The most urgent issue is the question of migrant children, who, unlike their working parents, remain dependent on private insurance plans. The problem with this is that it doesn't cover the higher levels of medical compensation. The tragic evidence of this gap in the law is exposed by the case of fourteen-year-old Katareeya, daughter of Australian parents employed by the Czech Academy of Sciences, who died in October last year because her treatment, despite the commercial insurance she had, couldn't be covered by her policy.

In the Czech Republic, migrants have public health insurance only if they have permanent residence or occupation, and if their employer is based in the Czech Republic. The public system is even for foreign scientists who have a long-term contract in the country, asylum seekers and some children within two months of birth. Public insurance is not available to businessmen, spouses and descendants of migrants. They must open commercial insurance policies.

This, according to the Ministry of Health, is not sufficient and should be adjusted. Commercial insurers should not be allowed to refuse a foreigner, and should be obliged to provide the same care that is covered by public insurance. According to commercial agents, it is not possible to give them public insurance, as this would supposedly lead to financial destabilization of the system, as their long-term bind to the state is also necessary, as well as their long-term contributions. There are also concerns about medical tourism and an increase in sickness among immigrants abusing the system.

Opposing a mere modification of the commercial insurance has been a consortium of NGOs working with migrants. They are for the inclusion of migrants into the public health insurance option. The inclusion of these excluded groups of foreigners would not bring increased costs and would in fact be economically advantageous to the system, according to many experts. Most aliens who are excluded are younger people of a productive age, with lower average healthcare needs and costs.

The government has twice seen an updated proposal of a health insurance law from the Ministry of Health, first in September and then again in mid-November, but put it aside both times because of its poor quality. The alarming situation remains unresolved.