Difficulties Faced by Foreigners in Madrid, Spain
Access to Healthcare System:
Rights to healthcare system constitutes an important aspect of basic living rights for immigrants in Madrid and how they feel about the access and quality of healthcare system shapes their perspective of life quality in Madrid. The health of immigrants has also become a relevant topic from a public-health standpoint.
The first important feature to be noticed is the irrelevant distinction between legal and illegal immigrants. Legal immigrants enjoy access to public health care and so do illegal immigrants; as long as they are documented at the local level (Calavita, 1998), they can have access to health as basic social needs.
So, more attention is needed to compare immigrants with local habitants, autochthonous population. In general, when we compare their education level, marital status and monthly income, we find that the autochthonous population register a higher percentage of citizens receiving an income over 1200 euros per month. Regarding the perceived health and lifestyle, immigrants had significantly lower values for alcohol consumption and smoking and engage in more physical exercise (Antón, 2010). In general, we do not observe significant differences in the use of healthcare resources by immigrants compared with autochthonous population, except in terms of hospitalization for over 12 months (Buron, 2008). Immigrants also tend to show fewer consumption of medical drugs than the autochthonous population, but the respective relative self-medication percentages were similar in both populations (Antón, 2010). Lastly, both populations demonstrate a similar percentage of influenza vaccination, with slight differences (Jiménez-García, 2008).
Several barriers do exist despite universal coverage of healthcare system implemented in Madrid and in Spain generally. On the one hand, the requirements are limited and easy to fulfill to receive an individual healthcare card (IHC) and healthcare is free at the point of delivery (Rubio, 2008). It is also notable that the no requirements are set for receiving emergency care. On the other hand, problems do occur when discussing the immigrant population in particular. Firstly, there seems to be an overuse of the healthcare system because little value was given when the healthcare system is free and of quality (Antón, 2010). Secondly, the requirements for obtaining an IHC may not be fulfilled under certain circumstances when immigrants do not register at the city council. Instead of being able to provide a postal address (Calavita, 1998), some may use fake ones or pay to use someone else’s (Villarroel, 2016). Thirdly, the dissemination of information may not be efficient when it is realized via social workers at the health centers. Either they explain well or they make immigrants pay. Overall, the geographical, organizational and economic aspects play a role in defining the behavior pattern of immigrants vis-à-vis healthcare system in Madrid, Spain.
Legal and administrative procedures
We can trace our current legal system and administrative patterns towards immigrants in Spain to the LOE reform, when different bills were discussed and led to the promulgation of most important Law 4/2000, i.e. Organic Law on the Rights and Liberties of Foreigners in Spain and Their Social Integration.
We note several features under this current system. Firstly, emphasis was placed on equalities of rights between legal residents and Spanish nationals under most of their political and social rights, including the right to family reunification but except the right to vote or to be appointed to public office (Garcés, 2012). Secondly, the system put in place to tie several rights of illegal immigrants of accessing health and education facilities to El Padron, rather than to legal residence. This also enables illegal immigrants to enjoy social benefits that they could not before, as long as they proceed with the municipal register process. Thirdly, ordinary individual regularization, i.e. arraigo, is facilitated and application of expulsion measure based on illegality in work or residence becomes rare. Illegal immigrants, therefore, only refer to those who try to enter Spain illegally (Agudelo-Suárez, 2009). For those who are already inside the territory, the penalty would be a fine.
Thus, for immigrants entering Spain and arriving in Madrid, it is important to practice their documentation rights in El Padron, no matter legal or illegal. The implication of El Padron is essential, since it ensures the access education and complete health care without discrimination. However, under the status of illegal immigrants, political and union rights to assembly, demonstrate, associate, unionize and strike were denied (Arango, 2013).
In terms of the implication of the judicial system for non-resident foreigners, LO II/03 puts on ground the measure of expulsion for those who committed crimes. LO I4/03 implied the prospect of police gaining access to data pertaining to the El Padron.
Another system character for immigrations is contracting foreign workers in their place of origin, so as to channel migratory flows. Under this perspective, the Spanish Government signed various agreements with African and Latin American authorities to facilitate the reception of immigration. Still, the access to entry remains restricted and gives rise to more illegal immigration than before.
