31 | February 2022
State Medical Assistance and the making of a fake problem
Within the context of the French presidential elections following two years of pandemic, the State Medical Assistance (Aide Médicale d’État or AME) is once again targeted by several presidential candidates. Created in 1999, this medical assistance system allows taking care of non-hospital treatments for people illegally residing in France (depending on their residence and income). Arguing the AME’s supposed financial burden and its pull factor (‘appel d’air’1) which would make France particularly attractive to migrants, conservative and far-right parties suggest further restricting, if not completely putting it to an end. In other words, the ills of our health system are instrumentalised, problematised and solved only through the AME’s ‘cost’, despite the scientific consensus on the merits of this system and the need to preserve it for both medical and ethical reasons.
Gathering scientific expertise and professional experiences, this issue of De facto accounts for electoral news with facts. To the pull factor rhetoric, Céline Gabarro reports the deterioration of the conditions to receive AME coverage. Through figures, Paul Dourgnon, Florence Jusot, Antoine Marsaudon et Jérôme Wittwer demonstrate the AME as being underused. Nicolas Vignier puts the AME’s economic cost into perspective by underlining the significant health and budgetary impacts that would stem from putting an end to the AME. In light of 20 years of debate, Caroline Izambert notices the evident gap between the political discourse and the scientific expertise. The enquiry on foreigners’ access to healthcare affects further European countries. Roberta Perna recounts how the Italian far-right is criticising the universal and inclusive nature of the health system, to predominantly target migrants. Christiane Vollaire and Phillippe Bazin reconsider the Greek ‘archipelago of solidarity’ through images where resistance is growing towards helping native and migrant populations before a collapsing health system. In fine, Jérémy Geereart expounds on the role associative sectors have been holding in the fight to change legislation and improve foreigners’ access to healthcare in Germany.
Betty Rouland, Scientific coordinator
1 An ‘appel d’air’ translates into an ‘indraught’. It is a technical term used by firefighters, it describes an air flow that stimulates combustion. The term is used by right and far right parties to associate immigrants with flames that deprive the French of air. The metaphor has become common in public debates and it stands for a ‘politically correct’ version of an invasion.
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