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Background: Undocumented migrants are a population that is of concern in the policy discourse in many countries, including Thailand. Objective: Draw lessons regarding the health insurance management for undocumented migrants in certain developed countries. Material and Method: Literature reviews were conducted on academic literatures of the Europea...
Context in source publication
Context 1
... practice, the laws in each country almost always require an undocumented migrant patient to undertake certain kinds of registration/ legalization. Taking into account, the financing system, and the degree of care in the EU countries can be classified into six groups as shown in Table 1. ...
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Background: Public health insurance schemes can offer households financial protection against health care costs and help to resolve inequality in health care provision. The current study evaluates the impact of the Nigerian National Health Insurance Scheme (NHIS) in reducing financial hardship for a sample of Nigerian households working in the heal...
Citations
... A natural prerequisite for healthcare access is the ability to present some form of personal identification at the first point of contact. Smaller primary or community care initiatives such as outpatient preventative health visits or immunization drives may be able to waive this requirement, but the nature of inpatient, surgical and obstetric care in most healthcare systems often necessitates that some form of identification documentation be provided [31]. This is often tied to an individual's right to healthcare financing and compensation, as eligibility for government or private coverage requires some form of personal identification as a means to audit and trace payouts to individuals [31,32]. ...
... Smaller primary or community care initiatives such as outpatient preventative health visits or immunization drives may be able to waive this requirement, but the nature of inpatient, surgical and obstetric care in most healthcare systems often necessitates that some form of identification documentation be provided [31]. This is often tied to an individual's right to healthcare financing and compensation, as eligibility for government or private coverage requires some form of personal identification as a means to audit and trace payouts to individuals [31,32]. This is the case in Pakistan, as access to hospitalbased care is often restricted to registered citizens -for example, in the Punjab province, one can only apply for a "Sehat Sahulat card" to access healthcare financing if they can provide proof of citizenship [33]. ...
Background
As developing countries take steps towards providing universal essential surgery, ensuring the equitable distribution of such care for underrepresented populations is a vital function of the global surgery community. Unfortunately, in the context of the global “stateless”, there remains much room for improvement.
Key issues
Inherent structural deficiencies, such as lack of adequate population data on stateless communities, absent health coverage policies for stateless individuals, and minimal patient-reported qualitative data on barriers to surgical service delivery prevent stateless individuals from receiving the care they require – even when healthcare infrastructure to provide such care exists. The authors therefore propose more research and targeted interventions to address the systemic issues that prevent stateless individuals from accessing surgical care.
Conclusion
It is essential to address the aforementioned barriers in order to improve stateless populations’ access to surgical care. Rigorous empirical and qualitative research provides an important avenue through which these structural issues may be addressed.
... In many other developed countries, nationwide policies are already in place to support immigrants' right to healthcare. For instance, in England, undocumented migrants can access healthcare services in emergency cases, as well as court-ordered or public treatments [37]. In Germany, migrants are permitted to receive various healthcare services, including postnatal care and treatment for infectious diseases. ...
... In Germany, migrants are permitted to receive various healthcare services, including postnatal care and treatment for infectious diseases. Undocumented migrants can be exempt from charges if they apply for a health card through the welfare office [38], while those without a health card are still entitled to emergency care without any charges [11,37]. In France, the health policy enables undocumented immigrants to receive essential healthcare services, including emergency and life-threatening treatment, as well as maternal and child healthcare, without any legal resident requirements. ...
... In France, the health policy enables undocumented immigrants to receive essential healthcare services, including emergency and life-threatening treatment, as well as maternal and child healthcare, without any legal resident requirements. A special program called "State Medical Aid" has been implemented to provide undocumented immigrants with access to healthcare services similar to French citizens if they have resided in France continuously for more than three months [37,39]. In the United States, the Emergency Medical Treatment and Labor Act (EMTALA) mandates hospitals to provide emergency room care to all patients, regardless of their ability to pay, including undocumented immigrants [40]. ...
In Japan, a considerable number of foreigners encounter challenges in accessing appropriate healthcare services due to the lack of insurance coverage. However, the absence of a public database on these individuals makes it difficult to assess their health problems and healthcare access status. This study aims to investigate the characteristics of vulnerable Thai patients in Japan and to shed light on the specific challenges they face within Japan’s healthcare system. A retrospective analysis was conducted using records of patients who required emergency healthcare support from the Royal Thai Embassy in Tokyo between 2004 and 2020. Descriptive statistical analyses were performed to examine the general characteristics, insurance status, and diseases of the patients. Additionally, patients were classified as either prolonged residents or brief residents based on their duration of stay in Japan until hospital admission (1 year or more or less than 1 year). A total of 74 patients were identified, with the majority (91.9%) lacking insurance coverage. Notably, there was an increase in the number of brief residents, including tourists, during the 2010s. Prolonged residents were more likely to experience chronic diseases, whereas brief residents were more prone to sustaining injuries. The patient records from the Thai Embassy consistently highlight the urgent requirement for emergency healthcare support within this population. However, the existing policies in Japan fall short in adequately addressing the healthcare access needs of this vulnerable population. Therefore, it is crucial to provide additional support and interventions to enhance their healthcare access.
... In addition, some participants mentioned the idea of integrating the HICS (for migrants) with the UCS (for Thais). Some participants referred to the United Kingdom (UK) health insurance scheme and the National Health Service, which is the only organisation responsible for all beneficiaries or ordinary residents in the UK [30]. Ordinary residents can include legal immigrants if they stay in the UK for longer than three years. ...
Thailand is a popular host nation for international migrant workers, particularly those from Cambodia, Lao PDR, and Myanmar. Thailand has introduced approaches to protect their rights for health and social welfare, using various mechanisms over many years. However, the implementation of these policies is dynamic and has been influenced by national security, economic necessity, and public health concerns. The aim of this study was to explore how Thailand designs and implements health and social welfare policies for migrants in Thailand, both before and during COVID-19. A qualitative analysis was used alongside interviews with 18 key informants in various sectors in this field. Thematic coding was applied. Results show that there were seven key themes emerging from the analysis, including: (i) sustainability of the HICS; (ii) people dropping out from the Social Security Scheme (SSS); (iii) quality of health screening in the Memorandum of Understanding (MOU) migrants; (iv) health screening problems and state quarantine management in response to COVID-19; (v) managing the migration quota and dependency on migrant workers; (vi) influx of migrants in the backdrop of COVID-19; and (vii) poor living conditions of migrants and the impact of COVID-19. The majority of interviewees agreed that undocumented migrants is a critical concern that impedes access to migrants’ health and social welfare. This situation was especially pronounced during the second wave of COVID-19 in Thailand, which took hold in migrant communities. In the short term, the poor living conditions of migrants urgently need to be addressed in order to contain and mitigate this crisis. In the long term, there needs to be an improved health system design that includes migrants, regardless of their immigration status. This requires intersectoral policy coherence, including the hastening of nationality verification to sustainably mitigate undocumented migrants.
... Most of the ASEAN countries, such as Brunei, Lao PDR, Indonesia, the Philippines, Singapore, and Vietnam, were found with a few stateless people in the country which may indicate an effective implementation of the nationality law and naturalization of the stateless people. This is comparable to the situation in developed countries where illegal immigrants are undertaken the nationality verification and become fully legalized to be insured by the main insurance scheme similar to the citizens of the host country [116]. ...
This study aimed at summarizing the existing health policies for stateless populations living in the 10 ASEAN countries: Brunei, Cambodia, Lao PDR, Indonesia, Malaysia, Myanmar, the Philippines, Singapore, Thailand, and Vietnam. We followed scoping review method recommended by Arksey and O’Malley. Our inclusion criteria were based on three concepts: populations (stateless and undocumented people), issues (healthcare policies and regulations), and settings (10 ASEAN countries). Our findings suggest that none of the ASEAN countries have explicit healthcare policies for stateless people except Thailand. We also observed that ratification of international human rights treaties relating to the right to health does not necessarily translate into the provision of healthcare policies for stateless population. Although Thailand seems like the only country among 10 ASIAN countries having health policies for stateless populations in the country, the question remains whether having a policy would lead to a proper implementation by ensuring right to health.
