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Inequalities and Multiple Discrimination in Access to Health Care in Austria
Carmen Munteanu - Communications Coordinator
28 May 2014
The International Centre for Migration Policy Development (ICMPD) together with the Research Institute of the Red Cross published a framework document for the comparative report "Inequalities and multiple discrimination in access to health care", prepared by the Agency for Fundamental Rights (FRA).
The paper gives an overview of the main features and the structure of the Austrian health care system and analyses the anti-discrimination legislation, based on site conditions.
The health care system
Austria’s health care system is based on compulsory insurance through public health insurance funds. Most people benefit from health insurance through employment, but lower income persons - particularly those who are not eligible for unemployment benefits or minimum social aid - are generally excluded from the system. Public hospitals are however bound to treat patients regardless of their insurance status in case of medical emergencies. Migrants without documents and citizens from other EU Member states who work informally, as well as asylum seekers who abandoned the procedure are the most vulnerable categories.
The Austrian health care system is similar to other universal tax based systems such as those in the UK or Sweden. Despite the relatively large coverage and despite the principle of equal treatment consecrated in the health legislation, there are serious differences in treatment between various categories of persons. The access of groups at risk to medical services has recently improved through the general prevention programmes and the implementation of minimum social aid schemes. However these schemes refer only to EU and SEE citizens and third country nationals with a permanent residence; other categories, such as asylum seekers, migrants without documents, third country nationals with temporary stay who are not insured, cannot benefit from minimum social protection.
Antidiscrimination legislation
Austria has a tradition in the development of gender equality legislation, but has not worked with a coherent anti-discrimination system in relation with other criteria unless forced to do so by non-discrimination directives. Discrimination on the basis of age, gender, race, religion, beliefs, sexual orientation was covered by two laws on equal treatment; disability was however subject to different bills. The transposition of the community acquis resumes in Austria the already existing inequalities between different vulnerable categories. Thus discrimination on the basis of disability, religion and belief, sexual orientation and invalidity is forbidden only with respect to employment, but not to the access to goods and services.
Although the Commission for Equal Treatment noted that most cases of discrimination are based on race and gender grounds and occur in relation with employment and access to housing, goods and services, health care is an area for which discrimination has not been documented. The fragmented nature of the legal framework and the poor institutional capacity of specialised health care bodies do not offer any solution for the cases of discrimination in the area of health care.
Statistical data
Data collected in 2006 and 2007 through Austria Survey Health offer more useful information than periodical statistics and enable a separation by gender, age and immigrants. An analysis of these results made it possible to identify certain patterns related to gender, age and migration history, both with respect to the health condition and to access to medical services. Results should be interpreted carefully, because ethnicity or migration can be easily considered risk factors while there are actually other factors of social inequality, such as poverty and unemployment, which influence the results. Austria’s report on "socio-demographic and socio-economic determinants of health" brings forward other health determinants, in addition to age, gender and immigration, such as: income, education, occupational status, unemployment. Certain groups are of course more frequently affected by certain health issues, but a multi-causal analysis of morbidity should be undertaken in order to identify the factors influencing the health of various groups.
The Austrian health care system has certain structural deficiencies, although it aims to universal coverage. The long waiting time for medical treatment, the discrepancies between planning and budget assignments, the bureaucracy in the case of treatments requiring approvals from the public health fund are some examples. Even when medical staff is aware of the need for cultural adaptation of the services to patients and of the need of special training of medical staff, the system’s structural problems may act as barriers to migrants’ access to medical services.
Source: http://www.icmpd.org
The paper gives an overview of the main features and the structure of the Austrian health care system and analyses the anti-discrimination legislation, based on site conditions.
The health care system
Austria’s health care system is based on compulsory insurance through public health insurance funds. Most people benefit from health insurance through employment, but lower income persons - particularly those who are not eligible for unemployment benefits or minimum social aid - are generally excluded from the system. Public hospitals are however bound to treat patients regardless of their insurance status in case of medical emergencies. Migrants without documents and citizens from other EU Member states who work informally, as well as asylum seekers who abandoned the procedure are the most vulnerable categories.
The Austrian health care system is similar to other universal tax based systems such as those in the UK or Sweden. Despite the relatively large coverage and despite the principle of equal treatment consecrated in the health legislation, there are serious differences in treatment between various categories of persons. The access of groups at risk to medical services has recently improved through the general prevention programmes and the implementation of minimum social aid schemes. However these schemes refer only to EU and SEE citizens and third country nationals with a permanent residence; other categories, such as asylum seekers, migrants without documents, third country nationals with temporary stay who are not insured, cannot benefit from minimum social protection.
Antidiscrimination legislation
Austria has a tradition in the development of gender equality legislation, but has not worked with a coherent anti-discrimination system in relation with other criteria unless forced to do so by non-discrimination directives. Discrimination on the basis of age, gender, race, religion, beliefs, sexual orientation was covered by two laws on equal treatment; disability was however subject to different bills. The transposition of the community acquis resumes in Austria the already existing inequalities between different vulnerable categories. Thus discrimination on the basis of disability, religion and belief, sexual orientation and invalidity is forbidden only with respect to employment, but not to the access to goods and services.
Although the Commission for Equal Treatment noted that most cases of discrimination are based on race and gender grounds and occur in relation with employment and access to housing, goods and services, health care is an area for which discrimination has not been documented. The fragmented nature of the legal framework and the poor institutional capacity of specialised health care bodies do not offer any solution for the cases of discrimination in the area of health care.
Statistical data
Data collected in 2006 and 2007 through Austria Survey Health offer more useful information than periodical statistics and enable a separation by gender, age and immigrants. An analysis of these results made it possible to identify certain patterns related to gender, age and migration history, both with respect to the health condition and to access to medical services. Results should be interpreted carefully, because ethnicity or migration can be easily considered risk factors while there are actually other factors of social inequality, such as poverty and unemployment, which influence the results. Austria’s report on "socio-demographic and socio-economic determinants of health" brings forward other health determinants, in addition to age, gender and immigration, such as: income, education, occupational status, unemployment. Certain groups are of course more frequently affected by certain health issues, but a multi-causal analysis of morbidity should be undertaken in order to identify the factors influencing the health of various groups.
The Austrian health care system has certain structural deficiencies, although it aims to universal coverage. The long waiting time for medical treatment, the discrepancies between planning and budget assignments, the bureaucracy in the case of treatments requiring approvals from the public health fund are some examples. Even when medical staff is aware of the need for cultural adaptation of the services to patients and of the need of special training of medical staff, the system’s structural problems may act as barriers to migrants’ access to medical services.
Source: http://www.icmpd.org
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