Literature review on health insurance management for cross-border undocumented migrants in European region: Worth learning lessons for Thai healthcare system

Abstract

The objectives of this article are to draw lessons concerning the management of migrant health insurance policy in the European Union (EU) countries and to optimise those lessons for the greatest benefit of migrants in the Thai context. A literature review with purposive search was applied as the main method for this study, with a focus on “undocumented migrant", which is defined as "someone who, owing to illegal entry or the expiry of his or her visa, lacks legal status in the transit or host country". The term also applies to migrants who infringe a country's admission rules and any other person not authorized to remain in the host country. The review findings suggested that service management for undocumented migrants in EU countries can be categorized into 3 groups; (1) services covering only emergency case, (2) services that were expanded beyond emergency care but did not cover all benefit packages and/or covered only parts of undocumented migrants, and (3) services that provided (almost) comprehensive benefit packages. This variation across countries depends on political context, public health structure, and migrant policy direction in each country. Compared with the EU countries, the migrant policy in Thailand is quite open as the benefit packages are comparatively universal. However, there exists worth learning challenge, namely, some undocumented migrants have not been insured due to fear of exposing themselves to the public authorities. Therefore, promoting health workers serving as linkage between the government officers and undocumented migrants, having strong policy message in making the insurance policy more open and mandatory to all undocumented migrants, avoiding inconsistent implementation due to various interpretations across areas, reducing conditions in insuring undocumented migrants, and cooperating with private sector at the implementation level, are likely to be key measures that lead to more effective policy implementation in the real setting.