Illegal immigrants' impact on the United States healthcare system

¶ … Illegal Aliens on the Healthcare System

Running Page: INSULT to INJURY

Illegal Aliens' Impact on U.S. Health Care System

The chronic problem of illegal immigrants' sharing costly, abundant and expert healthcare services system with citizens has mounted through the years. One reason is the lack of effective legislations to modify immigration laws. Another is a duality of federal policy, which vows to serve the interests of citizens and which declares an "open-door" policy to the world. California and Maryland register large populations of illegal aliens who not only share their taxpayers' social benefits. They can also secure what, in some cases, is not available even to these taxpayers themselves. A thorough study on the current situation and past efforts is warranted and more than timely.

Research Method

This study will use mainly the descriptive-normative method of research in recording, describing, interpreting, analyzing and comparing data gathered from authoritative and recent sources of information. It may also use a complementary questionnaire or survey method in gathering responses and other information from and about the sample population. The sample will consist of individual respondents chosen at random in select hospitals and clinics in California and Maryland with large populations of illegal aliens.

Findings and Conclusion

The message of President George W. Bush's 2006 State of the Union Address was keeping American economy competitive through stronger immigration enforcement and border protection (Stoil 2006). Shortly afterwards, he promoted immigration reform as the focus of his domestic legislation. Heated debates ensued as a result of the inconsistency. Intents and attempts at evaluating and modifying the immigration have been going on in Washington in the last two decades. The last major change was the Immigration Act of 1990, which created the three categories of legal immigrants, namely, family-sponsored immigrants, employer-based immigrants, and the so-called "diversity" immigrants, who sponsor themselves. The Act set annual limits to the number of visas for each category, a quota for each country and a bipartisan Commission on Legal Immigration Reform to work on the technical aspect of a rational immigration policy. The Commission recommended a more effective system of verifying work authorization in an attempt at reducing illegal immigration. However, it failed to develop a basic law, which would match employment and family reunification needs. As a consequence, the Immigration Act of 1990 ironically induced the current illegal immigration problem. Visa issuances were limited at a period of worst recession. But right after, the economy rapidly and vigorously expanded.. The demand for low-income, hourly workers and seasonal employees attracted at least 11 million foreign nationals for these jobs in recent years. Laws from1991 to 2001 did not recognize or sufficiently address the change in circumstances. From 1996 to 2003, less than five or six bills per year were presented in Congress, which addressed immigration issues. Few of these immigration reform bills tended to further restrict legal immigration and imposing criminal penalties for illegal aliens. The President and Congress might come to terms more deeply with the reality of illegal immigrants on account of all their adverse effects on the population. But the declaration that America must keep an open-door policy has screened the sore facts, which led to the development of current immigration problems (Stoil).

An honest and thorough review of the history of the United States reveals that it was built primarily by immigrants who sought a better life for themselves and their family through productive industrial pursuits (Sanders et al. 2006) and by establishing a culture of diligence and efficiency. Almost anyone could migrate to the U.S. until the late 19th century. That early, the federal government began attempts to control the influx of aliens through different legislations. Western and Northern nationals were the beneficiaries of these legislations. Restrictions were aimed at non-whites. The Chinese and the Japanese were prohibited from entering the U.S. Then other Asian workers were observed to work at most railroad and mining jobs at lower wages. President Theodore Roosevelt tried to negotiate with Japan to suspend immigration in exchange for non-segregated education for Japanese children then in California. Congress enacted three laws, meant to preserve the true "character" of the nation. These were the Emergency Immigration Act of 1921, the National Origins Act of 1924 and the Displaced Persons Act, which restricted the entry of "undesirable" aliens to the U.S. (Sanders, et al.).

The Immigration Act of 1965 allowed almost equal numbers of aliens from all over the world to enter the United States but reduced those coming from Latin America (Sanders, et al. 2006). This increased the number of illegal aliens from Mexico and South and Central America, who fled from poverty, civil discord and political persecution. The Refugee Act of 1980 gave them legal entry but retained severe restrictions on social service program budgets of Southwest border and some coastal states. Responding to the heated anti-immigrant sentiments and the accompanying economic problems, Congress enacted the Immigration and Reform and Control Act of 1986, which sanctioned employers who would knowingly hire illegal immigrants. It also provided for an amnesty program, which legalized illegal aliens who had been living in the U.S. For at least four years. The Immigration Act of 1990 allowed a 40% increase in immigration. Then Congress passed the Immigration Act of 1996, which increased the number of border patrol agents and restrict the provision of social services to illegal aliens from Mexico (Sanders, et al.).

In comparison with about one million legal immigrants every year, there are about 400,000 who enter the U.S. illegally (Sanders, et al. 2006). Statistics say that there may be 4 to 11 million illegal aliens now living in the country. Federal and State laws have been passed to deny social service benefits to these illegal aliens. The Welfare Act of 1996 virtually deprived them of all benefits, including Supplemental Security Income. They could have only temporary housing, emergency medical assistance, and disaster relief. California passed the 1994 Save Our State Amendment, which denied public social and welfare service, public non-emergency healthcare and public education to illegal aliens. This law has been contested as violating federal immigration law, due process and the provisions of the Equal Protection Clause of the 14th Amendment by denying free education to the children of illegal aliens. Proponents, however, insisted that such programs actually attract illegal immigration. Illegal aliens cost the federal government approximately $26 billion in social services and criminal justice system expenditures each year. Advocates who take the side of illegal aliens contend that they contribute to the tax base, as most of them come to the U.S. To work. They add that depriving illegal aliens of access to public education and healthcare will tend to increase crime and public health problems. These are among the arguments raised in debates for and against programs, which provide or deny social services to illegal aliens (Sanders, et al.).

The Health Security Act guaranteed universal healthcare coverage for all Americans (Clarke 1994). It promised to simplify healthcare paperwork and delivery systems, control health costs and promote individual choice of coverage plans and health care providers. The Act, however, did not tie up with funding available from employers who would pay the benefits or coverage. It did not provide appropriate incentives for the wise use of healthcare resources, had no economic incentives for the choice of lifestyles of healthcare services. It required simplification of administrative procedures, relied too much on government regulation and too little on public sector initiative and few incentives for medical research and technology advancement (Clarke).

More than half of almost 37 million U.S. citizens who have no health insurance have jobs but mostly work for small companies (Eichstaedt 1993). Former Bill Clinton's health plan was commendable, but it failed to address rural health care and health care for the uninsured. Among the uninsured are illegal aliens. The problem could be resolved only if the competing systems cooperated and if companies and health care providers shared the added costs (Eichstaedt).

According to an article published in the Washington Post, Americans pay millions of dollars to provide health care and medical treatment for illegal aliens (Boulet 2004). It said that the U.S. government would help subsidize a four-year $1 billion dollar program to shoulder some of the costs for treating illegal immigrants. Senator Jon Kyl sponsored the subsidy with funds in the Medicare bill. Houston's Harris County Hospital District, for example, spent $330 million to treat and immunize illegal aliens for a period of three years (Boulet).

Baltimore County Republican Delegates Patrick L. McDonough and Richard K. Impallaria wanted to know how the influx of illegal aliens has affected the welfare of the people of Maryland (Dembeck 2004). The Immigration and Naturalization Service said that there were approximately 56,000 illegal aliens in Maryland. Only 18 other States had bigger illegal alien populations, according to the INS. The citizens and other legal aliens were losing their jobs to illegal aliens, who were willing to accept lower wages. Moreover, the legislators felt that illegal aliens were also putting substantial pressure on the State's health care system. The Franklin Square Hospital Center, for example, reported that more and more illegal aliens were coming to its emergency room every day. It said that its uncompensated care rose from $11 million in 2002 to $14.8 million in 2003. A spokeswoman for the hospital, however, said that the increase could not be all attributed to illegal aliens. A spokeswoman for the Maryland Hospital Association remarked that, while illegal aliens appeared to have been a financial drain on hospitals, there were no hard statistics or facts to show how they had impacted the health care system of the State. The only certainty was that the increasing and unpaid bills would be compensated for by raising everyone's hospital rates (Dembeck).

Providing health care services to illegal aliens for free has not only drained taxpayers (Hanson 1994). There have been cases when these illegal aliens acquire these services and American citizens cannot. A classic case was that of a Hispanic, Hermillo Meave, who was ruled as eligible for a heart transplant for free at the Sharp Memorial Hospital in San Diego in September, 1991. The overall transplant cost of care was $1 million. Using fraud, Meave proved his eligibility and this meant that the cost would be borne by the State. Meave's case was a classic illustration of the condition of illegal immigrants who would take advantage of the expensive, State-funded social services, especially health care. California State officials noted that approximately 2,000 illegal aliens cross the border to the State every night. Yet the federal government had not done anything to contain the problem. Instead, the laws set up even attracted the illegal population (Hanson).

California Governor Pete Wilson joined the governors of Texas, Florida, New York, Illinois, New Jersey and Arizona in urging the federal government to pay the $7.5 billion annual expenditures for the illegal alien population (Hanson 1994). The governors noted and deplored that in some cases, illegal aliens could receive better benefits than American citizens. Governor Wilson announced that he had appointed more Medi-Cal fraud investigators to screen the tens of thousands. These people cross the border to take advantage of the State's abundant, but taxpayer-funded, social services. Increasing costs have unjustly deprived legal residents of services they themselves needed. The federal government should repay California's annual expense of $3.6 billion for the care of illegal aliens. The care included and spanned elementary and secondary education to prison cells, but mostly federally mandated health care. The Omnibus Budget Reconciliation Budget of 1986 required all States to provide emergency medical and childbirth services to all illegal aliens through Medicaid programs. The lure of free medical aid increased the number of illegal aliens 18 times. Records said that California spent $22 million to serve them. They could obtain the services by simply presenting a utility bill or a driver's license to establish residency or declare the intention to remain in the United States (Hanson).

There were more than 2 million illegal aliens in California in the early 90s alone (Hanson 1994). This was more than half of their national population. The problem exceeded the shouldering of health costs for these immigrants. It extended to the care of their American-born children. Statistics revealed that almost 97,000 babies were born to undocumented women under Medi-Cal coverage. In fact, the biggest share in State welfare costs, at 40%, was for these publicly funded births of illegal immigrants. Because they wee American citizens, they were entitled to a full range of public assistance. In most cases, their mothers were entitled too. In 1991, a radio and television advertising campaign, called Baby Cal, promoted proper prenatal care for poor women in the State. In the first two years alone, almost $80,000 was spent for translation of the advertisements to Spanish. The translation was sent to Mexican radio and television stations. The campaign enticed Mexican residents to go to the U.S. To have children there. They used to bring some things for their support. Recently, they did not even bring anything. They were confident that the government would pay them (Hanson).

Governor Wilson commented that the border, which separates Mexico and Southern California are contoured to let a steady supply of illegal immigrants into the U.S. (Hanson 1994). That border is porous enough to make the passage easy and frequent, like every day. These illegal aliens come to the U.S. mainland to work, to study or even to commit crimes. In reaction to Medi-Cal-connected frauds, Governor Wilson increased the number of investigators from 66 to 101. Many of those crossing the border had no birth certificate, no Social Security number or any other identification. This made the job of fraud investigators quite difficult. But what was really frustrating about the policy was that many of the services secured or given these undocumented aliens were not available to legal residents themselves. Yet these federal policies were sustained by taxpayers' money. There was indication of bipartisan support for the initiative in California. But in the case of the other five States, the problem was getting the people to realize how serious the situation was. Governor Wilson worked to pressure Washington to confront this problem. A lawsuit was said to be developing to force a change in the law governing the provision of health care to illegal immigrants. Governor Wilson also urged for a constitutional amendment to deny American citizenship to children of illegal aliens. The political will to see these initiatives to success did not seem to be coming. Governor Wilson flatly emphasized that the only real solution to the problem was for the federal government to control the border, pay the bill and amend the law. In the meantime, emergency rooms would continue to bloat with illegal aliens demanding emergency treatment. Hospital staff, social workers and hospital resources would continue to be stretched. The true picture of the situation could even be larger than reported. No one really knew how many illegal aliens managed to secure health care. Some of them would continue to be fraudulent claimants who tended to increase by another 25 to 50%. Hermillo Meave who managed to secure a free heart transplant at the entire expense of the State raised many troubled thoughts. Meave's transplanted heart was a rare one, which could have been given to an American who needed, awaited and deserved it. On hindsight, some observers asked if donated hearts should not be reserved for American recipients. At any given time, there would be three or four patients waiting for a heart to be transplanted to them (Hanson). This incident made the whole issue of organ transplants an issue as controversial as illegal aliens obtaining expensive and substantial health care at the expense of legal residents.

Expected Results or Outcomes

Determine the magnitude of the problem of illegal immigration

Consider what legislations and other measures have been done to curtail or address the problem

List the problems encountered in initiatives to oppose the refusal to provide healthcare services to illegal immigrants

Measure the extent of illegal immigration and its effects in Maryland and California through random but representative surveys

Review all legislations covering illegal immigration with the end-view of adjusting their effectiveness in solving the problem