The State Duma decided to amend the entry procedures for foreigners coming to Russia to require them to buy medical insurance. As explained by Alexey Zhuravlev, the State Duma deputy from the “United Russia” party, who initiated the measure, this is necessary in order to stop the illegal “medical tourism,” when citizens of the Commonwealth of Independent States (CIS) countries come to Russia to get skilled and free medical assistance. Most of those foreigners are patients with serious diseases, as well as expectant mothers.
According to Zhuravlev, today this process is, in fact, not regulated by law. According to the law “On the Procedure for Exit from the Russian Federation and Entry into the Russian Federation,” foreign nationals who enter Russia on a valid visa must present proof of medical insurance. This requirement does not apply to those who enter Russia under visa-free arrangements. Article 19 of the Law on Health Care (“On the Fundamentals of Public Health Protection in the Russian Federation”) specifies that medical assistance provided to foreign nationals is regulated by the Government Decree № 186. The Decree, inter alia, states that in cases of illness, accidents, injuries, poisoning and other conditions requiring urgent medical intervention, emergency, including specialized, medical care is provided to foreign nationals free of charge.
The legislator proposes to amend Article 19 of the Law on Health Care, as well as Article 25.9 of the Law “On the Procedure for Exit from the Russian Federation and Entry into the Russian Federation”. As Zhuravlev suggests, the amendments should require citizens of the former Soviet Union countries to buy a medical insurance policy.
The legislator noted that in Russia there are two types of ambulance care: emergency and urgent. Emergency is a situation that is life threatening, such as terrorist attacks, accidents, etc. This type of medical care, according to Zhuravlev, should remain free. But urgent care, that includes assisted childbirth, would be provided to foreigners for a fee.
Zhuravlev also insists that migrants should be billed by the Russian Federation for provision of any medical assistance, except in case of emergency.
“When Russian citizens travel abroad they buy insurance, which makes sense. If there is no insurance, most civilized countries still provide medical assistance, but then the patient is billed, sometimes for tens of thousands of euros. We believe that this practice must be introduced in our country as well. Foreign nationals who come to visit us, should be required to buy health insurance,” says Zhuravlev.
He suggests that a foreign national who received medical care and is unable to pay for the services should be subject to immediate deportation.
“The amount of debt a treated and then deported foreign national owes to our country does not disappear, and that individual will be denied entry into the Russian Federation until the bill is paid,” stressed the Duma deputy.
To illustrate the problem, Zhuravlev refered to a maternity hospital in Vladivostok, which in 2011 alone provided services to 83 women in labor from the CIS countries who did not have health insurance, and five of them did not have any ID. To all of them, childbirth and postpartum care was provided for free.
Alexei Zhuravlev’s colleagues in the State Duma agree that the problem of providing medical care to the citizens of the CIS countries is becoming more acute from the budgetary point of view.
Sergei Kalashnikov, the Chairman of the Duma Committee on Health, says that the problem has reached such proportions that Russia has essentially become a big maternity ward for the CIS countries.
According to him, the federal budget costs for medical care provided to migrants are huge. Every year hundreds of millions of roubles of the Russian taxpayers’ money are spent to provide assistance to citizens of the neighboring countries.
“This problem must be addressed comprehensively. We should do what many countries have done: upon entering the country, an individual must present a proof of health insurance. On the other hand, many migrant workers are often unable to buy a health insurance policy, however their services are needed in this country. In such cases, an employer who hires migrant workers must take care of that issue, making a one-time payment for a one year policy,” suggests Kalashnikov.
Leonid Slutsky, the Chairman of the Duma Committee on CIS Affairs, agree with his colleagues that the matter is urgent.
“It is necessary to study the experience of other countries, to involve representatives of the relevant committees of the State Duma and the relevant agencies, especially the Ministry of Health and the Federal Migration Service. Zhuravlev is right. By providing such medical assistance, Russia incurs substantial expenses. People come here just to go straight to the emergency room and get treatment for free,” says Slutsky.
Saliya Murzabaeva, a member of the Duma Committee on Health, is confident that the problem is not limited to the provision of emergency assistance to foreigners. Another issue is pre-planned surgeries.
“Measures to ensure responsibility of the employer for provision health insurance to workers and his family members must be strengthened, in order to make health care affordable and available for migrant workers,” she says.
The explanatory note to the bill states that today the cost of ambulance exceeds 1.5 thousand roubles, and the cost of assisted childbirth is about 60 thousand roubles. For foreign nationals who do not have health insurance, the cost of such medical services provided by public health organizations and community health systems is covered by the budget – that is, by taxpayer money.