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As states cut their health care budgets to try to make ends meet, high rates of immigration are straining the health care system to the breaking point. One out of every four uninsured people in the United States is an immigrant. When the 35 million immigrants receiving insurance through publicly funded Medicaid are factored in, almost half of immigrants have either no insurance or have it provided to them at taxpayers expense. In some hospitals, as much as two-thirds of total operating costs are for uncompensated care for illegal aliens. Although a national total of annual unreimbursed medical expenses for illegal aliens is not available, it is clear that those costs are more than one billion dollars, given estimates for Texas $393 million, Los Angeles $350 million, Florida $40 million, and United States-Mexico border counties $300 million. The problem is on the rise: Immigrants legal and illegal who arrived between 1994 and 1998 and their children accounted for 59 percent of the growth in the size of the uninsured population in the last ten years. Federal laws requiring hospitals to treat anyone who enters an emergency room regardless of ability to pay have created an unfunded mandate for states and localities to fund health care for non-US citizens and illegal aliens. Yet at the same time, lack of enforcement of federal laws against illegal immigration has led to a pool of nine to eleven million illegal aliens in the United Statesand state and local taxpayers are being forced to foot the bill. Although immigration law enforcement is a federal responsibility, most hospitals receive little or no reimbursement for the care to immigrants that the federal government mandates that they provide. Lack of insurance leads many immigrants to use hospital emergency departmentsthe most expensive source of health careas their primary care provider. The problem has become so out of control that some Mexican ambulance companies are now instructing their drivers to drive uninsured patients across the border to the United States, where they will receive free treatment. The increase in uncompensated care for immigrants has forced some hospitals to reduce staff, increase rates, cut back services, and close maternity wards and trauma centers. At the same time that Washington is neglecting to pick up the tab for aliens whom it has failed to prevent from settling here illegally, the problem is exacerbated by state and local policies that grant costly benefits to people who violate immigration law. Reversing the escalating burden of uncompensated health care for immigrants and illegal aliens will necessitate enforcing laws against illegal immigration;
It will also require a change in public officials mindset: Instead of shifting the burden to local taxpayers often to those least able to pay when confronted with rising insurance premiums and medical bills, lawmakers must squarely face the consequences of immigration policy decisions. Our immigration system must be made consistent with United States national needs and priorities. THE SINKING LIFEBOAT Uncontrolled Immigration & the United States Health Care System Americas health care system is in crisis: The numbers and proportion of the uninsured are rising rapidly. Costs are skyrocketing2003 saw the largest increase in employer health care costs in 13 years 1 and posing an increasingly difficult burden on businesses and individuals. At the same time, state budget deficits mean states are cutting back public health care funding, and hospitals around the country are being forced to close or cut back services. In the midst of this crisis, mass immigration is straining the health care system to the breaking point. Indeed, more than half of all counties surveyed by the National Association of Counties say that recent immigrationboth legal and illegalis causing their uncompensated health care costs to rise.
High levels of unpaid medical bills also have forced local health care providers to reduce staffing and services and increase rates. Dozens of hospitals in the counties along the southwest border have either closed or face bankruptcy because of losses caused by uncompensated care given to immigrants. Were running an HMO for illegal immigrants and if we keep it up, were going to bankrupt the county. We have a $350 million debt as a result of these people receiving medical treatment illegally.
As states cut their health care budgets to try to make ends meet, high rates of immigration are causing a major drain on health care resources and taxpayer funds. Due to lack of enforcement of federal immigration laws, state taxpayers are being forced to fund health care services for illegal aliens at a time when they cant fund all their services for the general population. But the failures of federal immigration enforcement tell only part of the story. In many areas, the magnitude and cost of illegal immigration are also consequences of state and local policies that encourage illegal alien settlement by granting costly benefits to people who violate immigration laws. Under current law, hospitals must treat and stabilize anyone who seeks emergency care, regardless of income, insurance, or immigration status.
Because of illegal immigration and because United States immigration policy slants toward admitting relatives rather than immigrants with needed workplace skills, our immigration system literally imports poverty. Sixteen percent of all immigrant households live below the poverty level, and one out of every five households of non-citizens is poor versus eleven percent poverty among native households. The median household income for immigrant households is 13 percent lower than that of native households, and, for the households of non-citizens, it is 23 percent lower.
The cost of caring for these patients is absorbed by the counties or hospitals obligated to provide treatment, and some is passed on to insured patients. CRISIS ALONG THE BORDER The problem is particularly pronounced in communities near the southwest border, where there are high populations of illegal aliens. Border hospitals reported losses of almost $190 million in unreimbursed costs for treating illegal aliens in 2000 about one-fourth of the hospitals total unreimbursed expenses.
If no additional state or federal funds are forthcoming, county health officials have proposed closing emergency, trauma, and in-patient services at three hospitals, along with two-thirds of the county health center clinics and 100 private outpatient clinics. If these critical county trauma centers are closed, there is absolutely no doubt that injured people, both with and without medical insurance, will die unnecessarily because the other trauma centers are simply too far away, says Dr. Robert Hockberger, chair of Harbor-UCLAs Department of Emergency Medicine.
Over the last several decades, and despite the severe fiscal crises faced by local and state government, political leaders continued to promote policies that encourage illegal immigrants to take up residence in the county by explicitly accommodating people who violate immigration laws. A 1979 ordinance, known as Special Order 40, prohibits Los Angeles police officers from asking detained people about their immigration status. Similarly, the city continues to spend scarce money to build and maintain day laborer hiring sites, despite the fact that most of the people who seek work at them are illegal aliens. And in 2002, the county adopted a policy of accepting the Mexican consular ID card used almost exclusively by illegal aliens as a valid document for accessing public services, including non-emergency health care.
For example, one Florida hospital spent $347,000 to treat one illegal alien patient for respiratory distress, to care for him after he stabilized while a doctor in his home country could be found to accept responsibility for him, and to return him and his wife to Colombia. In another case, the facility spent $150,000 to give an illegal alien surgery for progressive curvature of the spine and then return him and his family to their homeland.
In one such case, a young leukemia patients parents applied for a visa...
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