School of Nursing and Human Sciences, Dublin City University, Dublin 9, Ireland.
Soc Sci Med. 2015 Jan;124:346-55. doi: 10.1016/j.socscimed.2014.04.013. Epub 2014 Apr 13.
This article deals with the transnational healthcare practices of Central and Eastern European migrants in Europe, taking the case of Romanian migrants in Ireland. It explores the implications of migrants' transnational healthcare practices for the transformation of citizenship in Europe, more particularly in terms of access to free public healthcare. The article places these practices in the larger perspective of global care chains, seen as including transnational flows of healthcare seekers and healthcare workers that link distant healthcare systems in an emerging European healthcare assemblage. The study adopted a holistic perspective, taking into account both formal and informal practices, as well as the use of healthcare services in both the host and the origin countries of migrants. These were explored during multi-sited fieldwork in Romania and Ireland, conducted between 2012 and 2013, and combining a variety of sources and methods (semi-structured interviews, informal conversations, documentary analysis, etc.). The article explores the links between migrants' transnational healthcare practices and two other important processes: 1) inequalities in access to healthcare services in migrants' countries of origin and of destination; and 2) the contribution of healthcare privatisation to these inequalities. It shows that Romanian migrants' transnational healthcare practices function as strategies of social mobility for migrants, while also reflecting the increasing privatisation of healthcare services in Ireland and Romania. The article argues that these processes are far from specific to Ireland, Romania, and the migration flows uniting them. Rather, they draw our attention to the rise of an unevenly developed European healthcare assemblage and citizenship regime in which patients' movements across borders are closely interlinked with diminishing and increasingly unequal access to public healthcare services.
本文探讨了中东欧移民在欧洲的跨国医疗保健实践,以罗马尼亚移民在爱尔兰为例。它探讨了移民的跨国医疗保健实践对欧洲公民身份转型的影响,特别是在获得免费公共医疗保健方面。本文将这些实践置于更广泛的全球护理链视角下,将其视为包括寻求医疗保健者和医疗保健工作者的跨国流动,这些流动将遥远的医疗保健系统联系在一个新兴的欧洲医疗保健组合中。该研究采用整体视角,既考虑了正式和非正式的实践,也考虑了移民在其原籍国和目的国使用医疗保健服务的情况。这些都是在 2012 年至 2013 年期间在罗马尼亚和爱尔兰进行的多地点实地考察中探索的,采用了多种来源和方法(半结构化访谈、非正式对话、文献分析等)。本文探讨了移民的跨国医疗保健实践与另外两个重要过程之间的联系:1)移民原籍国和目的国获得医疗保健服务的不平等;2)医疗保健私有化对这些不平等的贡献。它表明,罗马尼亚移民的跨国医疗保健实践是移民社会流动的策略,同时也反映了爱尔兰和罗马尼亚医疗保健服务私有化的增加。本文认为,这些过程远非爱尔兰、罗马尼亚和将它们联系在一起的移民流所特有。相反,它们引起了我们对发展不平衡的欧洲医疗保健组合和公民身份制度的关注,在这种制度下,患者跨境流动与公共医疗保健服务的获取减少和日益不平等密切相关。