The health sphere beyond borders: Coverage portability and justice in a global space

Bioethics 35 (1):79-89 (2021)
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Abstract

Medical coverage often stops at borders, for both travellers and long-term migrants. Such patchiness imposes a de facto limit on free movement. This article considers this phenomenon not as a mere policy choice or technical matter, but as a form of territorial discrimination that is incoherent and even unjust. This legacy of nationally bounded social citizenship rests on a mistaken version of solidarity. Moreover, with growing mobility and rising expectations of medical coverage around the world, the fragmenting of safety nets by the political honeycomb of statehood will become a vexing problem in coming decades. A proper understanding of the health sphere not only can justify incremental reforms that lessen territorial discrimination, without impairing either solidarity or sustainability. It also foreshadows a radically different vision of how social provision might work in a future global space beyond the nation-state.

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