Department of Health Care Management, Berlin Technical University, Berlin, Germany.
Department of Population Medicine and Health Services Research, School of Public Health, Bielefeld University, Bielefeld, Germany.
Global Health. 2020 Nov 20;16(1):113. doi: 10.1186/s12992-020-00642-8.
Welfare states around the world restrict access to public healthcare for some migrant groups. Formal restrictions on migrants' healthcare access are often justified with economic arguments; for example, as a means to prevent excess costs and safeguard scarce resources. However, existing studies on the economics of migrant health policies suggest that restrictive policies increase rather than decrease costs. This evidence has largely been ignored in migration debates. Amplifying the relationship between welfare state transformations and the production of inequalities, the Covid-19 pandemic may fuel exclusionary rhetoric and politics; or it may serve as an impetus to reconsider the costs that one group's exclusion from health can entail for all members of society.The public health community has a responsibility to promote evidence-informed health policies that are ethically and economically sound, and to counter anti-migrant and racial discrimination (whether overt or masked with economic reasoning). Toward this end, we propose a research agenda which includes 1) the generation of a comprehensive body of evidence on economic aspects of migrant health policies, 2) the clarification of the role of economic arguments in migration debates, 3) (self-)critical reflection on the ethics and politics of the production of economic evidence, 4) the introduction of evidence into migrant health policymaking processes, and 5) the endorsement of inter- and transdisciplinary approaches. With the Covid-19 pandemic and surrounding events rendering the suggested research agenda more topical than ever, we invite individuals and groups to join forces toward a (self-)critical examination of economic arguments in migration and health, and in public health generally.
世界各地的福利国家对一些移民群体限制了获得公共医疗保健的机会。对移民医疗保健准入的正式限制通常以经济论点为依据;例如,作为防止成本过高和保护稀缺资源的一种手段。然而,关于移民健康政策经济学的现有研究表明,限制政策会增加而不是减少成本。这一证据在移民辩论中基本上被忽视了。随着福利国家转型与不平等现象的产生之间关系的加剧,新冠疫情可能会助长排斥性言论和政治;或者它可能成为重新考虑将一个群体排除在保健之外可能给社会所有成员带来的代价的动力。公共卫生界有责任促进以证据为基础的健康政策,这些政策在伦理和经济上都是合理的,并抵制反移民和种族歧视(无论是公开的还是以经济推理为幌子的)。为此,我们提出了一个研究议程,其中包括 1)生成关于移民健康政策经济方面的综合证据,2)澄清经济论点在移民辩论中的作用,3)(自我)批判性地反思经济证据产生的伦理和政治,4)将证据引入移民健康决策制定过程,以及 5)支持跨学科和跨学科的方法。随着新冠疫情和周围事件使所建议的研究议程比以往任何时候都更加重要,我们邀请个人和团体共同努力,对移民和健康以及一般公共卫生领域的经济论点进行(自我)批判性审查。