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Dying for health care: Refugees, illegal workers face few options

Following is a weekly series that will explore healthcare issues for foreigners in Korea. - Ed. Andy, a refugee, fled to Korea in 2002, running from an oppressive regime, in the hopes of finding normality and liberty. As a refugee applicant, he hopes for a new future here. His case has been pending for five years. When Andy was diagnosed with a serious work-related injury recently, he did not have insurance, his employer did not provide its half of national medical insurance, and he was not compensated for sick leave. Although he has made much progress lately, he has been unable to work for two months. And yet - in terms of health care at least - he is one of the lucky ones. As a political refugee applicant, he took a labor-intensive job, as all refugee applicants in Korea do. The catch is that their refugee status does not permit legal employment. Because they are not permitted to work legally, they are often forced into accepting dangerous jobs and are usually not provided with any health insurance. They have no legal employment-rights, and employers are not bound to pay medical bills from work-related injuries - but Andy`s company did anyway. <**1>

"My company paid the medical bills for those ten days at a hospital and the MRIs that followed. My boss said I am not covered by the insurance system since I am a refugee applicant and not a documented migrant worker. But later he hesitantly told me that he would foot the medical bill if I have to undergo an operation," said Andy, who requested we use his nickname because of the sensitivity of his refugee request. Andy says the bigger question regarding health care for migrant workers is what to do about refugee applicants in Korea. "They have not yet been granted the asylum status they have been seeking by the government, nor have they been recognized as documented migrant workers. This condition puts all refugee applicants in Korea in a very awkward, risky and dangerous situation, in terms of health, work, education, insurance and personal safety," he said. Often referred to as three-D workers - who do difficult, dangerous, and dirty work - migrant workers number around 453,000, according to the Justice Ministry. Ministry statistics also peg the number of undocumented workers at 222,900. They account for around 2.4 percent of the total workforce, and most agree that the economy needs them at least as much as the workers need Korea. In terms of health care, the law is clear for registered migrant workers: They are to be treated the same as Koreans. Some, though, are not. More troubling issues lie with political-refugee applicants such as Andy and other undocumented migrant workers. By some estimates, they take up half of all migrant workers, but because they are in Korea illegally, they are not granted even basic health care. Many fear that if they turn up at a hospital or file a complaint with the Ministry of Labor, they will be deported. The director of Amnesty International Korea, Kim Hee-jin, told The Korea Herald: "(Documented) migrant workers have the same rights as Korean workers, by law. (But) I am not sure if it really happens in practice." Kim says the system itself is not the problem, and highlights the enforcement mechanisms and the dispersion of information among the migrant worker community as key problems. "As far as I am concerned, the insurance system for documented workers itself is fine. The main problem is not the system, but how employers see their employees. The health of the employees is not the priority for the employers." Under the Korea National Health Care System, the cost of health insurance is split 50:50 between employer and employee. But Kim says that documented workers can easily be taken advantage of because of their lack of knowledge of the health system. "In reality, many who don`t know the system would not understand where the cost burden falls for health insurance. A clearer explanation is needed." Most large corporations treat migrant laborers fairly and equally. The Amnesty International head sees smaller employers as the main violators. "Many big corporations have no differences between heath care for Korean workers and migrant workers. It is those small companies who often do not follow the policy. The monitoring system is not there, and that makes the problem worse." Local charity organizations have taken it upon themselves to provide medical care for migrant workers. The director of the Migrant Workers` Hospital, Kim Hae-sung, said in a telephone interview that the hospital was established in July 2004 because of the sharply increasing number of migrant workers, and that it is the only hospital of its kind in the world. They only accept foreigners. Before the special hospital was established, he had been aiding in making funeral arrangements for deceased migrant workers. "We did about 1,500 migrant worker funerals, and that included mistreated, or untreated, construction site accidents. Those people were not able to get treatment. Other cases included people who had sepsis and were treated with only pain relievers. "Being able to help arrange funerals was a necessary service, but we wanted to save lives too," the hospital director said. "Treatment, operations and admission are all free and the hospital is run by donations from the public and companies" and the government. Herald Media Inc., publisher of The Korea Herald, is one of the companies that contributes to the hospital`s funding. Last week, chairman Jungwook Hong donated $3,200 to the hospital, and he joined Herald employees by volunteering there for one day. Kim said the hospital treats both documented and undocumented workers. "Many workers (who do not have access to health care) are not able to get properly treated, or miss the period of being treated, so they die," he said. The hospital also established a shelter in which injured workers can stay overnight to receive treatment. There are about 300 workers living in the shelter currently. The reason so many go without any health insurance, according to Kim, is that the cost is so high. "Foreign workers can freely apply for health insurance, but the cost is high, so they have no money to apply." Kim from Amnesty International says that mistreated registered migrant workers should contact organizations that can help them. "Often, the migrants` service providers call the employer and request compensation in a strong way." But she added that, in the case of undocumented workers, there is no hope for help from employers unless, as in Andy`s case, the employer voluntarily provides treatment. But those cases are few and far between. "If it is an undocumented (worker), compensation (from employers) will never happen." By Matthew Lamers (mattlamers@heraldcorp.com) Mina Yeom contributed to this story.

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