States Parties recognize the right of the child to the enjoyment of the highest attainable standard of health and to facilities for the treatment of illness and rehabilitation of health. States Parties shall strive to ensure that no child is deprived of his or her right of access to such health care services.
Convention on the Rights of the Child, Article 24.1
Payment for health-care services, as well as services related to the underlying determinants of health, has to be based on the principle of equity, ensuring that these services, whether privately or publicly provided, are affordable for all, including socially disadvantaged groups.
CESCR General Comment No. 14: The Right to the Highest Attainable Standard of Health (Art. 12)
Mothers and children, irrespective of marital status and family relations, have the right to appropriate social and economic protection.
European Social Charter, Article 17
For many years Czech authorities fail to recognize the right of children from non-EU countries, whose parents are employed in the Czech Republic, to access financially available quality health care. The only health care plan option available for those children for 5 long years has the scope of a travel insurance (no pre-existing conditions, oncology, HIV or mental health covered) with occasional pediatric visits. Managing conditions that private health insurance doesn’t cover out of pocket can’t be considered an available alternative even in case of minor problems, as foreigners from outside the EU are paying on average triple prices for every medical service.
The table below illustrates that the discriminating Czech approach towards children of publicly insured third-country nationals is a unique dishonorable practice among other European countries.
Health insurance market in different countries of the European union is very alike, with each country guaranteeing universal health care to its residents. Generally, universal health care is provided through a solidarity system of public health insurance funded by tax-payers (with the exception of the Netherlands where it is provided by a highly regulated market of private health insurance companies). Private health insurance is considered a complementary option offering premium services – wider provider network, shorter waiting times, co-payments reimbursement for public health insurance, extra coverage like massages or single hospital rooms.
EU country | Market specifics | Children | Unemployed spouses |
---|---|---|---|
Austria | Public health insurance, complementary private health insurance offers premium services. Everyone who resides in the country for more than 6 months can enroll into public health insurance. | Co-insured with the employed parent at no extra cost | Co-insured at no extra cost if engaged in raising one or more children living in the same household. Otherwise spouses pay the premiums themselves. |
Belgium | Public health insurance with co-payments, private health insurance offers premium services and co-payments coverage. | Co-insured with the employed parent at no extra cost till age 25 unless they are fiscally independent | co-insured with the employed foreigner, fixed premium is payed. |
Bulgaria | Public health insurance (NHIF), private health insurance offers premium services. Everyone who holds long-term residence permit is enrolled into NHI. | Enrolled into NHIF with state paying the premiums till 18 y.o | Enrolled into NHIF, fixed premium is payed. |
Croatia | Public health insurance with fixed co-payments, private health insurance offers premium services and co-payments coverage. | Children have public health insurance. Child of a foreigner outside of EU pays minimal premium. Child of a EU resident has their premiums covered by the state. | Spouses of employed foreigners have public health insurance. If a spouse is a third-country national they pay minimal premium, EU residents don’t pay anything. |
Cyprus | Public health insurance (GHS) with fixed co-payments, private health insurance offers premium services and co-payments coverage. | Children (less than 26 y.o) of employed foreigners are enrolled into general healthcare system (GESY) | Enrolled into GESY |
Czech Republic | Universal healthcare through public health insurance, private health insurance specifically for foreigners with limited coverage similar to travel insurance (no pre-existing conditions, cancer, mental health coverage). Public and private health insurances for foreigners are mutually exclusive – once a foreigner becomes eligible for public health insurance, their private health insurance is annulled. | Private health insurance for foreigners only with limited coverage | Private health insurance for foreigners only with limited coverage |
Denmark | Public health insurance, private health insurance offers premium services. All residents of Denmark are entitled to public health insurance. | Insured together with the employed parent at no extra cost till 15 y.o | Enrolled into public health insurance, pays fixed premium |
Estonia | Public health insurance. All residents can sign an insurance contract with the Health Insurance Fund. | Insured together with the employed parent at no extra cost till 19 y.o | Enrolled into public health insurance with fixed premiums, for pregnant women or those raising kids premiums paid by the state |
Finland | Public health insurance. Private health insurance offers premium services but is uncommon. Persons who are residents of a Finnish municipality (i.e., have a place of domicile in Finland) are entitled to the public healthcare. | Enrolled into public health insurance at no extra cost. | Enrolled into public health insurance |
France | Public health insurance, private health insurance offers premium services. All residents get access to state healthcare after three months of residence. | Co-insured with an employed parent at no extra cost till 18 y.o. | Co-insured with the employed foreigner at a fixed percent of his salary |
Germany | Public health insurance, private health insurance offers premium services. All legal German residents get access to Government Health Insurance System. | Co-insured with an employed parent at no extra cost | Co-insured with the employed foreigner at no extra cost |
Greece | Public health insurance with fixed co-payments, private health insurance offers premium services and co-payments coverage. All legal residents are entitled to Social Health Insurance. | Co-insured with the employed parent | Co-insured with the employed foreigner |
Hungary | Public health insurance, private health insurance offers premium services. All long-term residence are entitled to public health insurance. | Enrolled into public health insurance, before permanent residence pay the monthly premium (~60% of the adult premium) | Enrolled into public health insurance, pay fixed monthly premium (around 230 euros in 2018) |
Ireland | Public health insurance, widely utilized complementary private health insurance offers premium services and fees compensation. Every ordinary resident (who is living or intending to live for at least 1 year in Ireland) is eligible for public health insurance (Health Service Executive or HSE) | Enjoy same entitlement to health services as their parents. Child care till age 6 is free of charge. | Enroll into HSE. Maternity services are free of charge. |
Italy | Public health insurance with occasional co-payments, private health insurance, though uncommon, offers premium services and fees compensation. Every legal resident is entitled to public health insurance (Servizio sanitario nazionale or SSN). | Enroll into SSN. Pregnant women are exempt from fees. | |
Latvia | Public health insurance, complementary private health insurance offers wider network and premium services. | Children of an employed parent can enroll into public health insurance system. | Can enroll into public health insurance system, if taking care of a child less than 7 y.o or at least 3 children less than 15 y.o. Otherwise only private health insurance option is available. |
Lithuania | Public health insurance, complementary private health insurance offers premium services. | Children are publicly insured till 18 y.o, state pays the premium | State pays the premium for pregnant women up to 56 days after delivery. Otherwise spouses need to get private health insurance. |
Luxembourg | Public health insurance with fixed co-payments, private health insurance is a popular option of additional coverage providing premium services and co-payment reimbursement. | Children are co-insured with the employed parent at no extra cost till 30 y.o. | Spouses living in the same household are co-insured with the employed person. |
Malta | Public health insurance, private health insurance is uncommon. | Co-insured with the employed parent at no extra cost till 18 y.o. | Co-insured with the employed foreigner at no extra cost |
The Netherlands | Social Health Insurance System is comprised of private entities – no public health insurance. Everybody has private health insurance. | Private health insurance, children till 18 years don’t pay the premium | Private health insurance |
Poland | Public health insurance (Public National Health Fund) insurance, complementary private health insurance providing premium services. | Co-insured with the employee at no extra cost | |
Portugal | Public National Health Service (Servico Nacional de Saude, SNS), complementary private health insurance offers over premium services and co-payment reimbursement. Any legal resident of Portugal is eligible to enroll into public health system. | Co-insured with the employed parent at no extra cost. | Co-insured with the employee at no extra cost. |
Romania | Public health insurance, complementary private health insurance offers premium services and co-payment reimbursement. Any person who is legally resident in Romania can benefit from the national health insurance system from the date of starting the contribution payment to the fund. | Don’t pay the premium till 18 y.o or till 26 y.o in case of study | Enrolled into public health insurance, fixed premium is paid. Pregnant women or those who just recently gave birth don’t pay the premium. |
Slovakia | Public health insurance, private health insurance uncommon. | Public insurance if a parent has public health insurance, state pays the monthly premium | Public health insurance in case of contractor work, private health insurance otherwise |
Slovenia | Public health insurance, complementary private health insurance. | Enrolled into public healthcare, free of charge till 15 y.o (or 26 y.o in case of study) | Enrolled into public healthcare |
Spain | Public health insurance, private health insurance provides premium services and co-payment reimbursement. | Co-insured with the employed foreigner if residing in Spain. Pregnant women or those who just recently gave birth are publicly insured with premiums paid by the state. | |
Sweden | Public health insurance, private health insurance offers premium services and co-payment reimbursement. Everyone staying or intending to stay for over 12 months in Sweden is considered a resident and entitled to public healthcare. | Entitled to public health insurance, all services are free of charge till 18 y.o | Entitled to public health insurance |