‘Roaming’ health insurance for migrant workers urged

Filipino domestic helpers in Exchange Square in Central.

A principal health specialist of the Asian Development Bank has underscored the need for “roaming” health coverage amid rising migration demands.

ADB’s Eduardo Banzon said national health insurance systems in many Asian countries may not be able to provide sufficient health coverage to migrant workers.

“As movement across countries becomes easier and more frequent, the one situation we all dread is getting sick and needing to access health services in a foreign country. Even as we worry about getting well, we end up worrying more about how to pay for it,” he said.

“Countries need to make their health coverage ‘roam.’ If increasing mobility, innovative thinking, and collaboration across countries have rapidly made phone roaming a reality, health coverage should be able to roam, too,” Banzon added.

Asian countries have made impressive strides toward providing health coverage for their citizens—particularly the poor—by setting up national health insurance systems (NHIs) that compel the formal sector to contribute to premiums. They also facilitate the enrolment of the non-poor informal sector, and fully subsidize the insurance coverage of the poor and other vulnerable populations.

Indonesia’s national health insurer, for example, now covers 169 million people; while the Philippine government reports that 92 percent of all Filipinos are insured. India will soon expand health insurance coverage to over 800 million people, while the covered population in China is over a billion.

“But as countries expand health care services for the covered population, they also need to guarantee the same health coverage for citizens when they are in foreign countries, as well as for foreign residents,” Banzon said.

Asians, in particular, have been increasingly moving around the region, mostly to find jobs, with up to 31 million migrant workers in 2015 alone.

That number is expected to rise as the Association of Southeast Asian Nations Economic Community makes it easier for workers to cross borders.

“The increasing movement across borders into growing and interconnected economies will surely make roaming universal health coverage (UHC) a reality soon. This is crucial for informal communities like migrant workers, who are vulnerable to a range of infectious and non-communicable diseases, mental health disorders, maternal mortality, substance use, alcoholism, malnutrition, and violence. They face barriers to decent health care – especially if their legal status is uncertain,” Banzon said.

While the Philippines requires its outgoing migrant workers to get health insurance coverage, this means paying upfront and getting reimbursed later. Indonesia, Nepal and other countries are implementing similar schemes, and experiencing the same weaknesses and problems.

“In a world where borders are blurring and becoming increasingly permeable, health coverage needs to be just as mobile. If not, it will never be truly universal,” Banzon said.