The State of the Right to Health Among Migrant Population : Access to health insurance and services

Access to health insurance for migrant workers and the migrant population: Among the migrant workers, it was found that most of them could access health insurance through the migrant worker registration process according to the Cabinet Resolutions. However, in terms of management, there are still limitations that impede the migrant population’s access to health insurance, as follows:

1. Management of health check-up and health insurance for migrant workers: During 2012-2013, there was confusion regarding the government’s policy on managing migrant workers or registering migrant workers. This has led to a period when two groups of migrant workers had to receive health check-ups and health insurance at approximately the same time. Such confusion in health check-ups and health insurance sales by hospitals has prevented many migrant workers from purchasing them.

2. As health check-up and health insurance services have to be provided for a large number of migrant workers as service recipients, it has given rise to delays in the process and given brokers a chance to take exploit such opportunities causing an increase in health insurance costs.

3. Problems were found as migrant workers who sought medical treatment services at hospitals are required to produce receipts for health insurance purchase along with their health insurance cards, passports, and work permits even though such receipts can easily get lost or damaged. After all, they already have health insurance cards or have their information registered in the health insurance system already. Requiring migrant workers or their employers to keep and produce health insurance receipts when seeking services is an unnecessary requirement.

4. Among migrant population and migrant children, their major problem accessing health insurance is concerned with the implementation at the local level, which is still inconsistent and may not comply efficiently with the Ministry of Public Health's policies, especially the sale of health insurance to migrant populations and migrant children. In certain areas, requirements exist to prevent the sale of insurance such as when the persons cannot produce identification documents, or when they are sick children, or when they are migrant and pregnant women.

5. Most migrant workers and migrant population do not have information about health insurance, so they do not understand the necessity or do not know the details of health insurance, which affects the decision of migrants to buy health insurance.

6. Problems with language communication between service providers and migrant population, attitudes and gesture of operational officers towards migrant workers, including delays and uncertainty in the provision of services by hospitals.

7. Due to the problems and difficulties in the health examination and health insurance system, including the Notifications of the Ministry of Labor according to the relevant Cabinet Resolutions, it has given rise to opportunities for migrant workers to be able to have health examinations conducted and health insurance purchased from private insurance companies. This causes problems for migrant workers, employers, and hospitals. In addition, private insurance offers benefit different from health insurance for migrant workers, including the limits of medical expenses. It also does not cover childbirth benefits, certain types of diseases, and disease prevention and control. This gives rise to concerns that if there is an epidemic among migrant workers, particularly when the medical bill exceeds the limit under the policy, migrant workers will have to seek medical treatment at the hospital anyway and it might not be possible to collect the fee from them.