Protect migrant workers too

THE South-East Asian region is home to major labour-sending countries (Indonesia, the Philip­pines, Myanmar) as well as labour-receiving countries (Malaysia, Singapore, Thailand, Brunei, which also receive large numbers of labour migrants from Nepal, Bangladesh, India).

In Malaysia, about one in four employed persons are migrants. In Singapore, foreigners account for about 40% of the island’s total workforce (2012), while in Thailand (2010), there were 2.46 million low-skilled migrants from three neighbouring countries (Laos, Myanmar, Cambodia).

Host countries benefit from the enhanced economic growth that migrant labour makes possible, while migrants benefit from employment and livelihood opportunities.

The social dimension of Asean’s regional integration however seems to have taken a back seat to trade liberalisation and regional econo­mic integration, judging by the glacial pace of progress towards a mandate (and instrument) for the enforcement of the Asean Declaration on the Protection and Promotion of the Rights of Migrant Workers (2007).

Universal Health Coverage

In the South-East Asian region, citizens of Malaysia and Singapore have long benefited from widely accessible tax-funded or subsidised government healthcare, and Brunei nationals (who do not pay personal income taxes) enjoy wide-ranging health and social benefits at public expense. In Thailand, the National Health Security Act (2002) extended healthcare coverage beyond civil servants and their dependents, and employees in the formal (private) sector, to the majority of the population who hitherto had limited access to healthcare.

The Philippines National Health Insurance Program (PhilHealth), established in 1995, reported that 79% of Filipinos were covered by 2013. Indonesia established a national health insurance scheme (Jaminan Kesehatan Nasional) in November 2014 with the ambitious target of enrolling 121.6 million citizens in the first year and achieving universal coverage for a projected 250 million citizens by 2019.

Universal Health Coverage (UHC), in a national context, often translates, however, into citizen entitlements, leaving migrant workers (documented and undocumented), refugees, and asylum seekers to fall through the cracks.

Not surprisingly, labour-sending countries favour more generous “quasi-citizen” access to social benefits for migrant workers in their host countries.

Trickle Down Regionalism?

The three labour-receiving Asean countries however (Malaysia, Singapore, Thailand) appear more preoccupied with a different category of health-seeking foreigner, namely, “medical tourists” which in Malaysia and Singapore may also include migrant workers with private insurance coverage. The Malaysian Government, for instance, which controls the second largest listed healthcare provider in the world, IHH Healthcare, focuses more on an integrated regional health market than on a regionally harmonised social policy.

On June 24, following its earlier public forums on regional labour migration, SEA Junction, in collaboration with the Heinrich Böll Stiftung, led a discussion on Seeking Health Across the Border, at Bangkok Art & Culture Centre.

It soon became clear that a very basic issue, namely the lack of a uniform definition of a “medical traveller” which had been demonstrably operationalised by reporting sources, remained problematical, whether in a regional overview, or in national reports. The resulting patchy and quite ambiguous statistics allow for wildly diverging estimates and pronouncements.

Migrant Rights and Responsibilities

Unlike the medical tourists much welcomed in Asean member states, migrant workers are often perceived as an added imposition on overburdened public services, if not as freeloaders. In fact, migrants in Malaysia pay about four times the user charges levied on Malaysians at government hospitals, under a mandatory hospitalisation and surgical insurance scheme that costs RM120 annually with maximum reimbursements of RM10,000.

Migrant workers in Malaysia also contribute significantly to public finances through annual levies (currently RM640 to RM1,850) paid for by the workers, along with assorted administrative charges (and consumption taxes).

These levies and charges, amounting to RM1,121 to RM2,331 annually, translate into de facto income taxes which are quite regressive.

For example, migrants earning RM1,000 a month would be paying a de facto income tax rate of 9% to 19%, which would put them in the same tax bracket as that of a mid-career academic in Malaysia, without the citizen entitlements of the latter. A Malaysian citizen earning the same minimum wage income as the migrant worker would be paying 0.6% of his or her annual salary as income taxes (more likely zero after tax deductibles).

Towards an Asean Social Charter?

Since regimes of taxation and social entitlements vary across Asean countries, a multilate­ral agreement among Asean member states on contributory options for migrants, which would entitle them and their dependents to designated “citizen-equivalent” social benefits in their host country, should perhaps avoid a one-size-fits-all approach.

An approach customised to the (evolving) taxation and social entitlement regimes of respective Asean member states may better accommodate, and build upon, the diversity of such regimes in the region.

The envisaged multilateral agreement for instance might adopt the generic principle that mandatory contributory regimes of the host country (including income taxes) could be extended to migrant workers, who in return would be entitled to social benefits as are available to local citizens.

This, arguably, might have better political traction among the decision makers and general public of the host countries, than a narrowly rights-based discourse and approach to social benefits and entitlements for labour migrants.

CHAN CHEE KHOON, ScD

Research Fellow

Centre for Research in International & Comparative Education

Universiti Malaya