Sick and Vulnerable Migrants in French Public Hospitals. The Administrative and Budgetary Dimension of Un/Deservingness

Abstract

This article explores how staff in French public hospitals are indirectly involved in the governing of migration through healthcare. It unpacks the construction of differentiated values of life assigned to specific categories of vulnerable (authorised and unauthorised) migrants according to their perceived un/deservingness in context of budgetary restrictions. This context emphasises tensions between medical and administrative staff in the decision-making process regarding access to healthcare. The analysis rests upon empirical data (participant observations and semi-directed interviews) gathered in ‘healthcare access units’ located in public hospitals. Perceptions of un/deservingness lead to both healthcare rationing and healthcare denial and are built upon entangled criteria related to both migration status and budgetary concerns. These mechanisms reveal the administrative and budgetary dimensions that underlie the perceptions of health-related un/deservingness, which is linked to the costs of healthcare: the higher the costs, the less likely patients are to be designated to be deserving of healthcare.