IThese are dark times for public health and, more broadly, the humanist values that underpin our society. We have just experienced one with the vote, on November 7, of the Senate abolishing State Medical Aid (AME). This vote, totally ideological, is carried by an irrational wave which ignores public health analyses, but also budgetary rationality. The AME allows undocumented foreigners, some of whom will remain in France and integrate, to benefit from care even though they do not, or not yet, have a residence permit. This is an exceptional transitional system which constitutes precarious social security, valid for one year and possibly renewable, which has nothing to do with the common law coverage by Social Security, permanent and universal.
The first distortion of reality consists of making people believe that all migrants come to France to benefit from its health system. This is not the case. They come mainly to work and escape poverty, war or dictatorships. They are most often young, and, as with any young population, their health problems are few. However, in France, like any other person, they must face the onset of chronic illnesses (hypertension, diabetes, etc.) and are particularly exposed to infectious diseases. The AME allows these irregular migrants to seek treatment and, in the case of pregnant women, to monitor their pregnancy.
The second untruth is to peddle that it is enough to treat urgent health problems. For all healthcare professionals, it is obviously absurd to expose a person to a vital risk before starting to provide them with care. We would treat diabetic coma, but not the diabetes that leads to it? We would treat stroke, but not hypertension? Would we only treat the tuberculosis patient when his lungs were irreparably damaged?
What the senators are proposing is, very concretely and very bluntly, to wait until people are on the verge of death to provide them with care with all the risks that ensue. It is so contrary to the values of medicine and the simplest humanity that no caregiver can accept such an imperative. The senators, out of a last bit of modesty, did not dare to call for no longer treating foreigners at all, but their reasoning leads to this. We are not naive, the senators know perfectly well that this system is both dangerous, inhumane and impractical. It doesn’t matter to them, the stranger has become for them a non-human who deserves neither help, nor kindness, nor care.
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