05 minutes

Bridging the healthcare gap

Genric Insurance’s Cornel Schoeman discusses how hybrid health solutions are helping bridge the gap between private healthcare access and rising costs.
Written by
Cornel Schoeman
Published on
November 11, 2025

In a recent conversation between COVER and Cornel Schoeman, Chief Operating Officer of Genric Insurance Company Limited, the focus turned to one of the most pressing and complex issues in South Africa’s employee benefits space: access to affordable healthcare.

The discussion centred on the medical funding environment, reflecting on the shifting balance between affordability, responsibility, and innovation in health cover.

The evolving employer–employee health equation - Cornel began by framing the context: medical aid costs have risen steeply, straining both employers and employees. “Traditionally,” he explained, “commercial entities contributed towards medical aid for certain portions of their workforce. But it’s become so expensive that affordability is under huge pressure, on both sides.”

This escalating medical inflation, he said, is not just a financial issue. It has begun reshaping how South Africans, individuals and companies alike, think about healthcare. “If you can afford a medical aid, it’s still the best place to be,” Cornel noted. “But the reality is that many can’t, including large parts of the middle class. And that’s where health insurance steps in as a viable alternative.”

The emergence of health insurance, he added, reflects a positive shift: people are thinking more broadly about health solutions, not just medical aids. Employers, too, are exploring innovative ways to provide care, from hospital plans and emergency cover to structured health insurance products. “We’ve even seen retailers offering group health insurance,” Cornel said, calling it “a step in the right direction.”

Health insurance: structure, purpose, and positioning - The conversation then turned to the core differences between medical aid and health insurance. “Medical aids must cover prescribed minimum benefits and chronic conditions,” Cornel explained. “Health insurance, on the other hand, is a stated-benefit product, there are defined limits to what’s paid out, which makes it more affordable.”

He was quick to point out that affordability doesn’t mean inadequacy. Rather, it’s about structure and access. “People don’t aspire to go to state hospitals. They want to be treated in private facilities, where service delivery and turnaround times are faster,” he said. “Health insurance gives them that opportunity at a manageable cost.”

He described a growing trend among employers: offering hybrid solutions that blend hospital plans with health insurance for day-to-day benefits. “That approach fills the gap between affordability and access,” he said. It also helps reduce absenteeism, an often-overlooked business impact of poor healthcare access. “If employees can get treatment quickly, they’re back at work sooner. It’s that simple.”

“Health insurance is not a downgrade. It’s a structured, affordable bridge that keeps people in the private system and supports a healthier, more productive workforce.”

Cornel Schoeman
Chief Operating Officer of Genric Insurance Company Limited

Affordability versus access, and the role of responsibility - Cornel emphasised that there is no “one-size-fits-all” answer. “Every company needs to look at its ethical and practical responsibilities,” he said. “Some can afford to fully subsidise employee medical aid while others can only contribute toward basic cover. What’s important is ensuring that employees have some form of private access.

The sad reality, he noted, is that for many households, healthcare becomes a “wishful” expense. “When you’re struggling to cover food and basic needs, health costs are often postponed. That’s where health insurance can make a real difference, providing structured, predictable cover within reach of lower- and middle-income earners.”

While he acknowledged the intentions behind the National Health Insurance (NHI) plan, Cornel was pragmatic about its limitations. “We’re supportive of any initiative that broadens access,” he said. “But universal healthcare on the scale of a medical aid is simply unaffordable. It’s about finding balance, what can the employer pay, what can the employee afford, and what solutions can bridge that gap?

Distribution, education, and the broker opportunity - Cornel stressed that access to appropriate products depends heavily on the distribution network, and that means brokers. “Our products are available both to corporates and individuals, but they’re sold through brokers. The broker’s role is crucial in educating clients about what’s available and suitable.”

He highlighted that many people are unaware of the distinctions between medical aid, health insurance, hospital plans, and gap cover. “There are about 8.7 million medical aid members in South Africa,” he said, “but only around 10% have gap cover, even though the cost of a hospital procedure can run into hundreds of thousands of rand. Education here is key.”

That education, he added, also creates a commercial opportunity. “Health is the perfect entry point for brokers. When you start with health, something every client feels immediately, you open the door to a deeper relationship. From there, you can expand into other classes of insurance. It’s not just a sales tactic; it’s about relevance.”

A shift toward holistic health solutions - Cornel sees a clear trend toward more integrated, realistic healthcare funding models, ones that recognise both the limits and the possibilities of the system. “Health insurance is not a downgrade,” he said. “It’s a structured, affordable bridge that keeps people in the private system, alleviates pressure on the public sector, and helps employers maintain a healthy, productive workforce.”

In an economy where access to quality healthcare remains a privilege, Genric’s approach represents an important middle path, pragmatic, inclusive, and attuned to South Africa’s realities.  

Cornel summed it up, “If you want a good conversation with your client, start with their health. It’s where they feel it most, and where real impact begins.

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This product is underwritten and administered by GENRIC Insurance Company Limited, a licensed non-life insurer and an Authorised Financial ServicesProvider (FSP: 43638). National Health Group (Pty) Ltd (2015/130345/07), a registered Managed Care Organisation (MCO110) and Administrator (ADMIN72), is contracted to provide administration and managed care services. This is not a medical scheme, and the cover is not the same as that of a medical scheme. This Policy is not a substitute for a medical scheme membership. Premiums are subject to an annual review. Terms and Conditions apply.

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