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The Association HOPS Options for Healthy Life Skopje and the Network for Protection against Discrimination addressed the Commission for Prevention and Protection against Discrimination with a complaint about a case of indirect discrimination based on health status. A woman who has been treated for hepatitis C in the past has not been provided with private health insurance. The private insurance company does not grant this right to other people who in the past or now are being treated for various diseases. In this way, insurance companies discriminate on the basis of health status and belonging to a marginalized group of people who use drugs and other groups of patients being treated for various chronic diseases.

The Commission for Prevention and Protection against Discrimination, acting upon the complaint, adopted an opinion that did not establish indirect discrimination on the basis of health status towards the persons who use drugs, but also towards other persons with chronic diseases.

According to the Commission, avoiding the risk of financial loss is a legitimate aim to discriminate against different groups of patients whether they are currently being treated or cured of a disease. In this way, the Commission incorrectly applies the Law on Prevention and Protection against Discrimination while defining a legitimate goal: the goal for the realization of which the means should correspond to the real needs in a specific case, to be precisely defined in advance, to be necessary for the realization of that goal, as well as to be proportional of the effects to be achieved. According to the Commission, is the profit of the insurance company a real need and is the discrimination of the patients a necessary way to achieve that goal?!

This practice is contrary to international standards in the field. According to the European Convention on Human Rights, legitimate goals for restricting rights can be state security, protection of health and morals, protection from crime and protection of the rights of others. The profit of private companies cannot be considered more important than the equality of citizens as their constitutional and internationally recognized right.

The Commission refers to the provisions in the field of private health insurance without taking into account that discrimination sometimes originates from the laws themselves. If something is regulated by law, it does not mean that it cannot be discrimination. It should be borne in mind that these persons are completely excluded from the right to private health insurance. For people with chronic illnesses that affect the amount of health care they receive, companies can provide a way to pay and calculate the actual cost of treatment, but not a complete cancellation of that right.

Considering that this Commission according to the Law should be an expert and independent body for prevention and protection against discrimination, the fact that this body is not sensitive enough in terms of violation of the rights of marginalized communities, which includes different groups of chronically ill patients, is particularly worrying.


10 November 2021