Comparison of benefits in the health system of migrant workers
“Comparison of benefits and fund management of migrant workers in the social security system and the Alien Insured Fund” compared medical benefits (Benefit packages) and fund management of migrant workers. Two systems of migrant workers managed by the government are the social security system. and the foreign insured fund It uses the benefits of the gold card system as a baseline to find inequality gaps. and develop policy proposals on benefits suitable for both migrant health systems without financial, fiscal, or personal status restrictions. The results showed that
the scope and conditions of protection
found that the social security system is compulsory insurance with partial government support. which the law requires employers Employees and the government must jointly pay contributions to the fund every month at the specified rate. Regarding the scope and conditions of coverage in the social security system, there are quite limited conditions. There is a time limit for making contributions before the birth of rights, for example, in the event of illness and disability, contributions must be paid for at least 3 months within 15 months before suffering harm or illness.
Similarly, in the case of childbirth, contributions must be paid not less than 5 months before the birth of the child. If the insured becomes sick or gives birth before the specified period Migrant workers insured must pay for medical expenses themselves or purchase temporary health insurance cards from the Ministry of Health. (Foreign Insured Fund) instead at the rate of 1,000 baht (500 baht health check, 500 baht health insurance), which in such a case causes double payments. And if the contributions are not paid for 3 consecutive months, that right will be terminated immediately.
For health insurance of the foreign insured fund, It is compulsory. Migrant workers insured must pay for health insurance cards including health check-ups at the rate of 1,000-3,700 baht according to the coverage period (annual or bi-annual, or 6-monthly, or 3-monthly). Under 7 years old, tickets cost 365 baht per year and 730 baht per 2 years, and must pass a medical examination as prescribed by the Ministry of Public Health first. Except for children under 7 years old who do not need a health check Migrant insurers can exercise their rights immediately after purchasing a health insurance card. And the insured will be terminated when the insured dies. or the health insurance card coverage has expired and the health insurance card has not been purchased. or has been entitled to social security And if the insured receives medical treatment at the service unit, they have to pay 30 baht per time.
while the gold card system does not have to pay health insurance premiums due to the welfare state system. The government pays or eligible persons can join to pay medical expenses of 30 baht per time, but this is voluntary only in the case of medication. and can exercise rights immediately after registration and the right shall expire only when such person has been protected by other rights of the State.
Different medical service benefits
It was found that the benefits of medical services differed between social security systems. Foreign Insured Fund And the gold card system offers 19 different medical service benefits, including special hospital room fees, several maternity visits, first aid to service recipients, and service providers who are damaged by receiving services and providing Services (section 41), organ transplantation. , bone marrow transplant for cancer patients, kidney transplantation, renal failure, AIDS antiviral drugs to prevent post-exposure infection, disease, or harm caused by substance use. Addiction according to drug laws, accidents or emergencies, psychiatric disorders, dental implants, dentures, convalescent and post-home care services, and post-treatment medical rehabilitation.(out-hospital), Thai traditional and alternative medicine services, referring patients to higher-potential services by aircraft, Transportation costs between naval services, medicines, and supplies that are necessary, and accessibility issues In which 19 medical treatment benefits, the gold card system protects more than 17 items, except for special hospital room expenses. dental implant treatment The social security system, but the gold card system does not.
For the social security system, there are 13 coverages, except for bone marrow transplants if the insured has been diagnosed with cancer before becoming insured, antiretroviral drugs to prevent infection after exposure to infections during treatment. jobs such as doctors, and nurses. In the case of infection after exposure to sexual harassment operated through the NHSO instead, convalescent and post-hospital services, medical rehabilitation after the end of treatment (out-hospital), referral of patients to higher-potential services by aircraft and initial assistance to service providers who have suffered damage from services (Section 41), which the social security system protects only service recipients who have been damaged from receiving services onlyWith all 6 benefits in this list, the gold card system have only the social security system.
While the Foreign Insured Fund in 19 lists, it was found that only two of them protect systemic migrant workers insured: injury or disability occurs because the person is incentivized to provide services. Rehabilitation and post-hospital services There are also several other benefits that are essential and essential basic benefits such as CKD, Psychiatric, Expensive Drugs, First Aid to Patients, and Vulnerable Service Providers. Receiving services and providing services (Section 41), dental prostheses and dental implants, disease or suffering from substance abuse under the law on drugs, organ transplantation, etc.
The same medical service benefits But the management is different.
In terms of benefits, medical services are the same. But the management is different. between the social security system Foreign Insured Fund and the gold card system, It was found that there are 27 benefits that all 3 systems have for those who are entitled or insured in the same system. but differ in management methods such as health promotion and disease prevention, childbirth, prosthetic devices and organs, the same disease requiring hospitalization for more than 180 days in a year, experiencing harm or Disabilities arise because of such persons’ incentives, dentistry, inter- route transportation, HIV/AIDS services, renal failure, heart diseases. ), brain surgery, chemotherapy or hormone or radiotherapy in cancer patients, family planning, cataract surgery, hemophilia prone disease. (Hemophilia), ischemic stroke (Stroke fast track), Acute ST-Elevated Myocardial Infection Fast Tract, urinary tract stones, asthma (Asthma), and patients with chronic obstructive pulmonary disease. (COPD), Tuberculosis, Diabetes and Hypertension, Laser project diabetic retinopathy, Hyperbaric oxygen therapy, Topical therapy. diving disease Decompression sickness, smoking cessation clinics, morphine therapy for terminally ill cancer patients, medicines and medical supplies with accessibility issues, disabilities, and different management approaches can affect accessibility. and service quality of different service units Because management strategies will incentivize service delivery. or unable to provide services to patients Disability, where different management methods may affect access to services. and service quality of different service units Because management strategies will incentivize service delivery. or unable to provide services to patients
It was found that in the gold card system, there are more than 20 items with specific management, enabling patients to receive a good quality of treatment and access to services without financial limitations, such as costly diseases such as cancer, and hemophilia. Lick, tuberculosis, heart disease, kidney failure, urinary tract disease antiviral drugs for AIDS, and 20 more expensive and difficult-to-access drug management systems, such as psychiatric drugs. Risperidone Sertraline Cancer drug Rituximab, expensive drug on account E (2), etc.
for the social security system, There are specific managed benefits and detailed payment methods, including maternity, and brain surgery. heart surgery The same disease requires hospitalization for more than 180 days in 1 year and disability It was also administered only for patients who needed expensive drug treatment on List E(2).
While the Foreign Insured Fund does not, as a whole, have a specific management system for expensive problematic diseases. and have access problems such as expensive drugs, treatment of renal failure patients so that patients can access services
From the comparison of medical benefits (Benefit packages) and the management of migrant workers’ funds from both systems, it is clear that the alien insured fund compared to the gold card system. And the social security system, it is necessary to accelerate the development of medical benefits packages for migrant workers insured in this system. Including the development of a specific management system for patients to receive a good quality of care and access to services without financial restrictions to reduce the disparity between health systems.