In our era of no-choice austerity, we are often told that politicians are obliged to make tough decisions, but some governments are setting new standards in callousness and inhumanity in their attempts to put their country's finances in order.
Take the decision by the Spanish government to deny medical treatment to 'illegal' immigrants.
Under the new law, which comes into force in September, immigrants without residence papers and work permits will no longer receive medical treatment, except in emergency cases.
The main reason for this disgraceful decision, as always, is financial: the ruling Partido Popular believes that the state will be able to save between 500 to 1,000 million euros per year by denying medical treatment to an estimated 153,000 foreigners who it believes are not entitled to by virtue of their illegality.
From September onwards, immigrants 'non-registered or not authorised as residents in Spain' will be left without a public health card, and will be forced to rely on medical treatment from charities and NGOs. This legislation is part of a swathe of austerity-driven changes to the Spanish national health system, which includes new charges on medicines and drugs.
Within this context, there is a strong element of crowd-pleasing populism in the PP's exclusion of the country's sin papeles (immigrants without papers) from universal health benefits.
Before the crisis, many employers made use of the constant pool of legal and illegal immigrant workers who came to Spain to work in services, agriculture and the construction industry, or as maids and domestic servants in middle and upper class households.
Now Spain's economy is crumbling by the day, and illegal immigrants are a surplus population at the bottom layer of Spain's tottering pyramid - and an easy target for a government looking to balance its budget through whatever means it can find.
Even though the law has not yet come into force, there have already been some bleak examples of what these distinctions between legal and illegal can mean. In Valencia, last week a Chinese sin papel named Ladi Fan was charged by a local hospital for a life-saving operation that she received last year.
Ms Fan was diagnosed with rectal cancer in December and the subsequent operation successful removed the tumor. But last week she received a bill for the very precise sum of 20.797, 39 euros from the regional government of Valencia for the treatment she received.
It would be interesting to know how the hospital reached such a precise calculation of how much Fan's life was worth - since this is in fact what these mathematics are ultimately referring to.
Even more to the point, it would be interesting to know how the hospital concerned thought that an unemployed migrant without papers in a civil partnership with an unemployed Spanish waiter could pay such a sum. Had it not been for her partner, who gave his own name and address and signed the papers enabling her treatment, she might not have received any treatment at all.
A local health centre has managed to register Fan so that she does not have to pay the 90 euros a week for an ileostomy bottle, even though she has no permit of resisdence. In September, she could lose that too.
To its credit the Catalan health services have refused to implement this law, on the grounds of solidarity and public health. But the implicit message in the new legislation is that the lives of illegal migrants are worth less than others, and that financial calculations have entirely taken place over elementary human considerations.
This philosophy is not unique to Spain. In the UK in 2008 the Labour government deported the Ghanian woman Ama Sumani who was on lifesaving dialysis treatment, because she had overstayed her visa. Sumani died soon afterwards. Last year, the Home Office came very close to deporting Rania Abdechakour, a five-year-old quadriplegic with cerebral palsy back to her native Algeria.
Now UKBA is currently seeking to deport Roseline Akhalu, a Nigerian student who overstayed her visa and is receiving lifesaving immunosuppresant drugs for kidney failure that are not available in Nigeria.
In countries where cuts are being inflicted on the whole population, decisions like these reflect a new determination to enforce the distinction between legal and illegal people, national citizens and foreigners, that is leading to a generalised race to the bottom.
Governments may think such decisions are a sign of toughness and rigour, and they will always please those who regard immigrants - whether legal or not - as unworthy intruders, parasites and ' health tourists'.
But to deny medical treatment to people who need it because of their immigration status is another sign of how barbarous even supposedly civilised societies can become, when crucial matters of life and death are reduced to how much things cost, and how much - or how little - some people's lives are worth.