The role of public-private partnerships in extending public healthcare provision to irregular migrants: stopgap or foot
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(2020) 9:48
COMMENTARY
Open Access
The role of public-private partnerships in extending public healthcare provision to irregular migrants: stopgap or foot in the door? Nora Gottlieb1,2* , Dani Filc3 and Nadav Davidovitch4
Abstract In this commentary to the paper “Ensuring HIV care to undocumented migrants in Israel: a public-private partnership case study” by Chemtob et al. we discuss the role of public-private partnerships (PPPs) as a mechanism for integrating previously excluded groups in public healthcare provision. Drawing on PPP case-studies as well as on Israel’s pandemic preparedness policies during the Covid-19 outbreak, we examine potential implications for the populations in question and for health systems. In our view, Chemtob et al. describe an exceptional achievement, where a PPP served as a stepping stone for the subsequent integration of irregular migrants’ in publicly funded HIV care. However, we argue that in many other cases PPPs are liable to undermine public healthcare and inclusionary claims. This view is informed by the fundamentally different concepts of healthcare that underlie PPPs and public healthcare provision (namely, health care as a commodity vs. access to healthcare as a right) and existing evidence on PPPs’ role in facilitating welfare retrenchment. In contexts that are dominated by an exclusionary stance toward irregular migrants, such as contemporary Israel, we believe that PPPs will become stopgaps that undermine health rights, rather than a first foot in the door that leads toward equitable provision of healthcare for all.
Introduction In many welfare states, so-called “irregular migrants” remain excluded from public healthcare provision, despite governments’ commitments to universal health coverage and the Sustainable Development Goals’ pledge to “leave no one behind” [1]. “Irregular migration” denotes human mobility outside those migration This comment refers to the article available at https://doi.org/10.1186/ s13584-019-0350-4.. * Correspondence: [email protected] Commentary to: Ensuring HIV care to undocumented migrants in Israel: a public-private partnership case study 1 Department of Health Care Management, Berlin Technical University, Berlin, Germany 2 Department of Population Medicine and Health Services Research, Bielefeld School of Public Health, P.O. Box 100131, 33501 Bielefeld, Germany Full list of author information is available at the end of the article
channels that are foreseen and authorized by states, such as bilateral labour migration arrangements. Being an “irregular migrant” is thus the outcome of interrelations between human movement across social spaces and states' enactment of policies within the same spaces [2]. The question of irregular migrants’ access to public healthcare epitomizes a tension inherent to the national welfare state-concept: On the one hand, the welfare state is an instrument for the realization of social and health rights and inclusion. On the other hand, it safeguards the nation’s public resources by distinguishing
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