Migration and Healthcare Reforms in Spain : Symbolic Politics, Converging Outputs, Oppositions from the Field

[en] Migrants’ healthcare entitlement represents a conflictive issue in the political battlefield, with research pointing towards the determinant role of party politics in determining policy outputs. Addressing the 2012 healthcare reform and 2018 counter-reform adopted in Spain by a right-wing and left-wing government respectively and drawing on qualitative analysis of parties’ discourses and policy measures, we argue that ideological differences along the healthcare-migration nexus were overemphasised to play symbolic politics. Partisan competition had less impact on actual outputs, while clashes between the central and regional governments, path-dependent practices and opposition from multiple venues played a central role in the policymaking process.

Disciplines :

Sociology & social sciences

Author, co-author :

Bruquetas-Callejo, Maria; Radboud University

Perna, Roberta ; Consejo Superior de Investigaciones Cientificas - CSIC

Language :

English

Title :

Migration and Healthcare Reforms in Spain : Symbolic Politics, Converging Outputs, Oppositions from the Field

Publication date :

2020

Journal title :

South European Society and Politics

ISSN :

1360-8746

Publisher :

Frank Cass Publishers, United Kingdom

Volume :

Issue :

Pages :

75-98

Peer reviewed :

Peer Reviewed verified by ORBi

Available on ORBi :

since 05 February 2022

Statistics

Number of views

47 (1 by ULiège)

Number of downloads

28 (1 by ULiège)

More statistics

Scopus citations^®

Scopus citations^®
without self-citations

OpenCitations

OpenAlex citations

Bibliography

ABC (2015) ‘ Alonso anuncia que los inmigrantes irregulares volverán a tener acceso a atención primaria ’, 31 March.
Akkerman, T., (2015) ‘ Immigration policy and electoral competition in Western Europe: A fine-grained analysis of party positions over the past two decades ’, Party Politics, vol. 21, no. 1, pp. 54–67.
Allan, J. P., & Scruggs, L., (2004) ‘ Political partisanship and welfare state reform in advanced industrial societies ’, American Journal of Political Science, vol. 48, no. 3, pp. 496–512.
Ambrosini, M., & Van der Leun, J., (2015) ‘ Introduction to the special issue. Implementing human rights: civil society and migration policies ’, Journal of Immigrant & Refugee Studies, vol. 13, no. 2, pp. 103–115.
Bale, T., (2008) ‘ Turning round the telescope. Centre-right parties and immigration and integration policy in Europe ’, Journal of European Public Policy, vol. 15, no. 3, pp. 315–330.
Bonoli, G., (2001) ‘ Political institutions, veto points, and the process of welfare state adaptation ’, in The New Politics of the Welfare State, ed. P., Pierson, Oxford UniversityPress, Oxford, pp. 238–264.
Cantero Martínez, J., & Garrido Cuenca, N. M., (2014) ‘ Ciudadanía, asistencia sanitaria y Unión Europea ’, AFDUAM, vol. 18, pp. 89–128.
Carrero, M. J., (2017) ‘ El Alto Tribunal dictamina que Euskadi carece de competencias para dar a los inmigrantes en situación irregular la tarjeta que abre la puerta a todas las prestaciones ’, El Correo, 2 December.
Centro de Investigaciones Sociológicas–CIS (2012) ‘ Barómetro sanitario 2012 ʹ, Estudios nº 2.936, 2.946 y 2.962, March–November, available online at: https://www.mscbs.gob.es/estadEstudios/estadisticas/docs/BS_2012/B.S.2012total.mar.pdf
Centro de Investigaciones Sociológicas–CIS (2016) ‘ Barómetro sanitario 2016 ʹ, Estudio nº 8816, March–October, available online at: https://www.mscbs.gob.es/estadEstudios/estadisticas/BarometroSanitario/Barom_Sanit_2016/BS2016_MAR.pdf
Cimas, M., Gullón, P., Aguilera, E., Meyer, S., Freire, J. M., & PérezGómez, B., (2016) ‘Healthcare coverage for undocumented migrants in Spain: regional differences after Royal Decree Law 16/2012ʹ, Health Policy, vol. 120, no. 4, pp. 384–395.
Cox, R. H., (2001) ‘ The social construction of an imperative. Why welfare reform happened in Denmark and the Netherlands but not in Germany ’, World Politics, vol. 53, no. 3, pp. 463–498.
De Benito, E., (2012) ‘ Feijoo: no soy partidario de disminuir la asistencia sanitaria a los ‘sin papeles ’, El País, 13 de agosto.
De Benito, E., (2014) ‘ Sanidad publica el modelo de seguro médico para inmigrantes ’, El País, 7 October.
De Benito, E., & Sahuquillo, M. R., (2012) ‘ Rechazo en bloque al plan de cobrar por atender a los sin papeles ’, El País, 8 August.
Díez, A., (2013) ‘ Rubalcaba al presidente: devuelva la sanidad a los inmigrantes irregulares ’, El País, 9 October.
El País (2012a) ‘ Sanidad prevé un Sistema inviable para cobrar a los enfermos crónicos sin papeles ’, 11 August.
El País (2012b) ‘ Hernando: “El servicio de salud universal no está para todo el universo” ’, 14 August.
El País (2012c) ‘ El PSOE acusa al gobierno de crear un monstruo de 17 cabezas ’, 31 August.
Elmelund-Præstekær, C., & Baggesen Klitgaard, M., (2012) ‘ Policy or institution? The political choice of retrenchment strategy ’, Journal of European Public Policy, vol. 19, no. 7, pp. 1089–1107.
EUROPA Press (2015) ‘ Pedro Sánchez (PSOE) anuncia la aprobación de una ley que “blinde” la financiación de la sanidad pública ’, 4 May.
European Commission against Racism and Intolerance - ECRI (2018) ‘ ECRI report on Spain. Fifth monitoring cycle ’, CRI (2018)2, Strasbourg, 27 February, available online at: https://rm.coe.int/fifth-report-on-spain/16808b56c9
Eurostat (2019) Eurostat database, available online at: https://ec.europa.eu/eurostat/data/database
Giger, N., & Nelson, M., (2011) ‘ The electoral consequences of welfare state retrenchment: blame avoidance or credit claiming in the era of permanent austerity? ’, European Journal of Political Research, vol. 50, no. 1, pp. 1–23.
Green-Pedersen, C., & Haverland, M., (2002) ‘ Review essay: the new politics and scholarship of the welfare state ’, Journal of European Social Policy, vol. 12, no. 1, pp. 43–51.
Green-Pedersen, C., & Jensen, C., (2019) ‘ Electoral competition and the welfare state ’, West European Politics, vol. 42, no. 4, pp. 803–823.
Green-Pedersen, C., & Odmalm, P., (2008) ‘ Going different ways? Right-wing parties and the immigrant issue in Denmark and Sweden ’, Journal of European Public Policy, vol. 15, no. 3, pp. 367–381.
Hall, P. A., (1993) ‘ Policy paradigms, social learning, and the state: the case of economic policymaking in Britain ’, Comparative Politics, vol. 25, no. 3, pp. 275–296.
Hampshire, J., & Bale, T., (2015) ‘ New administration, new immigration regime: do parties matter after all? A UK case study ’, West European Politics, vol. 38, no. 1, pp. 145–166.
Häusermann, S., Picot, G., & Geering, D., (2013) ‘ Rethinking party politics and the welfare state: recent advances in the literature ’, British Journal of Political Science, vol. 43, no. 1, pp. 221–240.
International Organization for Migration - IOM (2016) ‘ Summary report on the MIPEX health strand and country reports ’, IOM Migration Research Series no. 52, Geneva, available online at: https://publications.iom.int/system/files/mrs_52.pdf
Jensen, C., (2012) ‘ Labour-market- versus life course-related social policies: understanding cross-programme differences ’, Journal of European Public Policy, vol. 19, no. 2, pp. 903–935.
Korpi, W., (1989) ‘ Power, politics, and state autonomy in the development of social citizenship: social rights during sickness in eighteen OECD countries since 1930 ’, American Sociological Review, vol. 54, no. 3, pp. 309–328.
Korpi, W., & Palme, J., (2003) ‘ New politics and class politics in the context of austerity and globalization: welfare state regress in 18 countries 1975–1995 ’, American Political Science Review, vol. 97, no. 3, pp. 425–446.
La Nueva España (2012) ‘ El gobierno aprueba medidas contra el turismo sanitario ’, 3 August.
La Vanguardia (2015) ‘ El PP justifica las posibles multas a las autonomías por facilitar tarjetas sanitarias a los sin papeles ’, 21 August.
Levy, J. D., (1999) ‘ Vice into virtue? Progressive politics and welfare reform in continental Europe ’, Politics and Society, vol. 27, no. 2, pp. 239–273.
Lozano, J. M., (2016) ‘ El País Vasco defiende sus competencias ante la «reforma encubierta de la Ley de Sanidad ’ Acta Sanitaria, 14 September.
Lutz, P., (2019) ‘ Variation in policy success: radical right populism and migration policy ’, West European Politics, vol. 42, no. 3, pp. 517–544.
Médicos del Mundo España (2014) Informe Médicos del Mundo 2014. Dos años de reforma sanitaria. Más vidas humanas en riesgo, Médicos del Mundo, Madrid.
Ministerio de Sanidad, Consumo y Bienestar Social, Resolución de 20 de junio de 2019, de la Dirección General de Cartera Básica de Servicios del Sistema Nacional de Salud y Farmacia, por la que se hacen públicas las ‘Recomendaciones para el procedimento de solicitud, registro y expedición del documento certificadivo que acredita a las personas extranjeras que encontrándose en España no tengan residencia legal en territorio español, para recibir asistencia sanitaria’.
Moreno Fuentes, F. J., (2015) ‘ El puzzle de la exclusión sanitaria de los inmigrantes indocumentados en España ’, in Anuario de la inmigración en España 2014, Edición 2015, eds. J. Arango, D. Moya Malapeira, J. Oliver Alonso & E. Sanchez-Montijano, Bellaterra, Barcelona, pp. 278–299.
Moreno Fuentes, F. J., & Bruquetas-Callejo, M., (2011) Immigration and Welfare State in Spain, Fundación la Caixa, Barcelona.
Mortensen, P. B., (2013) ‘ (De-)centralisation and attribution of blame and credit ’, Local Government Studies, vol. 39, no. 2, pp. 163–181.
Natter, K., Czaika, M., & de Haas, H., (2020) ‘ Political party ideology and immigration policy reform: an empirical enquiry ’, Political Research Exchange, vol. 2, no. 1, pp. 1735255.
Partido Socialista Obrero Español (PSOE) (2015) Elecciones municipales y autonómicas 2015. Gobernar para la mayoría. https://www.psoe.es/municipales-autonomicas/gobernar-para-la-mayoria/tratar-la-salud-como-un-derecho-y-no-una-mercancia-es-gobernarparalamayoria/
Perna, R., (2019) ‘ Bound between care and control: institutional contradictions and daily practices of healthcare for migrants in an irregular situation in Italy’, Ethnic and Racial Studies, vol. 42, no. 12, pp. 2103–2122.
Petmesidou, M., Pavolini, E., & Guillén, A. M., (2014) ‘ South European healthcare systems under harsh austerity: a progress–regression mix? ’, South European Society and Politics, vol. 19, no. 3, pp. 331–352.
Petrocik, J. R., (1996) ‘ Issue ownership in presidential elections ’, American Journal of Science Review, vol. 58, no. 4, pp. 825–850.
Piccoli, L., (2019) ‘ The regional battleground: partisanship as a key driver of the subnational contestation of citizenship ’, Ethnopolitics, vol. 18, no. 4, pp. 340–361.
Pierson, P., (1996) ‘ The new politics of the welfare state ’, World Politics, vol. 48, no. 2, pp. 143–179.
Público (2012), ‘El TC da la razón al País Vasco en la sanidad para los ‘sin papeles”, 17 December.
Real Decreto-ley (RDL) 16/2012, de 20 de abril, de medidas urgentes para garantizar la sostenibilidad del Sistema Nacional de Salud y mejorar la calidad y seguridad de sus prestaciones.
Real Decreto-ley (RDL) 7/2018, de 27 de julio, sobre el acceso universal al Sistema Nacional de Salud.
Redacción Médica (2013) ‘ La senadora socialista por Alicante, Encarna Linares, destaca que esta modificación normativa ha generado mucha incertidumbre ’, 5 June.
Reeskens, T., & van der Meer, T., (2019) ‘ The inevitable deservingness gap: a study into the insurmountable immigrant penalty in perceived welfare deservingness ’, Journal of European Social Policy, vol. 29, no. 2, pp. 166–181.
Rico, A., (1996) ‘ Regional decentralization and health care reform in Spain (1976–1996) ’, South European Society and Politics, vol. 1, no. 3, pp. 115–134.
Rincón, R., Sevillano, E., & Sahuquillo, M., (2012) ‘ La salud para quien la cotiza ’, El País, 24 April.
Ross, F., (2000) ‘ “Beyond left and right”: the new partisan politics of welfare ’, Governance, vol. 13, no. 2, pp. 155–183.
Sahuquillo, M. R., & De Benito, E., (2012a) ‘ PSOE e IU rechazan el cobro por asistencia sanitaria a los ‘sin papeles ’, El País, 7 August.
Sahuquillo, M. R., & De Benito, E., (2012b) ‘Trato personas, no asegurados’, El País, 26 April.
Scuto, F., (2011) ‘ L’assistenza sanitaria agli stranieri irregolari in Italia, in Spagna e in altri stati europei ’, in Confini irregolari. Cittadinanza sanitaria in prospettivacomparata e multilivello, ed. N., Pasini, FrancoAngeli, Milano, pp. 129–166.
Seco, R., (2018) ‘ Un decreto para acabar con seis años de exclusión sanitaria ’, El País, 6 September.
Sevillano, E. G., (2015a) ‘Sanidad convoca a las regiones para negociar la atención a los ‘sin papeles”, El País, 25 August.
Sevillano, E. G., (2015b) ‘ Sanidad quiere exigir a los ‘sin papeles’ seis meses de padrón para atenderles ’, El País, 2 September.
Sevillano, E. G., (2015c) ‘ Cifuentes se adelanta a Rajoy y rebaja el coste de los fármacos a los sin papeles ’, El País, 14 September.
Sevillano, E. G., & Silió, E., (2015) ‘ Cifuentes ordena dar ya asistencia sanitaria a los inmigrantes ’, El País, 26 August.
Slothuus, R., (2007) ‘ Framing deservingness to win support for welfare state retrenchment ’, Scandinavian Political Studies, vol. 30, no. 3, pp. 323–344.
Starke, P., (2006) ‘ The politics of welfare state retrenchment: a literature review ’, Social Policy and Administration, vol. 40, no. 1, pp. 104–120.
Suess, A., Ruiz Péreza, I., Ruiz Azarola, A., & Jo MarchCerdà, J. C., (2014) ‘ El derecho de acceso sanitario en el contexto del Real Decreto-ley 16/2012: la perspectiva de organizaciones de la sociedad civil y asociaciones profesionales ’, Gaceta Sanitaria, vol. 28, no. 6, pp. 461–469.
UN Committee on Economic, Social and Cultural Rights (2012) ‘ Consideration of reports submitted by States parties under articles 16 and 17 of the Covenant. Concluding observations of the Committee on Economic, Social and Cultural Rights. Spain ’, E/C.12/ESP/CO/5, Spain, 6 June, available online at: https://www.refworld.org/docid/5065b70f2.html
UN Human Rights Council (2013) ‘ Report of the Special Rapporteur on contemporary forms of racism, racial discrimination, xenophobia and related intolerance, MutumaRuteere. Visit to Spain ’, A/HRC/23/56/Add.2, Geneva, 6 June, available online at: https://www.ohchr.org/Documents/HRBodies/HRCouncil/RegularSession/Session23/A-HRC-23-56-Add-2_en.pdf
Vis, B., (2016) ‘ Taking stock of the comparative literature on the role of blame avoidance strategies in social policy reform ’, Journal of Comparative Policy Analysis: Research and Practice, vol. 18, no. 2, pp. 122–137.
Willen, S. S., (2012) ‘How is health-related “deservingness” reckoned? Perspectives from unauthorized im/migrants in Tel Aviv’, Social Science & Medicine, vol. 74, no. 6, pp. 812–821.
Yilmaz, F., (2012) ‘ Right-wing hegemony and immigration: how the populist far-right achieved hegemony through the immigration debate in Europe ’, Current Sociology, vol. 60, no. 3, pp. 368–381.