State medical aid (AME), set up in 2000, allows foreigners in an irregular situation to benefit from reimbursement of their care. But, on March 15, the Senate adopted an amendment to the immigration bill aimed at removing it and replacing it with emergency medical aid (AMU), whose access conditions and scope would be more limited. LR senators, including Françoise Dumont, welcomed this vote. They believe that the AME constitutes uncontrolled aid which creates “a call for migratory air, which France no longer controls at all”. For their part, several learned societies and associations are concerned about the consequences for access to care for this fragile population and denounce this amendment which, according to them, goes against the principles of human rights.
NO / “That would be a mistake all down the line!”
By Prof. Pierre Tattevin, vice-president of the Society of Infectious Pathology in the French language
Abolition of the AME would be catastrophic. Anything that limits or delays access to care results in delayed diagnosis and treatment of disease. The human and financial consequences of delays in care are disastrous, with the increase in the severity of illnesses and their sequelae. When a health system is no longer concerned with a part of the population, it is no longer able to recognize and treat communicable diseases quickly. Many historical examples have shown that the risk of epidemics increases for everyone when access to care is hindered for a fraction of the population. The control of epidemics is more difficult and more costly for society when the reaction is delayed, which is inevitable if one restricts access to care.
The arguments put forward by supporters of the abolition of state medical aid are all fallacious. The cost of care covered by the AME represents only 0.4% of health insurance expenditure in France. Its removal would cost much more. Moreover, the work of health economists does not conclude that AME beneficiaries consume unnecessary care. All demographic studies show that migration for health reasons is a minority among the reasons for leaving countries of origin, that our social protection system is generally unknown to migrants, and that its restriction will have no effect on migratory flows. .
Health is a fundamental right of every human being. Let’s not allow a pillar of access to care to be destroyed by individuals motivated by political considerations and fantasies fueled by misconceptions.
YES / “The AME creates a draft”
By Roger Karoutchi, Senator (LR) of Hauts-de-Seine, Vice-President of the Senate
I have been hearing the same arguments and untruths from the same actors since 2012. Well-meaning associations tell us that we are monsters who would let people die, or public dangers who are ready to risk reigniting epidemics. It’s so caricatural… We never said that all AME services had to be abolished. The amendment that I had voted in the Senate in 2018 (Editor’s note: rejected by the National Assembly), and which has since been taken up, aimed to replace the AME with the AMU. The latter plans to maintain coverage of expenses for the prevention and treatment of epidemics (AIDS, Covid, etc.), pregnancies and serious illnesses. According to our estimates, it would cost between 500 and 550 million euros. It’s not zero.
What we refuse is the maintenance of 100% coverage of everyday medicine. Because, when the health insurance gives the AME card, the beneficiaries can access all the care (hospital, emergency) and can make their ascendants, descendants and brothers and sisters benefit from it (Editor’s note: in reality, only the spouse and the dependent children can benefit from it), which they have every interest in bringing. The AME creates a draft. And I’ve been told that smuggling networks direct immigrants to France if a member of their family has a health problem.
There are 400,000 AME beneficiaries. We cannot continue to say: “If you come to France, even irregularly, your health costs will be covered.” In 2014, I said that if nothing was done, the budget – which was 500 million euros per year – would exceed one billion in five years. Today we are at 1.2 billion. And, within five years, it will be more than 1.5 billion. Unless the immigration bill, which has been postponed yet again, is maintained. We will not let go of the AMU.
