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Who Supports Giving Immigrants Publicly Funded Health Care? A Comparative Study of Attitudes in the US, UK, Germany, Sweden, Portugal and Taiwan

Rueyling Tzeng (Institute of European and American Studies, Academia Sinica)

Keywords: Comparative research

Abstract

According to the literature, long-term immigrants have worse health statuses than recent immigrants and native-born citizens. Factors include the nature of jobs normally available to immigrants (i.e., high-risk and demanding physical labor) and lack of health insurance and/or access to adequate health care services. Despite the World Health Organization’s assertion that access to the highest possible level of health care is a fundamental human right, immigrants often have no or inadequate health insurance. Lack of citizenship status is the most important barrier.
This study examines public opinion toward access to publicly funded health care for non-citizen immigrants. A data set from the 2011 International Social Survey Programme (ISSP) is used to analyze how demographic characteristics (age, gender), socio-economic status (education, employment, household income), health status (self-rated, chronic conditions), health insurance (type and coverage), and views about their countries’ health care systems (confidence, efficiency, satisfaction) influence attitudes toward extending publicly funded healthcare to non-citizens. Respondents were from countries with different types of welfare systems: the US, UK, Germany, Sweden, Portugal and Taiwan. Although both the US and UK are considered liberal welfare regimes, the health care system in the US is largely operated by private organizations, and in the UK it is publicly funded. Sweden has the highest level of spending on social protection, while Germany and Portugal are considered conservative in this regard; all three have publicly funded health care systems. In contrast, Taiwan is considered a developmental welfare state, with a health system that is fully administered, but only partly funded, by the state.
This study analyzes various combinations of welfare state type and individual-level factors. It was predicted that respondents with lower household incomes, poor health statuses, private or no insurance, or low confidence in their respective health care systems would express less support for the idea of non-citizen immigrant access to publicly funded health care. Since social contexts established by government policies can shape public opinion, I believe that the influences of these factors vary in the six countries due to the individual characteristics of their respective social welfare systems.