Immigration policy and undocumented populations

¶ … Undocumented Foreign Nationals in the U.S.

The arguments surrounding the issue of undocumented foreign nationals, or illegal aliens, in the United States are intense. The issues reflect a broad spectrum of topics such as medical services and health risks posed by illegal aliens; crime; education; jobs; unemployment; Social Security; disability benefits - and there is really no end to the issues. Some of the issues are ones that are peripheral to that of illegal aliens, like globalization and open borders. However, at some point even the peripheral issues merge, and the focus rests with the problem of undocumented individuals, who have entered the United States illegally, and what rights, if any, they have; and what to do about the problem. The problem is one that must be resolved, because it has, in its worst manifestation, given forum to hate mongers and people of a white supremacist mentality, if not membership. In its best manifestation, it brings to focus the need to resolve the cultural, economic, and social disparities that exist on either side of the southern border of the United States. In this latter manifestation, there are greater opportunities to achieve more useful and productive outcomes - regardless of whether or not the border is closed or open - by bringing Mexico from the third world, to the first world. This paper will attempt to examine, in brief, some of these issues, and resolutions and potential outcomes.

Existing Problems

The existing problems posed by undocumented individuals crossing America's southern border into the United States illegally is a serious one. First, the geographical locations from which they traveling across to enter the United States, are third world countries in South America. Those countries have poor infrastructures - if they did not, most of their citizens would be content to remain in those countries. The poor infrastructure means that there is inadequate housing, nutrition, education, and public services, like sanitation, immunization, and medical care available to the citizens of those countries - most notably, Mexico. What this means to the United States is that illegals crossing into the country pose a potential threat to the citizens of the United States by way of infectious diseases.

The United States Department of Health and Human Services (HHS), falling under the auspices of the Division of Homeland Security (DHS), and wherein falls the reporting subordinate Division of Immigration Health Services (DIHS), which is the division responsible for medically clearing individuals who have been taken into custody as illegal aliens (HHS, 2007, found online at (http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5219a3.htm).The DIHS, in conjunction with the HHS and DHS, have taken on the responsibility of providing medical treatment, even at an inpatient level, to illegal aliens who have been determined to have active and infectious cases of tuberculosis. "The Health Resources and Services Administration's Division of Immigration Health Services (DIHS) estimates that approximately 150 TB cases are identified annually among INS detainees in the INS service processing centers (SPCs) and contract detention facilities (HHS, 2007, found online at (http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5219a3.htm).Individuals found active and contagious, will be quarantined and treated for the disease until it is determined that those individuals are no longer actively contagious and that they do not pose a threat to the public.

The individuals, once treated and inactive, are then released or deported, but every effort is made to ensure that the individual receives ongoing follow-up care. Unfortunately, the follow-up care that ensures the individual is not going infect the public is often insufficient in the country where the individual is deported to, and continued care and treatment fall secondary to the individual's personal goals and agenda. The following are two case scenarios reported by the DIHS:

CASE 1: "A man aged 28 years had drug-susceptible pulmonary TB diagnosed in Seattle, Washington, and was deported before completing TB treatment. One year later, he was apprehended in the United States and, after transfer to four correctional facilities, was found while in the San Francisco, California, county jail to have isoniazid (INH)-resistant TB. After 2 months of treatment for TB, he was again scheduled for deportation. Despite concerns raised by local public health officials and personnel from DIHS, the patient was deported without medications or a referral for treatment in his country. The patient told local TB-program staff that if deported, he would return to the United States. The patient's location is unknown HHS, 2007, found online at http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5219a3.htm."

CASE 2: "A man aged 31 years with human immunodeficiency virus (HIV) infection had sputum smear-positive TB diagnosed in California. He adhered fully to treatment for 2 months in the community before he was apprehended and placed in INS custody. Because of the patient's increased risk for TB relapse and for acquiring drug resistance, the local TB controller asked INS to recommend a "medical hold" to complete the patient's TB treatment. The state TB-control program cited state law to justify continuing treatment. Both efforts failed, and the final order of deportation was upheld. The local TB-control program was given 1 hour's notice in which to provide the detainee with a supply of medication and to refer the patient to CURE-TB, a binational referral agency to facilitate referral of medical information for TB patients who move across the U.S. border (2). He returned to his family in the United States within 2 weeks of deportation and resumed treatment for TB."

It becomes readily apparent as to why the HHS has determined that it is not in the best interest of the citizens of the United States to release or deport individuals who have been identified as active and contagious. The cost of detaining and treating these individuals becomes irrelevant in consideration of the potential harm they pose to the public. Therefore, treatment is inarguably the best approach.

Another hotly contested issue is whether or not states should issue driver's licenses to illegal aliens (New York Post, found online, (http://www.nypost.com/seven/11142007/news/regionalnews/out_of_gas_eliot_putting_the_brakes_on_l_9236.htm, November 14, 2007). In New York, as reported by the New York Post, tensions are high and state residents were very vocal in their opposition of issuing legal documents to illegal aliens. On November 14, 2007, the pressure was such that New York's Governor Spitzer, who proposed the legislation, withdrew his proposal in response to his constituency (New York Post, 2007).

There is, of course, a flip-side to not issuing illegal aliens driver's licenses. That is, that it might be better to know where the illegal aliens are by way of registering them to legally drive; as opposed to being unaware of their whereabouts in the country if they are forced to go completely underground. Issuing driver's licenses to illegal aliens also forces them to be responsible for driving. In the past an auto accident caused by an illegal alien who did not have a license or auto insurance would mean an uncovered liability, which impacts the cost of insurance nation-wide, and could be avoided by issuing driver's licenses to the illegal aliens. Also, issuing illegal aliens does not legally impact the status of the individual in the country. That an individual is licensed is not a positive or negative factor in a deportation proceeding; it is irrelevant to the individual's illegal status in the country. Thus, the outcome is that issuing driver's licenses to illegals 1) contributes to the tax base by the revenue collected on issuing the license, and 2) reduces the amount of uncovered liability in auto accident cases, which translates as a savings to consumers nation-wide; and, 3) establishes a paper trail to the individual, which, even if prohibited from using that paper trail for INS purposes, is available for other criminal investigations should the individual be implicated in that way.