This study aims to understand the impact of the designation of public hospitals as dedicated hospitals for COVID-19 patients on access to healthcare services for vulnerable populations, and to argue for the need to expand the concept of universal health coverage.
We conducted in-depth interviews with a total of 29 healthcare providers working in public hospitals and advocates between June and September 2021, and analyzed the findings using a framework approach.
We found that even before the COVID-19 pandemic, homeless people and undocumented migrants were experiencing constraints to healthcare access due to economic, institutional, and cultural factors, and that public hospitals are an important social protection mechanism for them. As public hospitals were mobilized as dedicated hospitals to respond to COVID-19, their access to healthcare services was further restricted. This process can be interpreted as a strategy of exclusion by the state, as the duty bearer of the right to health, to protect the majority during a public health crisis. To achieve true universal health coverage, healthcare systems must become more public.