used to screen for cancer of the breast, cervix and prostate respectively. Tanzanite One was also associated with 9%-13% lower utilisation of HBA1C blood tests, which measure blood sugar levels, compared with its Emerald and Onyx options, said Mametja.
Over half of SA’s labour force lived in poverty and many of these people were GEMS beneficiaries, said Public Service Co-ordinating Bargaining Council general secretary Frikkie de Bruin. “They are overindebted and have very large responsibilities caring for family members, which takes them below the poverty line. These adverse conditions make the social determinants of health even more important (to them),” he told symposium delegates.
kahnt@businesslive.co.za
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