Summary Report on MIPEX Health
This Summary Report on MIPEX Health produced by the ADAPT network is based on work carried out by the International Organization for Migration Health Division, in collaboration with COST Action IS1103 ADAPT and the Migration Policy Group (MPG). While many studies have compared different countries, concepts, categories and methods, the new MIPEX health data collects information in all MIPEX countries on 38 standardised indicators disaggregated for legal migrants, asylum seekers and undocumented migrants. These results are the first of many which are expected to result from this new data:
- Entitlements. For migrant workers, requirements related to employment or length of stay often obliged them to take out private insurance or pay their own medical bills. Asylum seekers were seldom entitled to the complete basket of health care services, while coverage for undocumented migrants ranged from practically non-existent to almost the same as for nationals (subject to a means test).
- Accessibility. Countries differ greatly in the efforts that were made to inform migrants about their rights to health care and how to exercise them. Often, health workers appeared to be as badly informed about entitlements as migrants themselves. For undocumented migrants, the threat – real or perceived – of being reported to the authorities was a significant barrier to access in a number of countries.
- Responsive services. Countries vary most in terms of support to improve the responsiveness of their health services. 8 countries take no measures whatsoever to meet the special needs of migrants, while 6 emerge with slightly favourable measures.
- Responsive policies. Data collection, research, planning, consultation and coordination which are needed to develop good policies existed in few countries.
Furthermore, the report finds that the strength of a country's migrant health policies, as measured by MIPEX, are related to their level of GDP, health expenditure, the percentage of migrants in a country, the date of accession of countries to the EU and the strength of their overall migrant integration policies. Health systems also seem to matter. The type of health financing used in each country (tax-based or insurance-based) makes a difference to ‘Quality’ but not to ‘Access’. It is widely assumed that tax-based systems are more inclusive, but this does not appear to be the case for migrants. On the other hand, such systems do seem better at introducing measures to adapt services to the needs of migrants. Finally, the results show that the ‘traditional countries of immigration’, which are often assumed to have better developed policies on migrant health than other European countries, tend to have higher scores but also show the effects of recent political shifts.
The summary report is based on the Recommendations on Mobility, migration and access to health care adopted by the Council of Europe in 2011, after a consultation process with migrant health experts and practitioners and within the framework of the project EQUI-HEALTH.
Migrant Integration Policy Index (MIPEX) was developed by the Migration Policy Group as part of the project "Integration Policies: Who Benefits", co-funded by the European Fund for the Integration of Third-Country Nationals, DG HOME.