Care Of Illegals Needn't Color Health Debate

Investor's Business Daily
June 29, 2009 Monday

On the Lou Dobbs show last week, the Rev. Samuel Rodriguez of the National Hispanic Christian Leadership Council and Bishop Harry Jackson Jr. of the High Impact Leadership Coalition were confronted with the policy choice of whether to give emergency treatment to a 3-year-old undocumented child.

Dobbs pushed a trade-off between "covering citizens and illegal immigrants." Rodriguez said that illegal immigrants should be covered; Jackson said they should not be treated the same as citizens, but then suggested that in practice he wouldn't turn the child away.

I suspect most Americans agree with Jackson. But what about for legal immigrants? Republican Sens. Orrin Hatch of Utah and Mike Enzi of Wyoming have an answer: Restrict them.

Their proposal would require that immigrants not be eligible for any new government health benefits until after having been legally in the country for five years. This repeats a formula on almost all federal welfare benefits that Congress imposed in 1996.

Pro-immigrant groups are pushing to effectively repeal that law by ending the time restriction in any new health care reform bill.

Underlying the debate is a popular perception that immigrants are bankrupting the nation's health systems and are a threat to any reform.

Even the Hispanic Caucus in Congress is quietly tiptoeing around the issue, mostly saying nothing.

But the facts are that immigrants, including Latinos, put proportionately less strain on our health systems than do Americans who are native-born.

Meanwhile, they contribute to the economy and -- if polls and activists are to be believed -- are willing to pay more in taxes for health care.

The country clearly cannot put out a shingle offering free care to the rest of the world. But immigration fears should not be allowed to color the debate.

Health care systems that are far more effective, efficient and generous than ours restrict government health care for nonresidents without the stinginess of something like the Hatch-Enzi proposal or tying ourselves into costly administrative knots to combat a problem that has been blown out of proportion.

A study published in 2005 in the American Journal of Public Health analyzing government data found that the amount of money spent by immigrants, and by the government on their behalf, was less than half ($1,139) the money spent by and for U.S.-born citizens ($2,546).

This is hardly surprising: Immigrants are younger than the population as a whole and go to the doctor less.

The strict limitations on their receiving government benefits such as Medicaid and the State Children's Health Insurance Program (SCHIP) means that public expenditures on immigrants are also similarly low.

For illegal immigrants, according to a study published in 2006 in Health Affairs, it was 0.6% of what U.S.-born citizens received in government health benefits.

A RAND study of immigrants in Los Angeles County, for example, found that only half of illegal immigrants had even seen a doctor in the last year.

But what of the images of immigrants crowding hospital emergency rooms? There are individual hospital exceptions that make for dramatic television, but they don't represent all hospitals in the country.

The Health Affairs study found that only about 6% of noncitizens used hospital emergency services in 2003, compared with 32% of citizens.

A UCLA study in 2005 of Mexican migrants who had been in California less than 10 years were only half as likely (about 10%) to have visited an emergency room than U.S.-born whites (20%).

In the minefield of health statistics, it has to be noted that those figures don't measure whether the people paid for the service or not.

According to the Government Accountability Office, there are no reliable numbers that measure uncompensated emergency room care by immigration status.

Latinos overall, legal or illegal, U.S.-born or not, do appear to receive more of such uncompensated care than do other racial or ethnic groups.

Hispanics make up 15% of the population, but a study published earlier this year by the New America Foundation found that they were responsible for a little more than 24% of the uncompensated care in emergency rooms in 2004. This compares with more than 56% for whites.

But even those numbers don't represent a hugely disproportionate fiscal black hole, and they include more than immigrants.

The real problem is the reverse: Immigrants pay much more out of pocket than do ordinary Americans for health care.

A third of immigrants have no health insurance of any sort, public or private. Among noncitizen immigrants, the number rises to 44%.

No health care reform will be cost-effective or morally acceptable unless it includes our immigrants.

http://www6.lexisnexis.com/publisher/En ... 29&start=2