Health care

Wednesday, 20 February 2013

Instruction of the Republic Fund of Health Insurance Related to Applying for Health Insurance by Persons of Roma Nationality – Deepening of the Problem

On 5 February 2013, Republic Fund of Health Insurance (RFHI) issued the Instruction for acting of competent branches in cases of persons of Roma nationality applying for health insurance. The Instruction was issued in accordance with the latest changes of the Regulation on the content, form and manner of submitting a unique application for mandatory social insurance, unique methodological principles and unique codex of codes for entry of data in the unique basis of the Central Register of mandatory social insurance (adopted in January 2013) in relation to conditions for applying for social insurance for persons of Roma nationality, who cannot be insured on some other grounds from the provisions of the Law on Health Insurance.

At first sight, the goal of the issuance of the stated act is compliance of the current regulations in the area of health insurance with the new solutions of the Law on Permanent and Temporary Residence of Citizens and accompanying bylaws (Rulebook on Form for Registration at the Address of the Social Welfare Center (SWC) and Instruction for acting upon registration of permanent residence at the address of SWC), which envisage the possibility of registration of permanent residence at the address of SWC for persons without the legal basis of housing in the Republic of Serbia (the ownership right over the apartment, contract on the apartment lease or other legal basis). RFHI Instruction has envisaged that persons of Roma nationality can obtain the status of RFHI insurer based on the statement that they are persons of Roma nationality and registration of their permanent residence at the address of the institution or SWC.

Praxis points out that in the period from July 2010 to March 2012, persons of Roma nationality were able to obtain health insurance based on the statement on the address of residence, without the request for fulfillment of conditions for formal registration of permanent residence. Specifically, the obligation to enclose the registration of permanent residence has been previously prescribed by the Rulebook of the Method and Procedure of Exercise of Rights from the Mandatory Health Insurance. After Praxis initiated the procedure for the assessment of constitutionality of the Rulebook before the Constitutional Court of the Republic of Serbia, the Rulebook was amended and the respective obligation abolished for the persons of Roma nationality without permanent or temporary residence. However, in March 2012, some RFHI branches started acting upon the Regulation on the content, form and manner of submitting an application for mandatory social insurance, requesting thereby from the Roma applicants to enclose the registration of temporary residence when applying for health insurance. However, in some RFHI branches, Roma applied in accordance with the rules of the amended Rulebook (without the registration of temporary residence). The application of the provisions of the Regulation has again imposed a hardly surmountable obstacle to the exercise of rights to health insurance and health care.

The adoption of RFHI Instruction directs the acting of the competent branches: adopted rules indicate that the acting bodies will require evidence on registered permanent residence in addition to the statement on belonging to Roma nationality.

Newly adopted solutions of the Law on Permanent and Temporary Residence of Citizens and accompanying bylaws were used as a basis for the adoption of new rules for acting of RFHI branches. However, it is worth pointing out that the registration of permanent residence at the address of SWC remains disputable. Polemics between the representatives of the competent ministries and services are still active, new solutions of the Law on Permanent and Temporary Residence of Citizens have not been consistently applied and social welfare centres receive requests for the registration of permanent residence at their address sporadically and rather reluctantly, mainly due to the lack of detailed information on the manner of acting. By observing the recent regulations in the concerned area, it can be concluded that the representatives of the competent ministries are still unable to provide complied and precise answers to some questions important for conducting of procedures needed to resolve the issue of registration of permanent residence. On the other hand, owing to the application of RFHI instruction, the branches  will require from persons of Roma nationality to enclose evidence on permanent residence, which is a condition many will not be able to fulfill unless the conditions for registration of permanent residence at the address of SWC are created.

The above stated supports the fact that the situation in the concerned area is confusing and additionally complicated by adoption of regulations that are not aligned with each other, that are insufficiently precise or contrary to the goals of protection of rights and interests of vulnerable population groups. In order to eliminate ambiguities, harmonize the procedures and solve socially sufficient problems of Roma population in the most adequate way, it is necessary to synchronize normative activities of responsible bodies, to approach the problem systematically and, certainly, to invest some effort to reach the solution as soon as possible, in order to enable the members of the vulnerable Roma population to access the right in a simplified manner.

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