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Lax or Luxe? The health service barriers faced by international students

International students encounter many challenges when accessing basic health services.

Studying at an international institution is the opportunity of a lifetime for some. For others, it can open up a complicated world of health issues, insurance claims and exploitation.

Laura* is 20 years old. She’s an international student studying a Bachelor of Commerce in Australia, and has been here since she was 18. Her hometown is New Delhi, and for her, studying at an overseas institution was an imperative opportunity – until she needed emergency gallbladder removal in October 2018.

In a country where the language wasn’t native to her, with medical jargon she couldn’t understand, very little time to properly process the surgery she was undergoing and costs associated with it, the situation was challenging.

Fortunately, she was eligible for insurance cover for the major surgery. But other treatments like specialist appointments, anaesthetic for surgery and follow up meetings with doctors were not covered, costing in excess of thousands of dollars.

She is still owing nearly two thousand dollars in medical expenses.

Her story is not unusual.

As an international student moving to another country, some at the age of 17 or 18, pregnancy and mental health may not be the first things on your list when choosing insurance. But, statistically speaking, over a third of health insurance claims among international students are pregnancy related.

The basic international student insurance cover is called ‘Overseas Student Health Cover’ and it insures students for some out-of-hospital medical services (as listed in the Medicare benefits schedule), in-hospital medical services, public hospital treatments and ambulance services.

Excluded from the cover is treatment for pregnancy related conditions in the first twelve months of arrival, alongside treatment for secondary conditions or disabilities that arise, and other conditions.

Sean Stimson, the head of Redfern Legal Centre’s International Student Service,  told Honi that a lack of clear knowledge and understanding of the services available to students makes it complicated for them to seek help.

“We found that there was very little information to assist international students. There was lots of information, but it was through different sources and also very rarely, was it presented in a community language.”

Research conducted by the Centre found that many international students are not utilising their health insurance as they should be due to gap payments that cost large sums of money. These payments can be a significant portion of a student’s fortnightly income, and on top of expensive rent costs, are not a priority for students to pay off. Consequently, many refrain from seeking treatment, to avoid expenses.

Mr Stimson highlights that for many students, the choice comes down to basic human needs like eating, versus expensive medical treatments.

“For you and I, perhaps having to pay 20,30,40,50 dollars to use it to get a treatment would be an obvious choice. But if the $50 was ‘do I want to eat this week’ or ‘do I want to go and see a doctor’, I think, well most of us are going to say ‘well we want to eat this week’.”

One of the key reasons the gap payment becomes so unaffordable for students is due to restrictions imposed on international students through the 40 hour working fortnight. As a part of condition 8105 of the student visa, students are limited to working a maximum of twenty hours a week, and forty hours a fortnight.

On minimum wage, this amounts to approximately $757.20 a fortnight. For international students with various bills and costs to pay; including rent, food, amenities and costs of living, this income is unsustainable. Instead, working more hours at below-minimum wage becomes a more valid option, or even doing jobs where payment is withheld until a certain number of extra hours are completed.

The Migrant Workers’ Taskforce report, released by the Government in March of this year, outlined the potential for student visa holders to be exploited by employers.

As a part of the recommendations of the report, the Taskforce is calling on education providers to provide international students with more information about their rights in the workforce. Mr Stimson says students often felt they were in the wrong, when they were exploited.

This often leads to mental health issues among the community.

When students then cannot access counsellors or support services, staying at University in a foreign country becomes almost impossible and health issues develop into severe and often debilitating illnesses.

Manfred Mletsin, an international student himself, who now works for the Council of International Students Australia says that cultural differences between Australia and the home countries of some international students is problematic, as culturally some international students are less informed on important information, like sex education, than others.

“A lot of international students come from south-east Asian countries and their sex-education probably isn’t as strong as it is in Australia or some European countries…”

“So that might put them into a situation where talking about sex, or talking about sexually transmitted diseases or even talking about pregnancy is just out of question.”

For international students under the age of 25, organisations like beyondblue provide free counselling and mental health services for anyone, including international students. However, many international students do not know that these services exist, nor how to access them.

Universities provide mental health treatment, and counsellors in many languages. But the demand for these services from international students in some universities outweighs the supply.  Resources can be minimal and waiting periods can go on for months.

Mr Mletsin found himself going to a general practitioner for mental health treatment, after being told that wait times at his university were in excess of two months.

Other findings of the research conducted by the Migrant Workers Taskforce show that nearly a quarter of international students are earning less than $12 an hour in wages, and 43 per cent are earning $15 an hour or less. This falls well below the minimum wage in Australia. A survey has been commissioned by the University of Technology Sydney and the University of New South Wales following these results, asking international students what they don’t know, and what they need to know to be able to avoid exploitation by employers and potential landlords.

Losing their visa is one of the major issues that is causing students to stay silent on some of the issues they’re experiencing. Such a loss would result in a student having to return to their country of origin. It can be brought on by failing subjects at University, or by working over the maximum hours permitted each week. Students become concerned about losing their visas, so often develop a reluctance to report issues to the police, or to officials, for fear of ramifications.

Though the lives of international students are often perceived as extravagant and luxurious, many are exempt from a most basic necessity: healthcare. Until that changes, these perceptions remain ill-founded.

*Names have been changed