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Malaysia: Employers must pay all medical cost of workers especially when it is a work-related accident or an occupational disease.

We, the undersigned 53 organizations, groups and networks are appalled that the Malaysian Government is now asking about 1.5 million migrant workers themselves, and not their employers, to buy a new Foreign Workers Hospitalisation and Surgical Insurance. If these migrant workers do not do so, the Malaysian government is threatening not to renew their work permits. The Malaysian Health Minister, Datuk Seri Liow Tiong Lai, also stated that the worker’s work permits will not be renewed if there are outstanding hospital bills. [Bernama, 7/1/2011, Foreign Workers with Insurance May Enter Hospital without Deposit]

What is worrying is that workers should never be required to pay for their treatment and necessary healthcare especially if the reason treatment is sought is a work-related or industrial accident, or some occupation-related disease.

With regard to migrant workers in Malaysia, who are required to get a clean bill of health before they enter Malaysia, and before they are given a work permit, it is only right for employers to be liable to pay for all treatment and medical charges if they do get sick in Malaysia. Further, it is generally the employer that determines where these workers must stay and work.

In Malaysia, whilst the social security of local workers are covered by the Social Security Act, migrant workers are covered by the lesser Workmen’s Compensation Act 1952, which unlike the former do not provide for continuous regular support and assistance until death for a worker who is a victim of an industrial accident or occupational disease. The Workmen’s Compensation Act, on the other hand, only provides for a one-off payment to the victim and/or their dependents where death has resulted from the injury/disease, that is a lump sum equal to sixty months' earnings or RM18,000, whichever is the less.

It is good that the Workmen's Compensation (Foreign Workers' Compensation Scheme) (Insurance) Order 1998, extended coverage to personal injury (and death) that is sustained in an accident which occurs outside the working hours of the workman. Given this fact, there only needs to be a minimum extension of coverage to cover any remaining matters that will require treatment, hospitalization and/or surgery, and this could be done quite easily by amending the relevant Act and/or broadening the scope of the current insurance that employers already do have to buy for their foreign workers.

Malaysian Health Minister, Datuk Seri Liow Tiong Lai, was reported saying that this new insurance was to ensure that foreign workers’ medical bills in public hospitals, which to date total RM18mil, will not be a burden to the Government. (Star, 26/11/2010, Compulsory medical insurance policies for foreign workers from next year). However, this cannot be right as there should not be any outstanding migrant worker medical bills at all.

Under the Workmen’s Compensation Act, the employer is clearly liable to pay for the conveyance to the hospital, treatment, ward charges, medicines and other expenses incurred in the treatment and rehabilitation of such workmen (sec.15).  The employer is clearly liable to pay directly to the management of such hospital all fees and charges, and as such one wonders what unpaid medical bills the Minister is talking.

Further, attention also should be drawn to Workmen's Compensation Regulations 1953, in particular Regulation 18, which deals with the issue of excess fees, “A workman admitted either to an approved or a special hospital shall, where such hospital is a private hospital, himself be liable to pay the amounts of any fees or costs incurred on his behalf in excess of the maximum amounts prescribed by the Minister of Health under section 15 (3) of the Act, and, where such hospital is a government hospital, such excess amounts shall be paid from public funds.” Since, the Minister is talking about government hospitals, there is certainly no way that there exist outstanding medical bills when it comes to migrant workers.

The Malaysian pro-employer government has proceeded to further protect employers of migrant workers by limiting the maximum amount fees and cost that is payable by an employer under the Workmen’s Compensation Act. As of 1st March 2007 (PU (A) 077/2007), this maximum liability of an employer for ward charges, including surgical ward treatment fee is RM300, for operation fees it is RM250, for X-Ray Fees it is RM100 and for other electric therapeutic charges it is RM100.

The rates stipulated are outrageously low given the fact that government hospitals and clinics charge migrant workers first class rates, and the lowest deposit for a migrant worker who needs to be warded is RM400, and if it was a surgical case, it is RM800-00. Operation charges can range from RM50 to RM3,000 depending on the type of operation. Ultrasound cost RM100. Radiology charges range from RM50-RM600. Lab charges range from RM5 to RM100 depending on the type of tests, and usually there will be quite a lot of tests needed.

But, even when the government does limit the amount that the employer is liable to pay, the excess as stipulated in Regulation 18 of the Workmen's Compensation Regulations 1953 is paid from public funds, and as such there really is no logical reason why there can ever be outstanding debt. It is really hoped that in Malaysia, the government does not expect the migrant worker to come up with the money themselves before the necessary treatment and/or surgery is done. Employers should make all the necessary payments immediately, and should thereafter do the needful to claim whatever excess payment from the public fund.

The Health Minister is naïve to insist that the migrant worker only need to provide their passport before treatment is given, as in most cases the employers and/or the agent do wrongly hold on to the passports of migrant workers. Sometimes, the passports are with immigration authorities and/or some other authorities. Hence, in the name of justice, all necessary treatment must be immediately provided to migrant workers on their arrival and registration, without insistence on the production of passport and/or payment of any large deposit. Let not the absence of a document and money be the cause of death or the loss of limbs of a migrant worker in Malaysia.

It is also very wrong to threaten to penalize the migrant worker with non-renewal of work permit, when any punishments in law should rightly be against the employer and should not in any way jeopardize the rights and the well being of migrant workers already in Malaysia.

We, the undersigned groups, hereby:-

a) Call on the Malaysian Government to ensure that all employers of migrant workers, not just those that employ domestic workers and in the plantation sector, be liable to pay for this new Foreign Workers Hospitalisation and Surgical Insurance;

b) Call on the Malaysian government to ensure that no worker would be made liable to pay for the conveyance to hospital, treatment, ward charges, medicines and other expenses following a work-related accident and/or for some occupational disease.

c) Call on the Malaysian government to repeal Maximum Amounts for Fees and Costs (PU (A) 077/2007), and ensure that employers of migrant workers be liable to pay reasonable amounts consistent with the rates imposed by the government for medical care and treatment of migrant workers at government hospitals.

d)  Urge the Malaysian government to review and remove the differential rates being charged for Malaysians and other foreigners, especially migrant workers, at government hospitals and healthcare facilities.

e)   Urge the Malaysian government to review the policy of ‘No Treatment until Production of Passport and payment of deposits”, and ensure that all who needs medical treatment and care are immediately given the said required care that will prevent loss of life and/or limbs.

 

Charles Hector

Pranom Somwong

 

For and on behalf of the following 53 organizations

Aliran

Archdiocesan Human Development Commission (AHDC)

Asia Pacific Forum on Women , law and Development ( APWLD )

Asian Migrant Centre(AMC)

Association for Community Development-ACD, Bangladesh

Building and Wood Workers’ International Asia Pacific Regional Office (BWI-APRO)

Burma Campaign Malaysia

Cambodian Defenders Project (CDP), Cambodia

Cambodian Human Rights and Development Association (ADHOC)

Cambodian League for the Promotion and Defense of Human Rights (LICADHO)

CCC  Netherlands

Center for Orang Asli Concerns (COAC), Malaysia

Civil Right committee, Kuala Lumpur & Selangor Chinese Assembly Hall

Committee of Asian Women, CAW

Democratic Party for New Society (DPNS), Burma

Health Equity Initiatives

Hsinchu Catholic Diocese Migrants and Immigrants Service Center (HMISC), Taiwan

IMA Research Foundation, Bangladesh

INFID, Indonesia

Judicial System Monitoring Program (JSMP), Timor Leste

Labour Behind the Label, United Kingdom

Legal Support for Children and Women(LSCW), Cambodia

MADPET - Malaysians against Death Penalty and Torture

Malaysian Trades Union Congress (MTUC)

Manggagawang Kababaihan Mithi ay Paglaya (MAKALAYA), Philippines

MAP Foundation, Thailand

Mekong Migration Network (MMN)

Metal Industry Employees’ Union, Malaysia

Migrant Care, Indonesia

Migrant Health Association, Korea

Migrante International

Migrants Rights Council, India,

Myanmar Youth Knowledge Initiative

Network of Action for Migrants in Malaysia (NAMM)

NGOs in Myanmar Web Portal

PACOS Trust

Penang Office for Human Development (POHD)

Persatuan Kesedaran Komuniti Selangor (Empower)

Persatuan Masyarakat Selangor & Wilayah Persekutuan (PERMAS)

Pusat Komas

Sarawak Dayak Iban Assocoation

Solidaritas Perempuan (Women's Solidarity for Human Rights), Indonesia

Suara Rakyat Malaysia (SUARAM), Malaysia

Thai Committee for Refugees (TCR)

Think Centre, Singapore

Transient Workers Count Too (TWC2), Singapore

UNI Global Union-Malaysia

Verite Southeast Asia

Vietnam Committee on Human Rights, France

WARBE Development Foundation-Bangladesh

WIRDA (Women Institute for Research Development and Advancement)

Women's Legal and Human Rights Bureau, Inc. (WLB), Philippines

Workers Hub for Change (WH4C)

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