Labor Migrants and Health Care Access in Russia: Formal and Informal Strategies

Abstract

This article analyses the strategies of labor migrants use to receive medical care, the self-assessment of health of migrants in Russia and examines the access to health care for labor migrants. The analysis draws upon a survey of migrant workers in the Republic of Tatarstan, Russia, in-depth interviews with migrants, interviews with employers, medical doctors and administration of local federal migration services and the analysis of legislation. The research found that self-medication is often the only possible response to disease amongst migrant workers. The main barriers to health care access for migrant workers is the ‘undocumented’ status of many foreign workers which means that they are unable to obtain health insurance from employers and deters insurance companies, the high cost of medical insurance policies and the inaccessibility of policies, the lack of motivation for employers to protect the health of migrant workers and a lack of medical facilities for medical examinations (which see the migrant as ‘involuntary client’). It is not only migrants without work permit or patents who are vulnerable, though they are more so, but also foreign workers with formal documents for working in Russia. Their often-informal working status exacerbates the problems for migrants face when trying to obtain health care. In this context, the question of health care access for migrant workers is not only concerned with institutions and health agencies, it is also the question of the migrant’s status, given the high levels of work without contracts, deprives them of the right to protection in the workplace and leaves them vulnerable to exploitation. The employer often refuses to provide insurance and provide opportunities for medical care for ‘official’ workers thus an a imminent change in the rights of migrants will not be coming soon.