“I can finally sleep at night knowing my mother’s dialysis won’t drain our savings,” says a grateful stateless resident. As Brunei reforms its public healthcare policy, lives are changing - but not without growing pains.
BANDAR SERI BEGAWAN, 06 JULY 2025: In response to ongoing concerns about shifting demographics, equitable resource allocation and rising healthcare costs, Brunei's health ministry has introduced a significant policy shift, granting free healthcare to stateless permanent residents, marking a decisive step towards inclusive medical care and reducing financial hardship for approximately 20,000 individuals.
Effective immediately, stateless residents with Purple IC cards now receive comprehensive medical treatments, including costly cancer, stroke, and cardiovascular disease therapies, at no charge, aligning their benefits closely with Bruneian citizens.
Previously, stateless permanent residents had access to free medication but faced steep bills for surgical interventions. Additionally, their registration fee for hospital visits has been slashed from BND$3 to BND$1, matching the rate for citizens holding Yellow ICs.
The Ministry of Health described the policy as fulfilling "His Majesty’s government’s commitment to inclusive, accessible healthcare," aiming explicitly to alleviate financial hardship among stateless communities.
Dato Seri Dr Isham noted the move is also a practical response to Brunei’s growing stateless population and rising chronic disease rates, both of which require a more equitable healthcare financing framework.
“By removing financial obstacles, we can encourage early medical intervention and preventive care,” said Health Minister Dato Seri Setia Dr Isham Jaafar, commenting on the policy’s potential to improve public health outcomes.
Explaining the rationale, Dato Seri Dr Isham stated in an earlier announcement that the policy ensures resources are focused on those who have no other recourse: "We must ensure healthcare subsidies reach those most in need, especially the stateless who lack any national support elsewhere."
However, the policy has sparked debate, as it simultaneously ends subsidised healthcare for permanent residents who hold foreign citizenship, imposing full charges for medical treatments and specialist referrals.
This decision notably impacted families of foreign-national permanent residents who previously enjoyed subsidised healthcare due to marriage to Bruneian citizens.
One concerned commenter shared: "A lot of patients with PR IC holders (foreign passports) are affected by this new system. They have to cancel their cancer treatments at JPMC because they couldn’t afford to pay the bills. I feel bad for them."
Although the government had formally communicated the policy change in advance, public perception suggests that not everyone felt adequately informed.
One commenter noted: "The manner in which this MOH fee payment was launched speaks of bigger problems on the horizon. It was rushed. I'm sure nurses haven't been trained on the costs of procedures and medication. There was no stakeholder engagement."
Supporters of the government's move argue that Brunei must focus resources effectively and sustainably, emphasising that foreign citizens worldwide typically bear full healthcare costs outside their home countries.
One online advocate remarked: "This step is logical. If you maintain a foreign nationality, it is fair to expect to pay healthcare costs or arrange insurance, as is standard globally."
Nevertheless, healthcare advocates recommend a balanced approach.
An anonymous healthcare advocate suggested individual case reviews, particularly for ongoing treatments, saying, "A compassionate transitional phase would prevent sudden financial hardship."
Brunei's government faces the intricate challenge of managing financial sustainability while addressing healthcare needs fairly. The Ministry of Health pledged extensive outreach to clarify the policy, easing its practical rollout and helping families navigate the changes.
To address confusion, the ministry is actively engaging with community leaders, ensuring affected individuals understand the policy implications and available alternatives, such as private insurance or support through charitable health funds.
Insurance providers, including Takaful Brunei Am and National Insurance Company Berhad, are now offering new or expanded packages tailored for expatriates and PRs with foreign citizenship.
These plans include minimum coverage of BND 100,000, per the phased implementation starting 1 July 2025, expanding again in January 2026.
“BITA encourages all affected individuals and employers to consult with licensed insurance companies and takaful operators in Brunei to explore suitable medical insurance/takaful plans that comply with the new requirement,” noted a BITA manager, underscoring how the shift is already prompting insurers to introduce targeted plans for PRs and expatriates in Brunei.
Insurance providers may also see this policy shift as an opportunity to expand tailored plans for expatriates and foreign-national PRs, possibly stimulating a new segment in Brunei’s private health insurance market.
For permanent residents with foreign citizenship already undergoing treatment, phased implementation strategies, such as allowing treatment to continue under previous terms or arranging manageable payment plans, could help mitigate the impact.
The dialogue surrounding healthcare equity continues, raising crucial questions about citizenship, fairness, and fiscal responsibility as Brunei strides towards a healthcare system designed for sustainable inclusivity.
This policy evolution underscores Brunei’s balancing act between compassion and fiscal prudence in its national development agenda. (MHO/07/2025)
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