We don't want to be thought of as Scrooges post-Christmas particularly
with the dashing approach of New Year 2006 but we did want to make some
comments regarding the consequences of illegal immigration on medicine and
health care. This has certainly been one of the most important and far-reaching
issues of 2005. We have received many letters from readers
asking us to "Please say something" on this emotional and
fractional issue.
An old axiom states that what happens in California is a precursor to what
happens in the rest of the nation. Unfortunately, this is true. So look for these issues
to be coming to a capital in your state soon if they haven't arrived
already.
According to the Department of Homeland Security, in 2000 the population of
California had the highest percent of illegal immigrants in the country.
The estimate by the Immigration and Naturalization Service was that 2,209,000 aliens resided illegally in the state, which was 31.6
percent of the estimated national total. Current 2005 illegal estimates
vary between 14 million and 22 million nationwide.
A study by the Federation for American Immigration Reform estimated that in
2004 the annual uncompensated cost of medical care for illegal immigrants
in California was $1.4 billion. Total uncompensated educational, health
care and incarceration costs were estimated to be 10.5 billion.
Care is frequently provided to illegal immigrants by emergency rooms and is
provided when a crisis exists rather than as preventive practice. Both
phenomena add to the high cost of health care.
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For 12 states, the
government pays hospitals for providing emergency services to illegal
aliens. In 2005, the state of California got $70 million to help with
dismal shortfalls. California's San Diego County was about $100 million in
the red and Los Angeles County about $140 million.
Many California hospitals cannot afford to absorb costs and many are forced
to close due to financial mandates for treating illegal immigrants. As
recently reported, 84 California hospitals are closing their doors forever.
Hospital closure degrades health care to all in the community and results
in job losses.
Federal laws provide states incentives to provide Medicaid coverage to
illegal immigrants. All state Medicaid programs offer an endless list of
services, with some states, such as Florida, literally including the kitchen sink
if home repairs and maintenance are needed. Only four states check for
citizenship before awarding Medicaid. California escalated in one year from 450,000 illegal aliens on Medi-Cal (California's version of
Medicaid) in 2002 to 750,000 in 2003.
Medi-Cal covers well-baby maternity care,
delivery expenses and long-term care that are incurred for children born
to illegal immigrants. Thus "anchor babies" become medical insurance
policies.
Noted medical lawyer Madeleine Cosman, J.D., Ph.D., wrote in her online journal on August 27, 2005, "Promoters of open borders and elevating the
status of Illegal Aliens brilliantly use Americans' medical compassion
against ourselves."
The medical literature reports that many undocumented immigrants sequester within
their bodies infectious and fatal diseases that long ago were fought and
eliminated by American medicine Now illegals may carry drug-resistant
strains of tuberculosis, malaria, polio, leprosy, plague, dengue fever and
Chagas disease.
Are there Potential Solutions?
A number of potential solutions to reducing uncompensated health care costs
require federal participation, which means that senators and congressmen
from California and elsewhere must introduce federal legislation while
state legislators and administrators do what is within their power to
improve state laws and regulations.
Some potential solutions include:
Adopt measures to systematically collect information on undocumented
alien use of taxpayer-funded services. Health care providers and civil
libertarians have blocked past attempts to collect such information.
Withhold foreign aid to the country of origin in the amount spent
providing uncompensated medical care and refund these moneys to providers
that granted services.
Require graduates of U.S. medical schools who are citizens of foreign
countries to spend community service time treating illegal immigrant
patients in the U.S. as contribution in kind to defray expenses billable to that
country of origin.
Provide transportation to cities in country of origin where that country
is able to provide medical care.
Let's resolve, this New Year 2006, to promote a respectful exchange of
ideas and opinions aimed at achieving a sane, safe and sensible solution
to the immigration and medicine dilemma. With this goal our citizens, legal
immigrants, illegal immigrants and those who desire to come to America and
play by the rules will have a better quality of life.
It is far easier to make progress within a win-win, rather than a win-lose
or lose-lose overture.
Robert J. Cihak, M.D., is a Senior Fellow and Board Member of the Discovery
Institute and a past president of the Association of American Physicians
and Surgeons. Michael Arnold Glueck, M.D., is a Visiting Fellow in
Economics and Citizenship at the International Trade Education Foundation
of the Washington International Trade Council. He comments regularly on
medical-legal-ethical issues.