Healthcare is a right – so why does it still feel like a privilege?

In theory, healthcare is a constitutional right in South Africa. Section 27 of the Constitution guarantees that “everyone has the right to have access to healthcare services, including reproductive healthcare.” That right is not limited by race, income or social status – it is meant to belong to all of us.

Yet, for many South Africans, the lived reality feels very different.

South Africa’s healthcare landscape is sharply divided. Around 84% of the population relies on the public healthcare system, which serves as the backbone of care for most people. By contrast, only about 15%–16% of South Africans have access to private medical schemes, despite this smaller group absorbing a disproportionate share of healthcare spending.

Public facilities – the clinics and hospitals that most of us are constitutionally entitled to – are often well-intentioned but overstretched. Long queues, staff shortages, outdated infrastructure and inconsistent supply of medicines are common – barriers that make accessing even basic care a challenge for many.

For too many, getting healthcare still feels like navigating an obstacle course; patients often wait for hours, even for routine consultations; specialist services can be weeks or months away; and rural communities experience even greater shortages of staff and resources. Meanwhile, those who can afford it seek care in the private sector, where access is faster and infrastructure more advanced – but the cost is prohibitive for most.

“Healthcare should not feel like a luxury reserved for the few,” says Lance Blumeris, from digital health provider, Unu Health. “The constitutional promise of healthcare access is not just a legal phrase. It is about people feeling that they can walk into a clinic when they fall sick without fear of barriers or uncertainty.”

The gaps in access are not abstract statistics; they are everyday lived experiences for families across the country. Recent surveys show that fewer than one in five South Africans has medical aid coverage, and the vast majority of those without it worry about affording care when they need it.

More than half of citizens report having gone without medicine or treatment in the past year because of cost or logistical challenges.

For people balancing job insecurity, household responsibilities, transport costs and the rising price of living, access to timely, quality healthcare can feel like an afterthought rather than a right.

The uneven nature of South Africa’s health system – with high-resource private care on one side and an overburdened public system on the other – has prompted a search for practical solutions that can ease pressure and expand meaningful access.

Digital healthcare platforms are emerging as one part of that conversation: enabling easier access to consultations, second opinions and support for those who cannot afford repeated in-person appointments, and helping to triage needs efficiently without patients needing to queue for hours.

“We are not replacing the public system,” Blumeris explains, “but we are working to ensure access – the lived experience of healthcare – aligns more closely with the constitutional right it should be.”

For that promise to be realised, the conversation must move beyond policy and into everyday experience – and toward solutions that make access real, tangible and equitable for all.

Image credit: Freepik/mrsiraphol