Well okay, my title was purposely provocative but I am not too far off the mark. Late today the NY Times reported:
The federal government is offering $1 billion to hospitals that provide emergency care to undocumented immigrants. But to get the money, hospitals would have to ask patients about their immigration status, a prospect that alarms hospitals and advocates for immigrants.
Well of course it alarms hospitals. They know what a dumb idea this is (disclaimer: I am a liberal). Immigrants aren’t going to seek the medical help they might need knowing that Uncle Sam will be there checking their passports. In post 9/11 times, when an illegal immigrant with a brown name can get held, seemingly indefinitely, under material witness statutes, why would they risk going to the hospital? Continuing with the article:
The Department of Health and Human Services wants hospitals seeking reimbursement to ask patients these questions, among others:
-“Are you a United States citizen?”
-“Are you a lawful permanent resident, an alien with a valid current employment authorization card or other qualified alien?”
-“Are you in the United States on a nonimmigrant visa” of the type issued to students, tourists and business travelers?
-“Are you a foreign citizen who has been admitted to the United States with a 72-hour border crossing card?”
Lawyers are already pointing to the 1964 Civil Rights Act in calling this a bad idea. You should read the other silly details in the article for yourself.
I’ll probably go into this more deeply on my personal blog but first – a few observations –
1) there’s no fed money for illegal alien hospitalization today
2) Many hospitals – despite negative convnetional wisdom – do NOT turn away folks who have emergency needs and can’t pay (there are exceptions but this is certainly the rule – that’s why so many hospitals need $$$ to begin with!)
3) this is a NEW program (e.g. a net increase in “generosity” – if that’s how you measure these things – in other words, more of my tax $$$ are going to new individuals than before)
4) the hospital does NOT have to ask for ID, it only needs the “proof of illegal alienship” if it seeks fed reimbursement. Don’t want the fed $$$? Then don’t ask about citizenship.
5) more broadly – YES, THERE SHOULD BE COSTS (EVEN POTENTIALLY MORTAL ONES) TO BREAKING THE LAW. They’re illegal, they broke the law.
My 2-second litmus test for this policy – If “The Race” (La Raza) is for it, then I’m against it.
V: externalities. Somebody with a contageous but treatable disease who stays away from the hospital endangers your life. TB is a serious issue. And remember, your janitors are probably undocumented, b/c of the way that enforcement patterns work …
ennis – if you can prove to me that we’re near the tipping point for TB and other contagious diseases, then we should directly attack those diseases / externalities – for ex., give La Raza free TB meds to give to their Race.
it’s hard to justify socializing this new sector of healthcare just for this case….
Vinod, point by point
1) There are plenty of unfunded federal mandates that require the additional funding.
2)According to this article, the Hospitals will be put in an even more precarious situation with respect to being incentivized to turn people away.
3) Two words: Unfunded mandates
4) It isn’t right to dangle money in front of hospitals, to be witheld unless they ask detailed questions which they know will result in people staying away. See point 2.
5) I can’t argue with this one, but life is tough. Not everyone is born into a good democracy.
And Finally. “Viva La Raza.” I love a good mutiny.
If “The Race” (La Raza) is for it, then I’m against it.
Man, even as a rhetorical flourish, that’s mean-spirited, they do good work. ¡La raza, unida, nunca sera divida!
“underfunded mandates” – so you’re arguing that in cases where the govt creates a problem, the solution is … more government & entitlements?
“La Raza” – all orgs (even Hamas) do some good somewhere sometime. If La Raza’s ultimate goal wasn’t full citizenship & open boarders, I could even support them on that basis…
La Raza is not morally equivalent to Hamas. It’s more equivalent to Dubya’s faith-based charities.
What percentage of doctors in US hospitals are foreign nationals? I’m sure they’re (mostly) legal (you never know with the INS, they can lose your papers and then declare you illegal).
I’m sure that changes the dynamic a bit, when doctor and patient are both nationals of the same country, a different country from the one they’re in. Especially now when xenophobia is high.