Advancing human rights in patient care of Roma: access to health insurance in Macedonia

Nesime Salioska, Theodore T. Lee, Ryan Quinn

Roma in Macedonia suffer from dire health consequences due to economic factors, such as high rates of unemployment and poverty, and social factors, including discrimination by medical providers. Although Macedonia administers a public health care system for its citizens, Roma frequently lack access to this system in contravention of the rights to health and equality enshrined in Macedonia's Constitution and international law. Applying a human rights in patient care (HRPC) framework to this problem, we discuss a facially neutral law that predicated access to health insurance for low-income citizens on the submission of a statement of income. This requirement created additional barriers to care, which we describe in this article. Even after the Constitutional Court declared the requirement invalid, the government failed to implement appropriate changes to the law in a timely manner. We argue this failure threatened the rule of law in the country and further marginalized and discriminated against Roma in violation of their human rights.