“You Lie!”: Going Beyond the Obama-Wilson Debate – Josiah Heyman
University of Texas at El Paso
Representative Joe Wilson famously interrupted President Obama’s health care speech to Congress by shouting “you lie,” just after the President had said that proposed legislation would not provide access to health insurance for undocumented immigrants. Factually, Wilson was wrong. The legislation indeed restricts the undocumented from receiving its benefits. But the central assumption of the debate itself is wrong. Obama claimed that a rigid line had been drawn; Wilson that it was not rigid enough. But on close examination the rigid line fades from sight.
In public health, our fates are connected. The H1N1 flu is a mild reminder of this. When there is a more severe pandemic, we will regret frightening off and making access hard for any of our biological neighbors. To offer a different, but I hope even more persuasive angle: health care access is a matter of mutual moral obligations, a network of ties accumulated throughout society. I know a 100-year-old woman, still in good health but needing a bit of attention. She herself is an immigrant, a citizen and retiree after years of marginalization and hard labor. Her caregiver is undocumented, undergoing the same life of sweat and stigma in the present day. They owe each other their existence. They depend on each other for their health.
The undocumented are among us; they are you and I, our mothers and fathers, uncles and cousins. More than three million U.S. citizen children live with at least undocumented parent–a parent who might one day be crippled from lack of simple health care. Families are healthy together or unhealthy together; the health care access of such “mixed status” families might be divided by law, but the health of such families is not so easily divided. The undocumented in very modest ways sometimes do have health coverage–though of all sectors, they work the most with the least use of public resources. An example is prenatal care for undocumented women, who are expecting future citizen children. Such children will live in our neighborhoods and attend our schools. The connections are inevitable, whether we honestly admit them or not.
Lack of papers keeping people from government programs is not really the main issue. Except for children, few would qualify for public benefits. In the main, undocumented people are working adults, not welfare users. Rather, their jobs are concentrated in sectors without health insurance, or with salaries so low that they cannot afford to utilize such coverage as would be available. If health reform passes, this situation may actually improve–not because the aim is to benefit the undocumented, but because the undocumented share the same obstacles as many others of us: the flaws of the employment based health insurance system.
At the same time, the federal government is pressuring employers to fire workers who do not have social security numbers that match recorded numbers and names. Leaving aside the operational flaws of this program, it is likely to push many undocumented workers and their employers into the black market. They will be back to being uninsured. What will happen then? Back to untreated illness. Back to expensive and overloaded hospital emergency rooms.
Why then the heated debate? The health costs involved are small, and the measures unlikely to matter much, even from a perspective that seeks to cut off access to care for the undocumented. I am not entirely sure of the answer, but it seems rooted in the notion of lack of deservingness because of their illegalized status and more widely their place as immigrant newcomers. Perhaps this is what happens with inequality in a period of decline: we turn inwards in a vicious competition to hold onto our own and deprive others of goods that are shared and redistributed in society.
The U.S. lacks a tradition of shared rights to health care, immigrants or not; this worsens possessive competitions. The possible health reform is a modest and flawed step away from this. But the ethic of redistribution reaches its current limit with undocumented immigrants, many of them Latinos, who symbolize absolute outsiderness resident within the bounds of our illusorily sealed-off nation. Yet immigrants will not go away. They are far too integral to our world, far too much a part of our economy and our society. The debate will certainly return soon, when Congress considers legalization of the currently unauthorized, specifically with regard to their access to insurance and health care programs.
We ethnographers have some duties in this situation. One is to document the mutual interconnections of immigrants (of all legal statuses) with the larger society. We need a robust factual ground to make persuasive cases in the moral debates over migration. The other is to spend time among the people who respond to immigrants to understand the bases of both rigid exclusion, the central assumption of the Wilson-Obama confrontation, and of moral connection. We know far more about immigrants than hosts, which hobbles our ability to understand and contribute to the public debate.
Josiah Heyman, PhD is Professor of Anthropology and Chair of the Department of Anthropology and Sociology at University of Texas El Paso (for identification purposes only). He is currently conducting research on access and barriers to health care for immigrants, and Latinos more generally, in El Paso, Texas (see Heyman, Núñez, and Talavera, Family and Community Health, 2009, Vol 32, pp. 4–21). Previous work has examined U.S. border enforcement, U.S. border officers, and border communities and cultures. He is the author of Finding a Moral Heart for U.S. Immigration Policy: An Anthropological Perspective (Washington, DC: American Anthropological Association) and Life and Labor on the Border: Working People of Northeastern Sonora, Mexico, 1886-1986 (Tucson: University of Arizona Press), and more than fifty scholarly articles and book chapters. He was chair of the Society for Applied Anthropology Public Policy committee from 2001-2007, and has participated extensively in the U.S.-Mexico Border and Immigration Task Force.
Heyman, Josiah. 2009. “You Lie!”: Going Beyond the Obama-Wilson Debate AccessDenied: A Conversation on Un/authorized Im/migration and Health. Accessed (date) at https://accessdeniedblog.wordpress.com/2009/12/01/you-lie-going-beyond-the-obama-wilson-debate/