IThese are dark times for public health and, more broadly, for the humanistic values ​​that underpin our society. We just experienced one the vote on November 7th on the abolition of state medical assistance (AME). This completely ideological vote is carried by an irrational wave that ignores public health analyzes but also budgetary rationality. The AME allows undocumented foreigners, some of whom remain in France and integrate, to benefit from care services even if they do not have or do not yet have a residence permit. This is an exceptional transitional system that represents precarious social security coverage, valid for one year and possibly renewable, and has nothing to do with general, permanent and universal social security coverage.

The first distortion of reality is to make people believe that all migrants come to France to benefit from its healthcare system. That’s not the case. They come mainly to work and escape poverty, war or dictatorships. They are mostly young and, as with any young population, there are few health problems. However, in France, like everyone else, they are faced with the onset of chronic diseases (hypertension, diabetes, etc.) and are particularly vulnerable to infectious diseases. The AME enables these irregular migrants to receive treatment and, in the case of pregnant women, to monitor their pregnancy.

The second falsehood is to claim that it is enough to treat urgent health problems. For all health professionals, it is patently absurd to put a person at vital risk before beginning care. We would treat the diabetic coma but not the diabetes that leads to it? We would treat a stroke but not high blood pressure? Would we not treat the tuberculosis patient until his lungs were irreparably damaged?

What the senators are proposing, specifically and bluntly, is to wait until people are on the verge of death to provide them with all the risks that that entails. It is so contrary to the values ​​of medicine and basic humanity that no nurse can accept such an imperative. Out of ultimate modesty, the senators did not dare to demand that foreigners no longer be treated at all, but their argument leads to that. We are not naive, the Senators know full well that this system is both dangerous and inhumane and impractical. For them it doesn’t matter, for them the stranger has become a non-human who deserves neither help, kindness nor care.

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