Universal right to health for vulnerable migrant populations An efficiency objective and a value to defend for primary care

The World Health Organization positions universal access and equity of care as criteria for assessing the performance of healthcare systems. The United Nations supports universal health coverage as a goal for 2030. In France, it has been proposed to redefine state medical aid (AME), arguing that it would save money. People in an irregular situation would have access to healthcare only for urgent medical situations. The state of health of all new arrivals is a cause for concern, with physical and mental health problems a frequent occurrence. Among them, illegal immigrants and asylum seekers are particularly vulnerable. Only a small proportion of those eligible for the AME are reported to have opened their entitlements. This position paper explores the interactions between the universal right to health and the vulnerability of migrant populations. It proposes that primary healthcare should take care of these vulnerable populations, applying the principles of proportionate universalism, outreach and doing-with. It warns that a reduction in the AME basket of services would increase the number of people refusing care, and worsen the health status of the populations concerned.