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The excluded from health

Several European countries have limited access to health care and have left thousands of immigrants out of their coverage

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The excluded from health

"One, two, three, four months and two weeks," finally calculates Ahou, a 30-year-old asylum seeker. It's time he spent in Madrid without any doctor controlling his pregnancy. Every time I went to health center, I couldn't get an appointment "because I didn't have a census." "Even without papers, I have right to health care in hospital closer to my home," claims Ahou. But right to health, established in different international commitments, is not guaranteed for all alike in Europe: more than half of 43,000 people served by world's medical NGO were excluded from European health systems in 2016, according to a report published at end of 2017 by organization.

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Doctors of world, working in more than 80 countries, estimates in its report people excluded: The failure of universal health coverage in Europe that more than 23,800 people served by ir specialists in 13 states of European Union did not have access to Health care or medical insurance in 2016. Of se, 19,000 (79%) were non-community immigrants, who arrived in EU to "earn a living" or to escape discrimination — for reasons of sexual orientation, political or religious ideas — of armed or family conflicts, report says; only in 2.5 % of cases people migrated to get health coverage.

Ahou, who prefers not to say his real name, crossed only Mali, Mauritania and Morocco before crossing to Spain in Patera to flee from a forced marriage. When he obtained Asylum seeker card (document giving access to public health), health center denied him assistance by claiming that his card should be accompanied by registration. The woman, however, did not manage to register in Madrid any of three times that tried because in house where re are already many people registered, as told by city Council. She was denied an appointment when she had a skin allergy, when she had stomach aches and when she became pregnant.

José Félix Hoyo, president of Doctors of World in Spain, stresses that health expenditure that se people can produce, from preventive point of view, "is absolutely minimal". Hoyo stresses that those excluded in Europe, who come mainly from Syria (13%) and Afghanistan (11.3%), "are healthy people." "The choice of road makes m young and disease-free," he says.

But in recent years, in Europe, countries like Ireland or Germany have limited access to health care. In Spain, since entry into force of Royal decree of 2012, access to health card is limited to quoted persons and to foreigners without residence permit in cases of urgency, of pregnancy or of being minor. Most communities, except for some such as La Rioja, subsequently issued internal regulations to ensure universal health coverage, which is not always fulfilled.

Ricardo, a 23-year-old Brazilian infected with HIV who asked to hide his identity, was denied assistance in a Madrid hospital because he had not spent more than 90 days in Spain. Since she had no health card, she was not assigned a primary care physician to prescribe medication she needs daily. In order not to interrupt her treatment, she had to wait for hours every day, for a month, in hospital emergency room. Like him, 18% of excluded health care providers in Europe use se services to get medical care.

The New Arrivals

Four million immigrants have arrived in Spain in two decades by plane, in patera or by jumping fence. More than a million people called for asylum in Europe last year. The country has, in a 500-day project with Guardian, Der Spiegel and Le Monde Newspapers, how se new Europeans adapt and how Europe adapts to m. A look at a phenomenon that is transforming Spain and continent

Every time he went to ER, Ricardo received a bill of 180 euros. For him, without residence permit or stable work, assuming that cost was impossible, as for nine out of every 10 patients of doctors in world. The excluded are especially people who live under poverty line. When Ricardo arrived in Spain seven months ago with his partner, he did not think it would be so difficult to access health system. "It's Europe," he thought.

Often se people do not have access to medical care because of administrative difficulties, because y do not understand local language, because y are facing discrimination or because y fear being denounced for ir irregular situation, according to World Medical report. Spain and France are countries where NGO has found more bureaucratic barriers to access health system (as stated by 30% and 27% of respondents, respectively); In Germany, economic barriers, i.e., too expensive consultations or health insurance (43%), stand out.

The difficulty in accessing system is, in addition to a violation of rights, a risk to all inhabitants of a territory, warns Robert Yates, expert in universal health systems at Royal Institute of International Affairs of United Kingdom. The scholar explains that it is of common interest to treat infectious diseases, such as tuberculosis or Ebola, and to vaccinated children. Western European countries are "rich enough" to cover se benefits, he says. "Without a doubt, publicly financed health services are more efficient and cheaper than private ones in medium and long term," adds Yates.

"The past economic crisis has led countries to become more selfish," says president of world's physicians. Thus, explains Hoyo, some countries seek "a supposed sustainability that in long term is not supported". "For system to be sustainable, we have to be all and all inside," he clarifies. And he emphasizes that immigration is a wealth rar than an expense. "More for aging societies" like European, ditch.

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