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Immigrants to lose medical aid under pending law amendment

Source: The Daily Herald 22 Nov 2014 06:22 AM

PHILIPSBURG--Immigrants, whether they hold permanent residence or temporary residence, will see their possibility of accessing medical and financial aid disappear if Parliament passes the draft National Ordinance on improving financial management of social security and care. The ordinance's general goal is cost savings for government.

The draft law is not yet in Parliament's hands, but an overview of it was given to Members of Parliament (MPs) by representatives of the Ministry of Public Health, Social Development and Labour VSA in a public Central Committee meeting on Friday.

The draft ordinance has as its motives introduction of measures to generate income for the Sickness Fund, protecting the country's budget, measures for improved management of health care-spending, improving the quality of care and a stepwise approach to National Health Reform.

To achieve those motives, changes are required to multiple existing legislations – Financial Assistance Ordinance, Medical Aid Ordinance, Social Health and Insurance SZV Ordinance and Sickness Insurance Ordinance.

Proposed change to the Financial Assistance Ordinance seeks to adjust the regulation to coincide with the ordinance regulating admittance and expulsion of immigrants LTU. The current ordinance allows persons with a residency permit to place a claim on financial assistance. The change will take away this possibility for people who are non-Dutch residents as the LTU requires them to have sufficient means of supporting themselves while in the country. The goal of this change is cost savings for government.

For the medical aid ordinance, the proposed changes call for an adjustments-in-care package with the goal of cost savings for government. There will also be the introduction of the obligation of residents to insure against expenses for medical treatment and care with the purpose of the stepwise approach to National Health Reform.

Also, there will be an introduction of the obligation to pay a premium to generate income for the Sickness Fund. This increase in income will enable the expansion of the population eligible for medical aid based on a solidarity principle, and give people who cannot be insured elsewhere, or experience difficulties insuring elsewhere, access to an affordable health care insurance.

Currently, medical aid is only given to persons with an income below NAf. 3,578, who have the Dutch nationality with over three months residence in the country, and to people with permanent residency (indefinite admission) with over five years residence in the country.

The changes to the medical aid ordinance, once presented and accepted by Parliament, will see all persons residing in the country, but do not have the Dutch nationality, be unable to access medical aid, unless they are age 60 or older with 15 or more years of residence in the country.

Sole proprietors with an income below NAf. 210 a day (the wage limit of Sickness Insurance Ordinance) will be able to access medical aid for the first time under the law change. Those sole proprietors who are above the wage limit, but can prove they cannot get coverage elsewhere due to pre-existing conditions, will also be covered by the change.

People with Dutch nationality with over three months residence in the country will continue to access medical aid. People with Dutch nationality who are over age 60 and have five years residence here will also be able to access medical aid.

Proposed changes to the SZV Ordinance seek the introduction of an interchangeable balancing fund (schommelfonds) covering the Sickness Fund and Accident Fund, as well as the Retirement Fund and Widow's and Orphan's Fund.

Proposed changes to the Sickness Ordinance aim to raise the wage limit, have former employees obligated to register as actively seeking work to promote quick return to job market and filter out persons who are no longer allowed to reside in St. Maarten based on their residence permit. Also, the changes will establish a right to medical treatment and care in French St. Martin and the former Netherlands Antilles (islands), based on care contracts.

So far, the draft ordinance has been a preparation of ordinance by Ministry VSA, presentations have been made to the Council of Ministers and stakeholders, and discussions were had with SZV. Still to be completed before the draft ordinance heads to Parliament are the advice of the Social Economic Council SER, approval of the Council of Ministers and the advice from the Advisory Council, and the writing of Further Report in response to that advice.

MPs welcomed the presentation and interacted with the ministry representatives about the draft law and other related health issues.


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