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Popular Science: How is healthcare for foreigners in Czechia?

Geographers from the Department of Social Geography and Regional Development in the Faculty of Science of Charles University in Prague are interested in migration and its aspects. In one of the case studies they investigated the Czech healthcare and insurance system in relation to foreigners. Based on Czech law Dušan Drbohlav, Dagmar Dzúrová and two colleagues from Spain made and tested the hypothesis that foreigners have disadvantages compared to native Czech citizens.

 

Since the 1990s there have been a lot of changes in the transformation following the collapse of the communist regime. International migration in a non-isolated country was one of them. Between the years 1993 and 2008 the number of foreigners increased from 77 000 to 440 000, now it is 4% of the total population. They are motivated by economic reasons. Half of them have long-term visas and the second half has permanent residence permits. Increasing the number of citizens means a wider field for research. Healthcare also belongs to that.

Health insurance is obligatory in Czechia. Healthcare in the Czech Republic is guaranteed for Czech citizens, European Union citizens and third-country citizens that have legal permits for more than 90 days and are registered employees. For migrants who are not employees (self-employed, students, children and other similar groups) healthcare is not provided. This applies to one-quarter of the foreigners in the Czech Republic (100 000 – 120 000). They are required to obtain commercial health insurance. Immigrants hope that some commercial insurance company will make an agreement with them. Immigrants should have health insurance in Czechia (in fact it is obligatory), however there is a lack of regulation of insurance conditions. In contrast, according to the World Health Organization (WHO), healthcare should be accessible to all. The aim of the research is to compare Czechs and Ukrainians within the Czech healthcare system.

A questionnaire for Czechs and Ukrainians has been set up. Researchers analysed data and compared the usage of healthcare. People filled in their personal characteristics (sex, education, age, employment, health status…) and the frequency of visits to healthcare workplaces – specialists, general practitioners, hospitalizations and prescribed drugs. With regard to the result we have to note that most of the Ukrainians were employees, i.e. they have insurance. Ukrainians with permanent residence permits are similar to Czechs. They visited general practitioners and were hospitalized more than Czechs, though on the other hand they visited specialists less. Ukrainians with long-term visas used the least services within the three focus groups. Generally, Ukrainians used services less than Czechs.

The results are similar to other European countries. Foreigners and natives use hospitalization and general practitioners. The difference is in the use of specialists. They are more visited by natives.

In spite of the fact that a lot of Ukrainians (particularly Ukrainians on a working mission with long-term visas) have entitlement to public healthcare, they do not use it. The problem is a lack of knowledge, distrust in the system or they don’t have stable employment. The next problem is inequality within a dual system of healthcare for migrants. Researchers found it to be discriminatory and a great challenge for healthcare policymakers in the Czech Republic.

 

MALMUSI, D., DRBOHLAV, D., DZÚROVÁ, D., PALÉNCIA, L., BORRELL, C. (2014): Inequalities in healthcare access by type of visa in a context of restrictive health insurance policy: the case of Ukrainians in Czechia. Public Health, Issue 59, 715 – 719 pp.

 

Tomáš JANÍK

Published: Apr 09, 2015 10:50 AM

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