While our health system is envied across the world, the most disadvantaged do not have such easy access to medical care in France. In its latest barometer revealed this morning, the non-governmental organization Médecins du Monde (MDM) is worried about the exponential increase in the number of patients treated in its reception centers and more particularly minors.
The figures speak for themselves: since 2008, the number of Médecins du Monde patients has increased by 33% and, in 5 years, the number of minors has increased by 69%, representing 12.5% of patients in 2012 These sick children are less than six years old in more than one in two cases.
In 90% of cases, they have no health cover, although they must benefit from it unconditionally, and only 40% are followed by the maternal and child protection services (PMI). At the time of their consultation, 32.4% of children required urgent or fairly urgent care, particularly for respiratory pathologies (56% of cases). In 2012, more than 3,100 minors benefited from 4,900 medical consultations in MDM’s care centers. In addition, 46% of pregnant women interviewed had a delay in monitoring pregnancy.
Mapping of the populations concerned
Among the 30,500 people that MDM welcomed in 2012, more than 98% of them lived below the poverty line (monthly income below 977 euros) and 13.2% were homeless. More than 90% of the patients are foreigners. And mainly from sub-Saharan Africa, the Maghreb and the European Union. Romanians, Algerians, French, Tunisians and Moroccans are the most represented. But today we are seeing the arrival of patients from European Union countries such as the Portuguese, Spaniards and Italians.
The pathologies observed are mainly linked to precariousness. It is above all a question of respiratory disorders but also of digestive pathologies (due in particular to the consumption of non-potable water), osteoarticular disorders and dermatological problems. In 2012, only 12% of patients had open rights (16% in 2011) to State medical aid (AME), reserved for migrants in an irregular situation, or to universal medical coverage (CMU) and 32% remained ” totally excluded from the healthcare access system “.
How to explain this increase in precarious situations?
In its report, Médecins du Monde explains that the obstacles encountered are essentially linked to the complexity of the legislation in force. The three-month residence criterion in France imposed by the regulations is an increasingly significant obstacle (32.8% in 2012 vs. 19.5% in 2011). Foreigners without a residence permit encounter an additional difficulty, which is the fear of being questioned, which leads them to limit their travel, in particular to support systems. The delay and non-recourse to care are not only linked to financial difficulties and the lack of health cover, but also to certain social determinants (housing, precariousness, administrative situation, cultural representations of health, etc.) and to the complexity of the organization of the health and social protection system in France. We also note that women are more affected by these “phenomena” than men.
Foreigners are not the only ones to be affected. The NGO notes that more and more French people also give up medical treatment : they were 13.5% in 2011, they are now 26.4%, undoubtedly due to the absence of complementary health insurance as well as the constant decline in health insurance reimbursements.
Consult the Observatory 2013 complete on the Médecins du Monde website