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article imageOp-Ed: France’s new headache: Free Medicaid for illegal immigrants

By Michael Cosgrove     Oct 23, 2010 in Health
A dangerous political time bomb is ticking in France in the form of a steep increase in the amount of free Medicaid being granted to illegal immigrants and alleged abuses of the system. The government is in a lose-lose situation.
The news couldn’t have come at a worse moment for the government. Just when French social security officials are widely predicted to release figures shortly showing that the French health service deficit is expected to hit €23bn ($32bn) and as drastic measures are being drafted to reduce health-care spending, it has been revealed that spending on free health care for illegal immigrants is rising between 3 and 4 times as fast as that of the health system in general.
The AME (Aide Médicale d’Etat, or ‘State Medical Aid’) system was introduced ten years ago and it was specifically introduced to offer free medical aid to illegal immigrants. This aid dispenses them from having to pay anything for doctor’s visits and medicines as well as hospital treatment and consultations.
However, the cost of the system has exploded since the end of 2008, with an increase of 13% in 2009 and 17% so far this year, and a recent investigation has discovered that abuse of the system is increasing. Also, an increasing number of doctors, pharmacies, social workers and hospital staff are beginning to denounce what they see as being a system with no limits or control mechanisms which is being used for reasons other than health care as well as higher levels of fraud and other abuses.
Social workers have noticed a large increase of illegal immigrants from Eastern Europe and countries such as Georgia, Chechnya and Russia who come to France for free treatment and a Parisian specialist on genetic skin disorders reports AME patients who have no residence permits coming to see her to organize expensive treatment and staying in France for months at a time. She says that many of them find her co-ordinates on the Internet on computers in other countries and that interpreters who accompany them are paid for their work by the system. Other treatment dispensed to illegal immigrants includes IVF test tube babies, AIDS treatment, and heroin substitutes which are collected in large quantities and sold on the black market or even exported for sale. Some AME patients enter the country illegally from Algeria on a regular basis for treatment.
Government officials responsible for preparing next year’s national budget are remaining tight-lipped on the issue, and it is not difficult to understand why. One official who knows the issue well did say the following however to journalists wanting more information on it; “This subject is explosive. Do you really want to send the voters over to {far-right National Front party leader} Marine le Pen?”
That is a very pertinent statement. Conservative voters are sure to be furious at the news of AME abuses and that at the same time that tax hikes and service cutbacks are being planned across the board along with the suppression of thousands of public sector jobs and an increase in the number of medicines which will become ineligible for reimbursement, the amount of money needed to fund the AME next year will be increased by 10%.
And this may well lead to a backlash voting for the National Front at the ruling UMP party and president’s expense.
On the other hand, cutting AME funding would inevitably result in a fierce opposition campaign along the grounds that it would be tantamount to refusing to dispense essential health-care and dividing people into who can have access to free health care in France. These issues are particularly sensitive in France, which is proud of its majoritarily free health care system. Also, accusations of a continuing anti-immigration campaign and government attempts to foster xenophobic attitudes would be bound to resurface just after the recent and highly controversial decision to repatriate Roma to their countries of origin. That decision is supported by the French, but only by a very small majority.
Public dissatisfaction with the government and the president are increasing and the authorities have had to deal with a long succession of political scandals and highly contested legislation in many areas.
They would surely have preferred that this issue didn’t exist, but it does. And whatever they do to try to deal with this insoluble headache, another major scandal is brewing.
This opinion article was written by an independent writer. The opinions and views expressed herein are those of the author and are not necessarily intended to reflect those of
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