The current state and the development of commercial health insurance for migrants in the Czech Republic
Abstract
The availability of healthcare for third-country migrants has been criticized in the Czech Republic for more than 15 years by a number of actors at both national and international levels. The following study focuses on the current state and the development of special commercial health insurance (CHI) for migrants in the Czech Republic.
The study also aims at the impacts of existing institutional settings on healthcare accessibility to third-country migrants in practise. The study uses qualitative methodological approach.
The research design is a historical case study. The study uses a combination of documents studying and empirical survey based on 14 semi-structured interviews with experts.
In comparison to public health insurance, conditions of CHI are significantly worse for migrants. It is based on market principles as any other insurance product.
The scope of the care covered is practically not regulated by law. The development of CHI for migrants can be divided into two basic periods.
In the 1993-2004 period the CHI for migrants was provided as a by-product of the largest public health insurance company (VZP). The second period (from 2005 till now) starts with the accession of the Czech Republic to the EU, when the market for commercial migrants' health insurance was opened to the other subjects and there was a significant marketization in this area.
The results clearly showed that the institutional evolution of migrants' CHI is a matter of competition of two opposite ideological streams - an endeavour to include migrants into public health insurance and an endeavour to preserve parallel function of both public and commercial health insurance for migrants. The current commercial insurance for migrants in the Czech Republic does not guarantee good accessibility of healthcare to legal migrants.