A civil servant friend of mine was complaining to me the other day about changes coming to PSEMAS medical coverage. He expected me to take his side right away. In his mind, any cut to state benefits is automatically a consumer issue.
I stopped him right there.
This is not a consumer protection issue for civil servants. It is an employment issue, and it is a taxpayer issue. As ordinary citizens, we pay for every single civil service salary and medical benefit through our taxes. So before we talk about protecting their perks, we have to ask a simple question: Are taxpayers actually getting good value for the money we spend?
Whenever these arguments come up, I look at it through one simple test: Does this make daily life easier and fairer for the ordinary Namibian?
When you look at PSEMAS that way, the picture is bad. The average taxpayer pays twice. First, we pay taxes to fund a comfortable medical safety net for state workers. Second, when we get sick ourselves, we have to stand in line at underfunded state hospitals that get whatever small budget is left over.
The Burden of an Oversized State
The main problem comes down to basic math that our leaders have ignored for years. Namibia now has over 100,000 civil servants. That headcount has grown much faster than our economy or our tax collections can handle.
When the state hires someone, it does not just pay a monthly salary. It takes on a lifelong promise to cover heavy medical aid costs for that worker, their family, and eventually their retirement.
Private medical aid has become too expensive for ordinary workers. Because of that, getting a government job is no longer just about serving the public. It has become a way to get a guaranteed state-funded safety net.
How this affects you: It hurts your pocket directly. A huge civil service drives up PSEMAS bills. High PSEMAS bills mean the Treasury needs more tax money. High taxes then squeeze local businesses, making it harder for private companies to keep prices down or hire more people.
Making small tweaks to fees or pushing costs onto pensioners will not fix this. It just hides a broken system while taxpayers keep paying the bill.
Income-Based Contributions: Fixing the Funding Model
If PSEMAS is going to survive without taking money away from schools, roads, and basic services, we have to change how members pay into it.
Right now, PSEMAS uses a flat contribution system. That means a low-paid office clerk and a top government official pay similar flat fees. That might look equal on paper, but it is completely unfair to low earners.
How this affects you: Because high earners are not paying their fair share, the scheme runs out of money. The Treasury then has to step in with taxpayer bailouts to fill the gap.
What the remedy should be: We need an income-indexed system. Monthly payments should be calculated as a percentage of basic salary. High earners and senior officials must pay more into the shared pool because they earn more.
This protects lower-paid workers and pensioners from huge out-of-pocket costs, brings real fairness, and stops the government from using public funds to rescue a broken system.
Setting Limits on Dependants
Another major flaw is that PSEMAS lets members register long lists of dependants without paying extra money to cover that extra risk.
This leaves the fund wide open to massive private hospital claims and over-spending.
How this affects you: It drains the national health budget. State clinics run out of basic medicine because public money is being spent to cover an unlimited risk pool for state workers.
What the remedy should be: Put a firm cap on fully subsidised dependants—for example, a spouse and up to three children. If a member wants to register more family members beyond that cap, they should pay the full cost out of their own pocket.
This simple rule stops public money from being wasted and keeps healthcare funds available without asking taxpayers for more money every year.
The Path to Health Equity
PSEMAS cannot stay an exclusive club funded by billions in tax dollars while ordinary Namibians rely on overcrowded state clinics.
Real consumer protection means demanding full value for every single tax dollar spent. Parliament, the Ministry of Finance, and the PSEMAS Board must stop using short-term fixes. By linking contributions to income, capping subsidised dependants, and controlling the size of the civil service, Namibia can build a system that is financially sound and fair to everyone.
What kind of future are we building for our children if our public systems consume our national wealth instead of growing it?
