Free dental medicine reviews for children from families receiving social welfare, or from vulnerable families with below average incomes
by Edvin Saliov, Roma Health Fellow
The laws that protect our human rights, and equal access to healthcare and services, aim to ensure the highest standards; however, the reality can prove to be quite different. It is often assumed that, since the European Union (EU) gives direct guidance to its Member States and to accession countries, they will respect the advice.
Dental medicine costs: the reality of North Macedonia
According to the Constitution of the Republic of North Macedonia, the law for health protection, Article 3, states that:
“Everyone has the right to health protection and there is an obligation to take care of citizens, to protect and to promote their health in accordance with this and other law”, i.e. every citizen has the right to health protection and this right should be enjoyed without incurring costs. In practice, the law means that the following should be provided by the state::
- taking care of citizens’ health and its promotion;
- early detection of diseases, and preventing / stopping injuries and other health disorders caused by the influence of the working or living environment,
- ensuring efficient healing in a timely manner; and
- providing healthcare and rehabilitation.
However, the current situation in North Macedonia is such that, unfortunately, this law is either directly or indirectly violated by healthcare institutions and by private dental offices. According to the National Institute for Statistics, in 2016, there were 58,022 social welfare recipients, of whom over 60 % are Roma.
Roma receiving social welfare find themselves in a very difficult financial situation. The majority is unemployed and living on very small incomes of between 1,500 to 3,000 denars per month, amounting to only 25-50 euros. Entire families survive for a whole month on this income, which has to cover their electricity, water, food and other basic living costs, as well as expenses related to their children’s education. .
Free vaccinations mean that vaccination rates among Roma children are at a satisfactory level. They also receive a basic medical examination at least once a year. However, this is not enough, particularly when it comes to their dental health.
Investigations carried out by several NGOs in the Eastern region of North Macedonia on the question “How regularly do you take your child to a dentist?” revealed that most Roma parents do so irregularly. This results in a situation where one in three Roma children suffers from caries or from infected teeth, largely because parents are unable to pay for this vital aspect of healthcare.
Despite the Constitution of North Macedonia stating that every citizen has the right to healthcare, many Roma children are unable to exercise this right. Families receiving social welfare simply cannot afford dental consultations, yet they do not want their children to have unhealthy teeth or get oral infections, which can lead to more serious health conditions. An ordinary dental examination or repairing an infected tooth in a private or public dental clinic costs between 10 to 15 euros, which is clearly too high for a family receiving 25 euros per month. Families without valid health insurance can expect to pay even double this amount.
It also seems very unfair that both poor and more affluent families are asked to pay the same sum to visit the dentist.
Potential solutions: free dental treatment for children from disadvantage families?
One solution would be that the government changes the law so that medical fees are adjusted according to the level of a family’s income. Moreover, why is there not free dental treatment for children from disadvantaged families? Why must children suffer from infected teeth because they are poor and their families receive social welfare?
It is time to change the law to ensure that everyone has equal access to the same standard and quality of healthcare. There are thousands of families in North Macedonia who want to ensure that their children have the same rights, regardless of their background. The case for free dental services for families receiving social welfare is more than clear.