Keith Jeremiah Govender was stabbed during a game of thunee.
Image: Supplied
TWO stories recently crossed my desk that carried a sobering weight. Distressed North Coast sugar cane farmers are warning that this season’s crop could go unmilled – livelihoods under severe pressure, financial margins stretched to breaking point, and luxuries such as adequate health care cover simply out of reach.
Then there is the deeply troubling story of Keith Govender, a 22-year-old Westcliff man who was stabbed in the head during what began as a friendly game of thunee at a Silverglen pool hall. Govender underwent emergency brain surgery and remained in ICU on a ventilator for some time, his family navigating a medical bill that has climbed to approximately R300 000.
Two very different lives, one painful shared truth: when a health crisis arrives without warning, the absence of proper cover strips away choice at the most devastating moment. The Govender family’s situation is one that deserves our deepest empathy. Govender had, until recently, been covered under his family’s medical aid – as most dependants are – but was removed from the policy upon turning 21, as scheme rules generally require.
This is not a failure of planning on the family’s part; it is a gap that catches thousands of young South Africans every year at precisely the age when they feel most invincible and least likely to think about healthcare cover. No family plans for their child to be stabbed. No family imagines that a Friday afternoon card game will end in an ICU. The Govenders are, by all accounts, a loving family doing everything in their power for their son, and their community has rallied around them. Their story is not one of negligence – it is a reminder of how quickly and cruelly life can change, and how important it is for young adults transitioning off parental medical aid to secure their own cover as early as possible. That urgency is compounded by a significant policy development.
On February 20, 2026, President Cyril Ramaphosa formally undertook, through the Office of the State Attorney, not to promulgate any provisions of the National Health Insurance (NHI) Act pending the Constitutional Court’s ruling on challenges brought by Solidarity, the Board of Healthcare Funders, the Western Cape Provincial Government, and others. Hearings are scheduled for May 2026 (IOL; BusinessTech, February 20, 2026).
The NHI – signed into law in May 2024, but never activated – remains in legal limbo. A decade-long roll-out was always envisaged even under the most optimistic projections. It offers no comfort to anyone in an emergency room today.
Medical aid schemes are regulated under the Medical Schemes Act, No 131 of 1998, and governed by the Council for Medical Schemes (CMS). They provide comprehensive in-hospital and day-to-day benefits and are legally obligated to cover the prescribed minimum benefits (PMBs) – 270 defined conditions that must be treated at cost.
Medical insurance, by contrast, is regulated under the Short-Term Insurance Act, No 53 of 1998 and overseen by the Financial Sector Conduct Authority (FSCA). It pays fixed benefit amounts on defined events – hospitalisation, surgery, or diagnosis – irrespective of actual costs incurred and does not cover PMBs. Premiums typically range from R300 to R600 per month, making it accessible even for tighter budgets.
Both products serve a legitimate purpose. The critical issue is understanding which one you hold, and what it will and will not do when the moment arrives. For those already on medical aid, GAP cover bridges the gap between scheme rates and what specialists actually charge – a shortfall that routinely runs at 200% to 500% above medical aid tariffs – making it one of the most cost-effective supplementary products available.
For those who genuinely cannot afford comprehensive medical aid – a smallholder farmer absorbing a failed harvest, a young worker earning below the income tax threshold – the answer is pragmatism: a reputable medical insurance product, a hospital cash plan, or a low-cost medical aid option.
Several schemes offer family options structured below R2 500 per month, and the CMS’s Low Income Medical Schemes (LIMS) framework exists for exactly this purpose. Something is always better than nothing. For those fortunate enough to earn a comfortable income, however, the conversation is different. Life deals us cards we do not choose – an accident, a sudden illness, a moment of violence in an ordinary place on an ordinary afternoon. None of us knows what the next hand holds.
South Africa’s public health system, under chronic strain and without a near-term policy rescue, is not the safety net many assume it to be. Medical aid cover is not a grudge purchase or a reward for reaching a certain income bracket. It is a fundamental act of responsibility to yourself and to the people who depend on you. Prioritise it accordingly, before other discretionary spending that, when weighed against your family’s well-being, can wait.
Begin with a proper needs analysis. Assess your household’s health profile – age, chronic conditions, anticipated procedures, and realistic hospitalisation risk – and engage a registered financial adviser accredited under the FSCA to conduct a structured comparison.
The CMS publishes annual comparative benefit tables at www.medicalschemes.org.za. Young adults coming off parental medical aid at 21 should, as a matter of urgency, secure their own cover immediately – even a basic hospital plan combined with a medical insurance product provides meaningful protection at a manageable cost.
South Africa’s medical scheme industry paid out R221.2 billion in benefits in the 2022/23 financial year (CMS annual report, 2023). That industry exists precisely because catastrophic illness or injury is beyond what most individuals can absorb out of pocket.
Govender’s family is holding on by a thread, sustained by hope and community. Their story is a profound reminder that health cover is not about anticipating bad luck – it is about being ready for it. The NHI remains in the courts. State hospitals remain under pressure. The time to act is not when the ambulance arrives. It is today.
Sanjith Hannuman is the CEO of AVIB and an employee benefits consultant who holds an MBA from UKZN, is an FSA of the Financial Planning Institute of South Africa, a human values practitioner, and a behavioural life coach who believes in the betterment of life for all.
** The views expressed do not necessarily reflect the views of IOL or Independent Media.