Nov. 17, 2007
Undocumented Shouldn't Mean Uninsured
The New Republic: Leaving Illegal Immigrants Out Of Health Care Only Costs Taxpayers Money
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Battle Over Immigrant I.D.s
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Last October, Dr. Jack Ludmir, the head of obstetrics and gynecology at Pennsylvania Hospital, oversaw the emergency-room treatment of a young woman who was seven months pregnant, hypertensive, and convulsing. Although her condition was, according to Ludmir, "rarely seen in the United States," his team diagnosed it quickly: She was suffering from eclampsia, a severe pregnancy-related disorder that can lead to premature birth, seizure, stroke, even death.
In this country, the condition is usually caught in its early stage known as pre-eclampsia, which can often be managed with prenatal care; but, with the mother already in the ER, doctors had no choice but to deliver the baby prematurely.
Over the next three months, the newborn was threaded with respiratory tubes while doctors flushed the mother's brain of excess blood three times. "You can't imagine the costs," says Ludmir. For as little as a few hundred dollars worth of prenatal care, he says, this tragedy - and at least $250,000 of medical care - could have been avoided. Unfortunately, this was not an option. The mother was an undocumented immigrant and therefore was ineligible for publicly funded prenatal care in Pennsylvania.
The one health care issue that Republicans and Democrats agree on these days is that illegal immigrants like Ludmir's patients should not have access to publicly funded health care. Republicans see this as a facet of the immigration issue - House Minority Leader John Boehner recently issued a press release charging that providing health care to illegal immigrants "increase[s] the tax burden on American families," while conservative commentators like Michelle Malkin are more naked in their hysteria, warning that the United States is in the midst of becoming "the land of the limit-less health care handout for 'undocumented immigrants.'"
The Democrats, meanwhile, are too cowed by the anti-immigration lobby - and the prospect of losing support for their individual health care plans - to defend the undocumented. Hillary Clinton and John Edwards have already decided to exclude illegal immigrants from their universal-coverage proposals, while Barack Obama has held his tongue on the issue. As a result, doctors such as Ludmir are likely to continue to see undocumented immigrants when their medical situation is most dire - and costly to society.
This isn't the first time that the combination of Republican hostility and Democratic timidity on the immigration issue has adversely shaped policy. In 1996, as part of welfare reform, Republicans insisted on banning legal immigrants from receiving Medicaid and S-CHIP (which assists families that make too much to qualify for Medicaid) for the first five years of their residencies. President Clinton grudgingly agreed to the provision in order to shepherd the welfare-reform bill through Congress.
The Republican argument that cheap public health care was attracting impoverished illegal immigrants into the country has since been called into question: In 2000, a study from Health Affairs found that less than 1 percent of undocumented immigrants "cited obtaining social services as the most important reason for immigrating." But, although its foundation has rotted, the policy still stands, setting the tone of the current debate: If we don't provide publicly funded health care even to some legal immigrants, why extend it to illegal ones?
There are currently 12 million undocumented immigrants in the United States - the majority of whom are uninsured. Among all immigrants, both documented and undocumented, less than 40 percent receive employer-sponsored coverage. The only federal health care program that covers undocumented and newly arrived legal immigrants is known as "emergency Medicaid." Under this program, the government will pay for emergency hospital care for the pregnant, elderly, and disabled, and for children or the parent of a child. (Although what, exactly, qualifies as an "emergency" is ambiguous: The federal government recently informed New York state that it would no longer fund chemotherapy.) Those who do not qualify for emergency Medicaid must pay for their treatment out of pocket, or the hospital must write it off as uncompensated care for which it should eventually be reimbursed, at least in part, by the federal government.
While it is true that the ER expenses of immigrant children are greater than the per capita average, probably because they are sicker when they finally seek care, immigrants tend to spend less money on health care than their U.S.-born counterparts. (One study in the American Journal of Public Health found that, in 1998, the average health care expenditures of a Hispanic immigrant, documented or undocumented, totaled $972. For a white, U.S.-born citizen, they were over $3,000.) Part of the reason for this discrepancy is because immigrants are, on average, younger and healthier than citizens. This would seem to be an argument for keeping the current system rather than expanding coverage, which tends to raise expenses as patients become insulated from the costs of their care. But, although immigrants may arrive in this country healthier, they regress toward the mean, developing many of the chronic conditions, such as heart disease and diabetes, endemic to U.S.-born citizens. They are also aging as a population. As a result, the number of disabled and elderly illegal immigrants is on the rise, and a recent study of North Carolina's emergency Medicaid system found that "[t]he largest spending increases [among the undocumented] ... are occurring among the elderly and disabled groups."
The obvious way to contain these costs is to insure the undocumented, so that they have access to preventive care before they degenerate into the tax siphons conservatives already claim them to be. And there is an additional reason to take this step: public health. Just a few unvaccinated individuals can threaten a whole community, a threat that is particularly acute among the undocumented, since they often work in the food service and agricultural industries. Unfortunately, Democrats continue to conflate the health care issue with the immigration one. Clinton and Edwards claim the health care problem will solve itself after they pass comprehensive immigration reform with a path to citizenship. But this is unlikely to happen anytime soon, and, by the point it does, the benefits of incorporating the undocumented population today, while it's still largely young and healthy, will have expired.
In the regrettable absence of comprehensive federal legislation, there are some smaller, more feasible measures that should be considered. One is to extend publicly funded health care to all legal immigrants. The second is that more states should extend prenatal care to the undocumented. On this front, the federal government has already done its part: In 2002, President Bush expanded s-chip eligibility to fetuses, giving states the option to cover the prenatal care of mothers ineligible for Medicaid, including undocumented immigrants. Disappointingly, most states, including a majority of the so-called "new-growth states" - those states whose immigrant populations grew most quickly in the 1990s - have not accepted the federal government's offer and provided the necessary matching state funds.
This is unfortunate, because there are compelling reasons to do so. A study by researchers in Colorado, a new-growth state, found that only 52 percent of the state's undocumented women received prenatal care during the first trimester, as opposed to 83 percent of all other women. Consequently, 40 percent of undocumented mothers experienced a complication of delivery, as opposed to less than 30 percent of all other mothers. And, beyond the moral imperative, there's an economic one. Researchers in California, the epicenter of undocumented immigration, have estimated that one dollar in prenatal care can save over three dollars in postnatal care. (California, as it happens, is one of the 15 states that provides prenatal care to its undocumented residents.) Prenatal care isn't just a drop in the bucket of spending on the undocumented either: Over 80 percent of emergency Medicaid spending on the undocumented in North Carolina, whose immigrant population nearly quadrupled in the 1990s, was for childbirth and complications of delivery.
Jack Ludmir's patient would certainly have benefited from this limited expansion of preventive health care. Her eclampsia left her partially paralyzed, in poor condition to care for a sickly child - one who, it's worth noting, is a U.S. citizen whose continued care taxpayers must now fund.
By Ben Crair
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See all 79 CommentsThe author goes on to use this erroneous arugment to support his view that all illegal immigrants should be entitled to healthcare insurance in the United states. However, although Canada and Mexico, have free health services, neither provide these services free to illegal immigrants in those countries on a universal base. Rather illegal immigrants are often required to pay for those services.
The question we should be asked is why are we giving citizenship to children based solely on birth in the United States. Again an example of our liberalness which neither Canada or Mexico follow.
It would be foolish to further flood the United States with illegal aliens by providing further benefits to those here illegally.
Nor in United States v. Wong Kim Ark were the parents illegal immigrants. Although courts have seemed to apply the case to illegal immigrants, I am unaware of a Supreme Court case that has actually decided the issue unequivecally.
Let the profiteering insurance companies sign up every one of them and let them contribute to it, just like every one of us have to.
The point is, if they''re here illegally, they don''t have the right to the pursuit of health, properity and those inalieable rights that belong to a citizen.
Let them go home and demand it from their own governments.
Or better yet, if they''re here in this country working, demand that the big businesses that are hiring them pay for their health care as protection against tax payer dollars! I think that''s a piece of legislation that should be put thru immediately if they want to bring in immigrants to flood the job market for their profitability with cheap labor.
Pass a Universal Health Care program for our citizens which excludes illegal immigrants and require those bustwards who hire them pay for their health care!
This is just another republican guilt trip being thrown in our faces! I can''t believe intelligent people are falling for this ***!
The Democrats are the ones supporting illegal immigration in most cases, some Republicans do as well, but not the majority of them. At least in my experience.
I''m an independent, Illinois, and both of my senators, Durbin and Obama are fully in the pro illegal immigrant camp. Both are Democrats.
This 1% is enough reason to support a policy that further restricts social services to illegal immigrants, eliminates birthright citizenship and rather has citizenship for minor children follow the parents citizenship status.
Those two changes alone would have an immense affect on the illegal immigration in this country.
Perhaps those most likely to hire them as "household" help, want to keep their cheap labor around, and prefer that the public give them benefits, like healthcare.
In any case, Rep. Boehner is representative of the hate Republicans have for illegal immigrants; a subject Hispanics care very much about. Re.p Boehner and his kind have labeled the GOP as anti Hispanic. In 11/2008, the GOP will reap what it has planted.
I think the confusion is that the Constitution states that a person is an American citizen if born on American soil. However, I think our founding forefathers didn''t expand upon that by mistake. I would think that they assumed that Americans having children on American soil, whether on a military post, embassy, or commonwealth, were American citizens. I don''t actually believe that this law pertains to illegal aliens having children on American soil. An apple tree produces apples. A pear tree produces pears. An apple tree does not, however, produce pears. Being in a MacDonalds doesn''t make you a hamburger. Americans breed Americans. Illegal aliens breed illegal aliens. So, a Mexican that has children on American soil doesn''t make the children Americans. The children are STILL Mexicans. The whole family needs to be deported.
Hate doesn''t have anything to do with it, except for those that resort to cheap tactics because they don''t have facts.
Since all illegal immigrants are not hispanics or all hispanics illegal immigrants, ethnic heritage really has nothing to do with the discussion. Its a troll tactic.
Apparently you do not believe the Senator should have told American citizens how much they are paying for providing this service? We prefer a government that does communicate with us, rather then plotting behind closed doors with "stakeholders" to the benefit of those that are not citizens.
This is essentially what illegal aliens are doing. They are expecting us to take care of them as well as our own, and we simply can''t. Illegal aliens are children to a different set of parents that need to take responsibility for them.
I must say, you are right. For the last 40 years, Latin American communities have been DEEPLY divided by wealth. Really, HORRIBLE juxtapositions of wealth and absolute "eat your own baby" poverty. America created a better, more equitable, society, and thats why all the Latin poor are over here... wouldn''t YOU do the same? I was in Latin America in the 1970''s and could SEE the problems occuring that this was going to create!!!
We need to close the border, send them home (if we can identify all of them), and FORCE (I mean, by arms if necessary) Latin American to take in its own POOR!!!!!!!! Al-Qaeda is a ruse. The true threat to America is Latin America (and other places) NOT looking after their own people, and FORCING them to leave to other shores (i.e. America).
Time to take ACTION against THAT kind of ''rich on poor'' predation!!! I''m sorry the world is over-populated. It''s not America''s job to take in the excess!!! And I say this as a Dem!
I agree. Oh gosh, yes, I agree. And I think we should actually go one step further. Invade Mexico! If they all want to be Americans, voila! Then, they would HAVE to follow all the laws and regs, and we would then go about improving the sorry conditions down there. I really don''t think that the Mexican government would be stupid enough to try to stop it. I know it sounds Imperialistic, but, hey, you made your own kids *** children. Give us your country and we''ll adopt them. And stay out of our business!
Well, maybe we''ve had enough of invasions for the present. For now, absolutely CLOSE the border. 100%. Then, try to identify those who''ve been here illegally less than 10 years and deport them (yes, pay them something if possible, that would be the right thing to do). Finally, put serious pressure on their governments to get rid of the HORRIBLE inequities I saw in the 1970s-80s (which, I''m sure, continue to this day), that has driven this gruesome expatriation. We are dealing with a FAILURE to deal with a typical overpopulation problem of too many countries over the last 50 years (if you want to see how to deal with the subject of southern overpopulation/inequity properly, take a look at Italy in the 1960s-70s).
America is a little too romantically impressed by its history as the place for the ''tired, oppressed, huddled masses''. That''s not an excuse for other countries not to get their sh*t together. Many Latin American countries in particular (I''ve been to these countries: trust me, to be upper middle class in them is a whole OTHER plane of existence), have decided to export their population problems. ENOUGH OF THAT NONSENSE!!!
How in the he11 do you think you got a hold of all of the Southwest and Texas???? By invading Mexico, maybe, just maybe?? Good grief, I love the irony.
It went like this.
"The illegal is like a robber in the house of the immigrant stealing his hard earned property".
The best of good byes frank bowers in austin, tx
Posted by bennyblack1 at 05:35 PM
Yep, they used to say this krap about the Irish too. "But they don''t live like us." "They''re dirty people." Or, I like when back in the 30s they would give IQ tests to some poor old woman from Poland who didn''t speak any English, and say "They''re sending all the sick retards to our country." Or,"We can let them Jews come in, they''re trying to take over the whole country." "Make sure none of them get of the ship, and jump to freedom." So, the U.S. sent back several thousands of Jews to face their ultimate fate in the Holocaust. Yep, by today''s standards, most of you wouldn''t even be here posting your anti-immigrant rhetoric, because your dirt poor, illiterate ancestors wouldn''t have even been allowed off the ship.
Hmm. It''s more like the so-called "illegal" is a stranger in his own land, stolen from his ancestors by illegal, unscrupulous, self righteous invaders.
Most of the illegal immigrants are hispanic-from mexico or South America.
There is no middle class in S.America,just poor and the very rich.
Their population is exploding and the uber rich have found the solution-send them over the border in US.
For more than 40 years Mexico''s main export is poverty.Have you ever been to Mexico City?They are calling these people-their own poor,half-breeds.
In less than 20 years USA will look like a third world country.
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