Deputy Health Minister Dr. Sibongiseni Dhlomo has clarified that non-South African nationals living in the country will not have access to the full package of health-care services under the proposed National Health Insurance (NHI) framework. His remarks come as debates intensify over the inclusivity of the scheme and its impact on foreign nationals.
Speaking at a parliamentary briefing, Dr. Dhlomo explained that emergency and essential medical care will remain accessible to everyone in South Africa, regardless of nationality. However, the comprehensive benefits envisioned under the NHI will be reserved exclusively for South African citizens and permanent residents.
“The South African health system has a constitutional obligation to provide emergency care to anyone in need, including foreign nationals. However, the full package of NHI benefits is for South Africans. Non-citizens cannot qualify for the entire package,” he stated.
This position, he noted, aligns with international norms where health systems prioritize citizens while still upholding basic human rights through emergency care provisions.
The announcement has sparked divided opinions. Critics warn that excluding foreign nationals from full coverage could worsen public health risks, especially in managing communicable diseases across porous borders. They argue that health policy should reflect the realities of migration and population mobility.
Supporters of the move, however, insist that prioritizing citizens is necessary to sustain the NHI, pointing to resource constraints in South Africa’s already strained health sector. They argue that extending comprehensive benefits to non-South Africans could overburden the system before it achieves stability.
Dr. Dhlomo stressed that government’s stance seeks balance: protecting the rights of all individuals while safeguarding financial sustainability. “We cannot run a system that is open-ended. Our primary responsibility is to citizens and permanent residents,” he emphasized.
Signed into law earlier this year, the NHI Bill seeks to establish a unified health-care system ensuring equitable access for all South Africans. Implementation will be phased in over several years, with details on funding and benefit packages still under discussion.
The exclusion of non-South Africans from full benefits is likely to remain one of the most hotly debated aspects of the NHI rollout, reflecting the complex intersection of health policy, immigration, and resource allocation in South Africa.
