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Health Care Reform: Illegal Immigrants
Sep. 11th, 2009 10:35 pmWhat follows can be considered political. Read at your own risk. Commentary is welcome, especially if my logic fails or I missed things.
I think the entire issue on illegal immigrants is entirely a red herring; there's no credible attempt to cover illegals anymore than they already are, if anything, the opposite -- which may be the wrong thing to do, see below.
Now, categorically I am in favor of only providing services to individuals with legal immigration (and otherwise, i.e. not having warrants, outstanding child support etc.) status. Basically, you get to enjoy services if you are paying the taxes that fund these services.
The problem with denying services to individuals who are not entitled to them is when the repercussions are worse then the original problem. Here are a few of the issues I see:
Assuming everyone is forced to buy insurance (hypothetically, I know this is a controversial point), you run into the eligibility requirement when selling said insurance, otherwise illegal aliens can just buy it like everyone else. All things considered, I think selling insurance to everyone would be the optimal outcome, ethically and financially. It goes against the sense of fairness, but it would mean that everyone getting care is pitching in and society would not be paying the price. But it's not that simple either, because...
Assuming everyone is forced to buy insurance, and you attempt to deny care to uninsured people, who by definition are doing something illegal, you run into more issues. Car insurance is mandatory. There are tons of people on the road that do not have it. Why would health insurance end up being any different? Then you have people who do not have proof of insurance with them, or there's a paperwork mix up, or their names do not match. This would most likely affect the poor most, as well as those individuals with names originating in languages with ortographies that do not have standardized transliteration to the Latin alphabet.
If you make medical care something people in dubious legal status are afraid to seek, they will not seek it. If health care providers are to report to law enforcement individuals with suspect status -- and law enforcement hardly has the resources to follow up on this as it stands -- you will end up with this result. The result is treatable conditions getting worse and resulting in permanent injury, death, and expensive ER care that society has to pay for.
Then you have the children of said demographic. Any policies would last about as long as it took for the first children to tragically die or get injured.
And all of the above is a moot point -- as long as medical professionals are even halfway decent people and have the Hippocratic oath, they will treat sick people -- and that's really the only sane way of looking at it that I can see.
Basically it boils down to this: The most effective way of keeping illegal immigrants from being a drain on social services of a society is to integrate them into society so they're contributing like everyone else. The problem of course is that doing so effectively rewards them for having broken the law. I have no idea how one deals with this dilemma.
This is another issue entirely that is fraught with trouble. Iff every individual had an federal ID card or there was another single, consistent registry of all citizens, residents, and legal aliens, you could conceivably ask for said card at traffic stops and similar contacts. Since there is no such system, nor will there likely be, it is exceedingly difficult for an law enforcement officer to find out whether someone is in the country legally or not. Short of harassing "alien looking" or "funny speaking" individuals there is no way of enforcing immigration status without demanding that citizens, residents and legal aliens can always provide proof of their legal status on demand. Without placing unacceptable restrictions on the freedoms of legals, there's no surefire way to catch illegals.
I think the entire issue on illegal immigrants is entirely a red herring; there's no credible attempt to cover illegals anymore than they already are, if anything, the opposite -- which may be the wrong thing to do, see below.
Now, categorically I am in favor of only providing services to individuals with legal immigration (and otherwise, i.e. not having warrants, outstanding child support etc.) status. Basically, you get to enjoy services if you are paying the taxes that fund these services.
The problem with denying services to individuals who are not entitled to them is when the repercussions are worse then the original problem. Here are a few of the issues I see:
Deny Care to People Who Aren't Eligible
Assuming everyone is forced to buy insurance (hypothetically, I know this is a controversial point), you run into the eligibility requirement when selling said insurance, otherwise illegal aliens can just buy it like everyone else. All things considered, I think selling insurance to everyone would be the optimal outcome, ethically and financially. It goes against the sense of fairness, but it would mean that everyone getting care is pitching in and society would not be paying the price. But it's not that simple either, because...
Assuming everyone is forced to buy insurance, and you attempt to deny care to uninsured people, who by definition are doing something illegal, you run into more issues. Car insurance is mandatory. There are tons of people on the road that do not have it. Why would health insurance end up being any different? Then you have people who do not have proof of insurance with them, or there's a paperwork mix up, or their names do not match. This would most likely affect the poor most, as well as those individuals with names originating in languages with ortographies that do not have standardized transliteration to the Latin alphabet.
If you make medical care something people in dubious legal status are afraid to seek, they will not seek it. If health care providers are to report to law enforcement individuals with suspect status -- and law enforcement hardly has the resources to follow up on this as it stands -- you will end up with this result. The result is treatable conditions getting worse and resulting in permanent injury, death, and expensive ER care that society has to pay for.
Then you have the children of said demographic. Any policies would last about as long as it took for the first children to tragically die or get injured.
And all of the above is a moot point -- as long as medical professionals are even halfway decent people and have the Hippocratic oath, they will treat sick people -- and that's really the only sane way of looking at it that I can see.
Basically it boils down to this: The most effective way of keeping illegal immigrants from being a drain on social services of a society is to integrate them into society so they're contributing like everyone else. The problem of course is that doing so effectively rewards them for having broken the law. I have no idea how one deals with this dilemma.
Verifying Immigration Status
This is another issue entirely that is fraught with trouble. Iff every individual had an federal ID card or there was another single, consistent registry of all citizens, residents, and legal aliens, you could conceivably ask for said card at traffic stops and similar contacts. Since there is no such system, nor will there likely be, it is exceedingly difficult for an law enforcement officer to find out whether someone is in the country legally or not. Short of harassing "alien looking" or "funny speaking" individuals there is no way of enforcing immigration status without demanding that citizens, residents and legal aliens can always provide proof of their legal status on demand. Without placing unacceptable restrictions on the freedoms of legals, there's no surefire way to catch illegals.
