The article reports on an empirical exploration of public service medical schemes governance, its variations and the dire financial repercussions and financial security for the members of such schemes in South Africa. Given the class-based 'dual nature' of the medical scheme terrain in South Africa through the existence of 'open' and 'restricted' schemes (the latter dominated by public-service ones), existing violations of good governance take a wide variety of forms and types. This despite the existence of legislation such as the Public Finance Management Act 1 of 1999 (PFMA), the Medical Schemes Act of 1998 and the regulatory body, the Council for Medical Schemes (CMS). It is understandable that the beneficiaries of public services of this nature expect them to provide affordable, honest, accountable, and useful services and products that are in accordance with their needs and financial means and resources.