Health costs for illegal immigrants hyped
The congressional debate over immigration reform is a war of numbers.
If there were a thousand illegal immigrants, little time would be devoted to the issue. However, an estimated 11 million people live, work, play and die in this country without permission from the government.
According to the Federation for American Immigration Reform, more than 1 million illegal immigrants enter the country each year. While here, they earn money — but they also consume expensive health care services. A standard argument by conservative, get-tough-on-the-immigrants organizations such as FAIR is that illegal immigrants are bankrupting our health care system.
According to the group’s report, “The Sinking Lifeboat, Uncontrolled Immigration & the U.S. Health Care System”:
“Thirty-three percent of immigrants have no insurance.
“Sixty-seven percent of counties responding to a survey claim that immigrants are the predominant users of uncompensated health care.
“Sixteen percent of all immigrants live below the poverty line.
“Among full-time wage earners, 51 percent of immigrants have employment-based coverage.
“Communities with high rates of uninsured residents are more likely to reduce hospital services and divert tax dollars to pay for uncompensated care.
FAIR expects any immigration reform coming out of Washington to include some plan to reimburse the states and counties for uncompensated immigrant care.
“At a time when the country is struggling to provide affordable care to millions of uninsured residents, President Bush’s immigration proposal would bring in hundreds of thousands more uninsured — and officially sanction a massive illegal population already here and already draining health care funds from struggling communities,” FAIR says.
For now, hospitals such as John Peter Smith in Fort Worth and Parkland Memorial in Dallas are left holding the doctor’s bag.
The JPS board has decided to deny outpatient treatment to illegal immigrants in an effort to save money.
The Allied Communities of Tarrant, a grassroots organization advocating for immigrant health care, has argued that preventive care is less expensive than emergency treatment, so it would make more financial sense to provide outpatient care to all and avoid the high costs that come with catastrophic and emergency room care.
A majority of the hospital board is unconvinced of any substantial savings.
However, this skirts the main issue: the alleged runaway immigrant health care costs.
A study published by six physician-researchers in the August issue of the American Journal of Public Health directly addresses the question of immigrant health care costs compared with citizens’ health care costs.
Their study of an analysis of 1998 national survey data of health care expenses differs from FAIR’s assessment of who’s driving U.S. hospitals to the poorhouse.
According to the physicians, in 1998:
“Immigrant health-care costs were $39.5 billion, or 7.9 percent of the total U.S. health care costs.
“Average health care expenses were $1,139 per immigrant and $2,546 per citizen.
“Uninsured immigrants’ expenses were 61 percent lower than those of uninsured U.S. citizens.
“Immigrants younger than 65 had 30 to 75 percent lower expenses than citizens of the same age.
“Immigrant children used the emergency room less often than citizen children, but immigrant children’s ER costs were higher.
“Immigrant children in the ER are sicker than citizen children.
The six physicians conclude that “the deficit of care among immigrants is probably not because of less need; immigrants in our study had slightly worse self-reported health than U.S.-born persons.”
Cultural and linguistic factors and fear of deportation have acted as steep barriers to immigrant health care access.
FAIR’s assessment of the immigrants’ lack of insurance and their low income is accurate. However, to conclude that the immigrants are primarily responsible for uncompensated health care costs is false.
The six physicians find no relationship between a state’s uncompensated expenses and the percentage of immigrants. They add that policies to terminate publicly sponsored health care coverage will result in little savings.
Based on this research, there is no valid reason to use the immigrant as the whipping boy for spiraling health care expenses.
U.S. health care costs are driven by a combination of economic and social forces, such as technology development, drug costs, malpractice awards, managed care, an aging population, lack of disease management, administrative costs and third-party payments.
It’s easy to blame the illegal immigrant for high health costs. It’s also grossly unfair.