LPN founder Sompong Srakaew
Access to health care is being thwarted as devious labour gangs withhold vital information about their rights.
Nineteen-year-old migrant worker Teh Uh has just one thing to say when he's asked about his right of access to medical care:"No one has told me."
He is one of thousands of migrant workers being exploited by unscrupulous and greedy labour brokers and at the mercy of corrupt health officials.
They simply haven't been made aware of their rights.
Teh Uh didn't realise his legal worker status could provide him the right to healthcare services in Thailand. He ended up buying expensive medicine from a local pharmacy.
Teh Uh owes tens of thousands of baht to a labour broker who brought him into the country and helped him apply for a passport and work permit.
"I was told not to come out from my shelter, otherwise, I would be arrested," said another Myanmar worker,37, who asked not to be named.
"I was told to contact my boss only if I'm sick."
But the truth is a migrant worker with a work permit can go to hospital without any need to contact a broker or their employer.
Under a cabinet resolution,employers are required to buy health insurance for migrant workers who have no access to healthcare protection under the social security system.
Employers must buy insurance for workers and their children aged 15 or younger, or they will not be permitted to renew work permits for their migrant workers, according to the Public Health Ministry.
But not every migrant worker has access. Labourers not eligible to join the social security system include those employed in fishery, livestock and farming businesses and domestic helpers.
The Public Health Ministry is responsible for ensuring that migrant workers receive healthcare protection, whether from social security or health insurance bought by their employers.
According to Samut Sakhon-based Labour Rights Promotion Network Foundation (LPN), many migrant workers who are legally registered here were told to pay more than 2,500 baht to a broker to buy a public health insurance card, against the actual price of 1,300 baht.
Some workers were told to pay as much as 4,500-6,500 baht for a health check-up, which is mandatory for health insurance card holders, although the Public Health Ministry set the fee at 600 baht.
The check-up is required only once a year, but some migrants were told to do it several times annually.
LPN founder Sompong Srakaew blamed the failure to crack down on cheating brokers, employers and corrupt officials. State agencies that have poor communication with migrant workers are also to blame, he said.
In some cases, migrant workers reportedly failed to buy health insurance cards because health officials told them to present a certificate from their employers, Mr Sompong said.
He suggested that the short-term solution for this situation may be to give migrant workers greater flexibility in accessing affordable health care perhaps by allowing them to purchase the insurance directly.
The card covers a wide range of medical care such as birth, dentistry,hospital rooms, drugs and vaccines.
Thaworn Sakunphanit, deputy director of the Health Insurance System Research Office, said a total of 189,754 migrant workers had bought health insurance cards since the beginning of this year, or only 20% of migrant workers who are required to buy the insurance card.
Dr Thaworn said the issue of migrant workers spread into several government agencies, thus opening loopholes for labour exploitation.
For example, the Interior Ministry is responsible for migrants' nationality verification; the Immigration Bureau issues passport and identity certificates;the Labour Ministry is in charge of issuing work permits and social security system memberships; and the Public Health Ministry is responsible for health check-ups and the health insurance card scheme.
"I think less than 20% of legal migrant labour knows about their medical rights," said Teh Uh."No one has told them."
He said labour brokers, government officials and employers are all part of the chain of migrant worker exploitation.
They exploit the workers simply by not telling them the truth about their rights to health care under Thai law,so that they can coerce the migrant workers into paying them high service fees.
A former member of a migrant worker trafficking gang, who gave his name only as Daeng,59, said the gang's strategy is to eradicate migrant labours'self-reliance by feeding them false information about their rights so that they have to rely on brokers.
The brokers charge high fees for various services ranging from work permit renewal, nationality verification,and purchase of health insurance cards.
Although the government has established one-stop-service centres around the country to make the process more convenient for migrant labourers, there are still loopholes for employers to avoid putting their workers under the social security system or buying health insurance cards for them, Dr Thaworn said.
By Paritta Wangkiat in Samut Sakhon
Source: Bangkok Post July 14, 2013