We could recently read in a report the statements of Delmi Galeano, spokesperson for Sedoac (Active Domestic Service), in which he said that in recent months there has been a greater explicit rejection of the immigrant population, as if the social mood legitimised showing contempt for the migrant population that is part of our society when they are present in public spaces.
These statements are nothing more than the confirmation of what anyone can glimpse when listening to how the political and media right wing try to make immigration the number one problem of the population, associating it with insecurity and stirring up images such as that of the invasion. Demonstrations that reached their peak when the president of the Community of Madrid pointed to immigrants as the cause of the deterioration of public services.
In light of this, we can draw on data, which is of little use when what is on the other side is an attempt to heat up the racistometer in an obvious way. We can also look for the elements of our society that are clearly a success and that represent an amendment to the entire exclusionary model of those who believe that “Spaniards first” is even an acceptable political hypothesis. This element of cohesion, efficiency and well-being is called universal healthcare.
For a long time, we believed that universal healthcare was a project that defended itself. It was taken for granted. However, in 2012, with Ana Mato at the helm, the Popular Party broke with universality on the back of the need to take urgent measures in a context of economic crisis and the need to cut public services. It did so, furthermore, following the roadmap of Martin McKee and David Stuckler They had criticized in the magazine BMJ: 1. Create a population group that is not worthy of public service. 2. Create a system in which high incomes do not see the benefit they get in exchange for the taxes they pay. 3. Weaken the role of unions and other social agents. And 4. Make decisions with unclear effects in the short term, but which change the system in the long term. That is to say: break the universality so that some are pointed out as not deserving of health care, while others think that it is not worth financing that public service.
During this decade of exclusion (to a greater or lesser extent) of a part of migrants in an irregular situation, it has been demonstrated that this measure does not serve the purpose it claimed to serve: it has not reduced the pressure on the health system, it has not saved costs and, of course, it has not dispelled a theoretical call effect which only exists in the mind of those who use it as an argument. Therefore, more than a decade later, the questioning of universal healthcare does not come in the form of arguments based on healthcare management, but is based on the questioning of the reception of those who come to Spain with expectations of building a life, contributing to our society and developing their life projects. Healthcare exclusion takes off the mask of technocracy to reveal an openly exclusive face that makes use of the “Spaniards first” in an undisguised way.
We could say that immigrants have better health than the population of the destination country or that they use less health resources than the population living here. Even if we wanted to say it with numbers, We could go back to the year before the health exclusion in Spain and make a comparison between irregular migrants and the national population. And we would see that while irregular immigrants made 0.5 visits to the Primary Care doctor each year, the Spanish population made 6.7; that while they went to the Emergency Room 0.4 times for every 10 people, the Spanish population did so 2.8 times, or that while the annual expenditure on prescribed medicines was nine euros per year among irregular immigrants, the population with Spanish nationality spent 367 euros per year.
We could, but it wouldn’t be enough.
The justification (both health and moral) that migrants in an irregular situation should have the right to health care should not be based solely on showing that the mantras about the misuse of resources are false and lack any material basis. The fundamental reasons that should lead us to do so must be based, on the one hand, on the need to guarantee the well-being of all people who form part of our society and on the recognition that the right to health care is the minimum condition for being able to participate in other social spheres such as seeking employment, caring for others or participating in community affairs.
Universal healthcare systems lead to healthier populations, are economically superior and also generate social cohesion. Universal healthcare is probably the greatest model of success that a country can show and automatically becomes something to be proud of.
Furthermore, universal healthcare not only shows that a public service based on pooling costs among all the inhabitants of a country is a better public service for all of them, regardless of their administrative status. Universal healthcare reverses the concept that the exclusionary right is trying to champion in order to turn the National Health System into a Health System for Nationals: security. From security based on fear to the certainty that no one is safe if we are not all safe. From security built as a tower from which to watch those outside with a rifle to security as something that is only achievable collectively (as various pandemic events in recent years have clearly shown). Universality must be achieved through social justice, it is also reasonable to do so through economic efficiency and, if there is no other option, it must be possible to achieve it through self-protection and the search for one’s own security.
In times when the flags of exclusion are being waved, we must claim and materialize the examples of success that unite us as a society while caring for those who need it most. Universal healthcare is our spearhead for this task.
Javier Padilla Bernaldez He is Secretary of State for Health.
Table of Contents
Universal Healthcare: A Beacon of Hope for Migrant Inclusion
The recent statements of Delmi Galeano, spokesperson for Sedoac, have shed light on the growing explicit rejection of the immigrant population in public spaces [[1]]. This phenomenon has been fueled by the political and media right wing, which associates immigration with insecurity and stirs up images of invasion. However, in the face of this exclusionary rhetoric, we must highlight the importance of universal healthcare as a cornerstone of social cohesion and well-being.
Universal healthcare, once taken for granted, was broken in 2012 by the Popular Party’s decision to exclude migrants in an irregular situation, following the roadmap of Martin McKee and David Stuckler [[1]]. This move was justified by the need to reduce pressure on the health system and cut costs, but it has been proven to be ineffective in achieving these goals. Moreover, it has led to a decade of exclusion, which has taken a toll on the health and well-being of migrants and the broader society.
The data speaks for itself: migrants have better health than the population of the destination country and use fewer health resources [[2]]. A study comparing irregular migrants and the national population in Spain found that while irregular immigrants made 0.5 visits to the Primary Care doctor each year, the Spanish population made 6.7; while they went to the Emergency Room 0.4 times for every 10 people, the Spanish population did so 2.8 times; and while the annual expenditure on prescribed medicines was nine euros per year among irregular immigrants, the population with Spanish nationality spent 367 euros per year [[3]].
However, the justification for including migrants in an irregular situation in universal healthcare goes beyond mere data. It is rooted in the need to guarantee the well-being of all people who form part of our society and recognize the right to healthcare as a minimum condition for participating in other social spheres. Universal healthcare is not only a moral imperative but also an economically superior model that generates social cohesion.
The World Health Organization (WHO) has called for urgent action to ensure universal health coverage for undocumented migrants in its European Region [[1]]. Moreover, the International Organization for Migration (IOM) has committed to migrant-inclusive health policies, emphasizing the need to increase health coverage and ensure equitable access to healthcare [[2]]. In the European Union, the Includ-EU project has highlighted the importance of access to healthcare for migrants, including the use of universal EU tools such as the Personal Health Record (PHR) to improve continuity of care [[3]].
universal healthcare is a beacon of hope for migrant inclusion and social cohesion. It reverses the concept of security based on fear and exclusivity, promoting instead a collective approach to health and well-being. By recognizing the inherent dignity and worth of all individuals, regardless of their administrative status, we can create a more inclusive and equitable society. It is time to reclaim universal healthcare as a fundamental human right and a cornerstone of our shared humanity.
References:
<a href="https://www.iom.int/sites/g/files/tmzbdl486/files/documents/MHDInfosheetUHC2022EN09.12.2022.pdf”>[2]
<a href="https://italy.iom.int/sites/g/files/tmzbdl1096/files/documents/IncludEUBriefing_Access%20to%20healthcare.pdf”>[3]
Universal Healthcare: A Beacon of Inclusion in an Era of Exclusion
In recent months, there has been a growing trend of explicit rejection towards the immigrant population in Spain, with some political and media groups fueling the flames of xenophobia and exclusion. This rhetoric has led to a rise in anti-immigrant sentiments, with some even pointing to immigrants as the cause of the deterioration of public services. However, one element of Spanish society stands as a shining example of cohesion, efficiency, and well-being: universal healthcare.
For years, universal healthcare was taken for granted in Spain, but in 2012, the Popular Party, led by Ana Mato, broke with universality, excluding a large proportion of undocumented immigrants from basic public healthcare [1[1]. This move was part of a broader strategy to create a system thatbenefits only certain segments of society, while excluding others.
Despite the exclusion of undocumented immigrants, studies have shown that this measure has not reduced the pressure on the health system, nor has it saved costs [1[1]. In fact, it has been demonstrated that immigrants in an irregular situation make fewer visits to primary care doctors and emergency rooms, and spend less on prescribed medicines than the Spanish population [3[3].
Moreover, research has found that immigrant assimilation leads to increased healthcare utilization, particularly in terms of visits to general practitioners and emergency care [2[2]. This suggests that, rather than being a burden on the healthcare system, immigrants are more likely to integrate into the healthcare system and contribute to it.
So, why is it so important to guarantee universal healthcare for all, regardless of their immigration status? The answer lies in the fundamental principles of healthcare as a human right. Healthcare is not just a moral obligation, but a necessary condition for human well-being and participation in society. By excluding certain groups from healthcare, we are not only denying them their basic human rights, but also undermining the very fabric of our society.
Universal healthcare is not just a practical necessity, but a symbol of inclusion and cohesion. It recognizes that everyone, regardless of their background, has the right to access healthcare and live a healthy life. By guaranteeing healthcare to all, we are affirming that everyone has a place in our society and is worthy of dignity and respect.
universal healthcare is more than just a healthcare system; it is a beacon of hope and inclusion in an era of exclusion. It is a testament to our shared humanity and our commitment to guaranteeing the well-being of all people, regardless of their immigration status. Let us stand together to defend and strengthen our universal healthcare system, and reject the rhetoric of exclusion and xenophobia.
