Inclusion Versus Exclusion: Framing Spanish Media Discourse on the Access to Health of Irregular Migrants

The Spanish post-Franco health model guaranteed universal access to health care—a system that was considered unique in the world, insofar as all residents in the Spanish territory were entitled to public health care irrespective of their legal status. Nevertheless, the Royal Decree-Law 16/2012, dated 20 April, was passed as one of the “urgent measures to ensure the sustainability of the National Health System and to enhance the quality and safety of its services”. It constitutes one of the major reforms under Rajoy’s cabinet (Partido Popular), that radically re-defines the system of the right to health. The RDL explicitly links entitlement to contribution to the system instead of “residency”. This change entitles those who pay or have paid some social security contribution (together with their beneficiaries) and excludes other categories, being the irregular immigrants the main group.

We critically examine Spanish mainstream media constructions regarding the irregular immigrant’s access to health care. The paper asks the following question: What are the main frames that support (frame of inclusion) and exclude (frame of exclusion) the irregular immigrants’ entitlement to health insurance coverage? We argue that different discourses are shaped based on the analysis of a sample of articles dealing with the Royal Decree-Law 16/2012, from two major Spanish newspapers: El PAIS (with progressive stand) and ABC (with conservative leanings),. The study corpus includes a sample of 278 articles from 2012 to 2016. Regarding “frames of inclusion”, we identify both, a human rights narrative an arguments that appeals to the universalistic vision of the Spanish political culture concerning the entitlement to health care, as reflected in the Spanish Constitution. When analyzing the “frames of exclusion”, our results highlight the cost-saving approach (in terms of overly-generous concessions concerning welfare benefits, the need to combat “health tourism” and the loss of quality of health care)