Czech Healthcare Act Update
We’ve reported previously on proposed amendments to the Public Health Insurance Act in Czechia; this has now been passed by the government. Minister of Health Vlastimil Válek says that the new legislation will be implemented in 2026 and will increase coverage options, for instance to include some types of dental treatment. It will also increase oversight of insurance companies and is aimed at improving benefits for those with health insurance. In addition, it will provide regional scholarship programmes to attract new doctors, allow for engagement with foreign healthcare providers, and fund patient organisations. This is a wide-ranging initiative.
Válek told the press that:
“The responsibility of insurance companies is now more clearly defined. Every Czech citizen is insured not by the Ministry of Health but by their specific health insurance provider…We are granting health insurance companies much greater flexibility to create incentives for policyholders who actively manage their health. They will be able to allocate up to six times more funds than they currently can.”
There’s also a focus on preventative care. Like many countries in the EU and elsewhere, Czechia suffers from long waiting times and variations in levels of care across regions. This new legislation is designed to try to address some of these issues.
Thai Health Insurance ‘Needs Clarification’
After a young British man fell off a motorbike in Pattaya and was denied treatment under his insurance policy, UK insurers have asked for more clarity surrounding healthcare for foreign nationals in Thailand. 28-year-old Jonathan Cobb was not wearing a crash helmet, and thus fell foul of a clause in insurance legislation which rules out cover in cases of “negligence, intent, illegal acts or risky behaviour.” Usually, the Thai health authorities will treat foreigners free of cost if they have a tourist visa, but this exemption clause ruled that out in Cobb’s case, and his parents had to pay £7K for his treatment.
The regulations are also unclear. It isn’t apparent, for instance, if the five-year Destination Thailand Visa includes free accident cover. Some retirement visas require you to have health insurance but some do not. Immigration lawyer Jessataporn Bunnag told the Thai press that:
“The government in recent years has introduced a host of different entry choices for tourists and long-stay expats to increase treasury income. However there has been little coordination which has led to confusion.”
Language Issues in Germany
According to recent reports, relatively few doctors in Germany speak English, resulting in communication issues for English-speaking expats in the country. Doctors rely on translators when seeing English-speaking patients, but it can be difficult to get hold of one. There are charities which provide translation services, such as the Leipzig-based Communication in Medical Settings, but these are few and far between. The government is apparently planning to introduce translation provision covered by the state health service, but it’s not clear when this will be implemented. Experts say that the government seem to regard it as a ‘nice to have’ rather than a ‘need to have,’ but add that as Germany becomes increasingly multicultural, with a high input of immigrant labour, communication in all areas of life needs to be as smooth as possible.
The German Medical Association voted in May in favour of translation services, saying that:
“Every day, we doctors treat patients whose mother tongue is not German. Often, communication is only possible with the help of family or colleagues from the medical profession, nursing staff or service personnel. This unprofessional language mediation is not only a burden for the translator, but also for the medical team and the patients, and it complicates the diagnosis or the appropriate treatment.”
Other nations are ahead of Germany in this respect. In Sweden, for instance, doctors can book a conference call with a translator, and you are legally entitled to have your medical notes written in a language you can understand.
If you’re in Germany and looking for an English-speaking doctor, this website may be of use: https://gesund.bund.de/en/search/doctors.
In-House Therapy on the Rise in the Netherlands
The Dutch press reported in November that company psychologists are becoming increasingly popular due to long waiting lists for mental health services. Companies such as HumanCapitalCare and PSION have taken on more therapists for their personnel. Occupational psychologist Sandra Bleyenberg at Arboned told the press that this was partly a cost issue:
“Employers know that having someone wait at home for treatment is often more expensive than quickly providing the right help. Shorter absences or preventing absences pay for themselves.”
It’s also due to the rise in mental health issues post-Covid. Company psychologists may have to refer some cases back into the mental health system, and there are also concerns about confidentiality. Personnel might not want to confide personal and sensitive information to someone who is essentially part of their employment structure. HR director at accountancy firm EY Maarten Lintsen says that his company is conscious of this and encourages anonymity, but is working on putting outside provision into place. He notes, however, that company psychologists can discern trends: in EY’s case, that expats often have issues due to lack of social support. The company set up a community to address this.
It is not just the Netherlands in which in-house psychology is growing in popularity. In February of this year, the BBC published an article on the phenomenon, citing Delta Airlines and Comcast as examples of companies who employ in-house therapeutic personnel. Delta, in fact, has on-site therapists at airports.
In the USA in particular, counselling is expensive and often not covered by health insurance – and it’s badly over subscribed. Companies such as America’s Premise Health, which offers on-site medical care, now has over 90 therapists placed in the corporate sector. In India, the gap is even greater, with again a corresponding increase in on-site therapy. With mental health issues on the rise, and a gap between patient and provision, we’re likely to see this phenomenon continue to grow in the next few years.