Inequality by design: The politics behind forced migrants’ access to healthcare

When a system comes under strain, the persons most likely to suffer from the repercussions are those at and beyond its margins, as the age-old rule ‘Help yourself before helping others’ typically guides crisis management within the system. Similar behavioural patterns on the side of policy-makers have left a distinct mark on the healthcare rights of forced migrants in the context and aftermath of the so-called ‘migration crisis’ of 2015–2016, as this article demonstrates. Following the crisis, this group of persons, who are traditionally situated at the margins of society already, have been pushed further outside social and healthcare systems through increasingly restrictive incorporation policies across Europe. By analysing recent legislative reforms in four countries (Germany, Italy, Sweden, and the UK) which stood out in various ways during the crisis, this article sheds light on the increasing politicisation and polarisation of the intersection of incorporation and healthcare. It shows that the crisis induced similar responses of legal adaptation in countries with fundamentally different healthcare and incorporation systems, and analyses the dynamics behind such processes of change. The article thereby contributes to a better understanding of healthcare legislation as a reflection of political opposition to or acceptance (if not fuelling) of societal inequalities.