Health Security for Migrant Workers in Thai Fisheries and Its Adaptation Under the Ratifications of C188 in Fishing Convention: Obstacles, Problems, and Direction for Future Development

Abstract

The research article consisted of the following objectives: 1) to analyze problems and obstacles arising from experience on health security for migrant workers in Thai fisheries; and 2) to synthesize a model as the alternatives for reforming the health security in the future to protect migrant fishermen, both in the short and long term, by emphasizing the possibilities and the possible effectiveness. The study applied a qualitative research method by surveying the documents, in-depth interview by way of semi-structured interview, and focus group discussion to brainstorm opinions. The key informants used for interviews and brainstorming opinions on health security for migrant workers consisted of 5 characteristics in order to collect and analyze data. From the study, the following results are found: 1. The main obstacles to providing health security for migrant fishermen are structural and related to politics and attitudes. In terms of structural problem, it originates from inequality, which is the discrimination based on one’s status, whether a person is Thai or not. Including, the lack of ‘national regulations’ in connecting a non-Thai person’s status with the health security system, which causes administrative issues and fragmented work, i.e., a lack of central coordinating entity with ‘authority’ to command or supervise the work. There is also a lack of balance between the stability concerns, human rights concerns, and international agreements. As a result, such obstacles lead to 2. A model that provides alternatives for reforming the health security to protect migrant fishermen which consists of the following alternatives: 1) cancelling health insurance cards from all migrant workers and enrolling them in the ‘social security system’; 2) the establishment of a ‘parallel system’ between the social security and health insurance cards, which has already been drafted as a legislation at the Act level; 3) proposing a ‘Draft on Health Security Act for Migrant Workers, Aliens, and Stateless Persons’ in the form of ‘new funding’, which includes all components; and 4) amending the laws or reinterpreting section 5 of the National Health Security Act B.E. 2545 to cover both Thai and non-Thai people, including the migrant workers.