Intra-EU migration and healthcare deservingness: A conjoint experiment in Belgium and Spain

Roberta Perna and Sebastián Umpierrez de Reguero

Social Science & Medicine, 2025, vol. 367, issue C

Abstract: Extant literature has largely analysed how European Union (EU) migrant citizens' welfare rights are framed in public discourses and affect social solidarity, delving into the concept of ‘welfare deservingness’. Surprisingly, the healthcare domain is comparatively less researched. Few studies have unpacked the concept of ‘healthcare deservingness’ and its variations across contexts when it comes to intra-EU migration and migrant citizens' healthcare rights. Running a survey experiment in Belgium and Spain (n = 1307 per country), respondents were asked who they would prioritise to access publicly-funded healthcare out of two fictitious patients who randomly differed in nationality, migration status, responsibility over ill-health, and employment status. The results indicate that individuals with a foreign EU nationality, a recent migration history, unemployed and who are deemed responsible for their illness systematically suffer from penalisation intentions to access healthcare. Importantly, foreign EU migrants belonging to the most perceived socially-distant ethnic outgroup suffer from a double penalty in prioritisation intentions. However, differences exist across countries. Deservingness criteria associated with the idea of a (individual and collective) responsibility towards healthcare and its funding have stronger effects in the Belgian social insurance regime, while criteria based on territorial belonging have stronger effects in the Spanish universalistic regime.

Keywords: Healthcare; Deservingness; EU migration; Conjoint experiment; Survey; Belgium; Spain (search for similar items in EconPapers)
Date: 2025
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DOI: 10.1016/j.socscimed.2025.117714

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