HANOI - A survey shows up to 90 per cent of country people who move to big cities aren't covered by social insurance and they don't qualify for subsidised care while they are away from their areas.
One new resident is Nguyen Duy Linh, 24, from Thanh Hoa Province, 130km south of Ha Noi. Linh is, in fact skilled, and found a job as an accountant at a small private company in Ha Noi after he graduated from the Ha Noi Business School in 2009. He is, however, poor and receives VND1.5 million (S$90) a month due to his modest experience.
The company boss refused to sign a work contract with Linh, because the labour law obligates his boss to pay social and health insurance fees for a worker with a contract over three months.
Consequently, Linh's life changed dramatically when he was diagnosed with kidney failure and had to live on dialysis.
"I have no health insurance. My income is not enough to pay for dialysis," said Linh. "My parent have to work hard to support my treatment, at around $300 per month."
Linh is one among millions of rural workers who moved to urban areas and now face difficulties due to the unhygienic environment and no health insurance coverage.
At a recent workshop on immigrant health in Ha Noi, Health Minister Nguyen Thi Kim Tien said unofficial statistics showed 30 per cent of urban residents were from the countryside.
"This contributed to the increase of transmitted diseases like dengue fever, diarrhoea and malaria," said Tien.
However, the labourer demographic was poor and consequently of low priority for the health and insurance sectors, she said.
Tien said the health ministry would collaborate with the International Organisation for Migration to research the health of new residents with an aim to proposing policies to minimise problems with their health care access.
Health experts said employers did not care much about the health and living conditions of their labourers, especially new residents who lacked support to improve their strength and awareness and minimise risks.
The Ministry of Health statistics showed only 30 per cent of private companies paid health insurance fees for their workers and 90 per cent of new residents from the countryside had no social insurance. They usually worked 14-15 hours a day, seven days a week and lived in unhygienic environment due to low incomes.
In Ha Noi, only 11 per cent of new resident labourers had work contracts compared with 90 per cent of local residents.
Deputy director of the Health Ministry's preventive medicine department Tran Thanh Duong said the new residents faced difficulties in accessing health insurance services away from their home towns.
For example, new residents only got paid 30 per cent of the health examination and treatment fees if they were away from their home areas.
Consequently many went without health care because they could not afford it.
"New residents don't even have access to the National Tuberculosis Prevention Programme."
Duong also said there was not enough research on their health condition in view of increased movements to big cities
Health Ministry legal department deputy head Nguyen Huy Quang said some regulations had shortcomings or were infeasible.
Health experts recommend health education be promoted by leaflets or holding direct talk with new residents and that research on the health of new residents be carried out to propose effective intervention and a communication programme.