Home > Health Reform, News Round-Up, Recent Post > News Round-Up (12/23/09) – Unspeakable Exclusion: Immigration and the Politics of U.S. Health Care Reform

News Round-Up (12/23/09) – Unspeakable Exclusion: Immigration and the Politics of U.S. Health Care Reform

Sarah S. Willen (SMU) & Nolan Kline (University of South Florida)

Although politicians on both the right and the left have expressed their reservations, the legislative push to pass health care reform before Christmas eve appears to be moving forward at full steam – importantly, without any substantive discussion of whether excluding unauthorized migrants and immigrants makes sense.

However the chips fall, we are left with one key take-home lesson from this lengthy, dramatic legislative saga: Americans of all stripes are, and remain, woefully ignorant about the scale and scope of unauthorized migrants’ and immigrants’ health needs; about the interconnectedness among im/migrants’ health concerns and those of citizens and authorized residents; and about the reasons – practical, financial, legal, and ethical – why helping im/migrants obtain health care might be in the collective best interest.

During the most recent debate, a few rare voices have bucked this trend. In a New York Times op-ed titled “Coverage Without Borders”, for instance, Cardinal Roger Mahony, Archbishop of Los Angeles, argues that,

“To deny our immigrant brothers and sisters basic health care coverage is immoral. To allow people’s basic health needs to be trumped by divisive politics violates American standards of decency and compassion.”  He raises a key question that few if any legislators have bothered to address: “How is the health of the entire country helped when the Senate will not even allow immigrants to use their own money to purchase their health insurance?” (See BusinessWeek for a comparison of the House and Senate bills.)

If Mahony’s key contribution to public debate has been to raise moral and ethical questions, a handful of others have questioned the specious financial wizardry generally cited in support of this stance. For instance, Susan Dentzer, Editor-in-Chief of Health Affairs, argued on NPR’s Diane Rehm Show that denying unauthorized immigrants the opportunity to purchase health insurance at their own expense is like denying them the chance to buy gasoline or food.

Other journalists raise similar questions. Both Mike Lillis of The Washington Independent and the editorial board at Colorado’s local Aurora Sentinel argue that it is economically unwise to cut unauthorized immigrants out of health care reform. “By refusing to sell [unauthorized immigrants] affordable health insurance,” the Sentinel contends, “such a plan nearly guarantees that the government instead forces almost every illegal immigrant in the country — all 12 million or so of them — into pricey hospital emergency rooms for their health care, which all Americans will then pay for through higher medical bills and insurance rates as hospitals pass along the costs.” Where are the data to either support or refute this argument? (Recent pieces by Timothy Noah and Christopher Beam, both noted in our last news round-up, make preliminary efforts to reason through the limited data currently available.)

Lack of data is one kind of problem, but deliberate misrepresentation is another altogether. In some zones of public discourse, including the Fox News Network, discussion is framed by ideologues who prefer political posturing to honest debate.  For a prime example, see the video footage of Bill O’Reilly’s aggressive, largely monologic “interview” with political critic and Columbia professor Marc Lamont Hill, which took Mahony’s op-ed as point of departure. “As a humanitarian,” O’Reilly tells Hill, “it’s hard to say that Jesus wouldn’t want everybody to get health care. On a humanitarian basis, you don’t argue it. On a fiscal basis, you have to argue it.” Rather than offering Hill a fair chance to respond, however, O’Reilly instead attempts to discredit his guest through a stream of facetious jokes, patronizing comments, and repeated interruptions.

Although the push for health care reform has clearly dominated the airwaves, a number of other stories are worthy of note. Valeria Fernández, writing for New America Media, reports on the new Arizona law that requires state workers to call ICE when unauthorized immigrants submit applications for benefits – even if such applications are submitted on behalf of U.S. citizen children. “Employees who don’t do that could face fines, lose their job and face up to four months in jail,” Fernández writes. In Arizona, where about one third of children have immigrant parents, “The law’s impact is having a chilling effect on the provision of health services for a population of children and women that is already underserved.” The brand-new law already appears to have yielded a drop in prenatal care visits, immunizations, and other crucial health care visits that could have a long-term impact on the health of families and communities.

International Migrants Day, recognized annually on December 18th, has also yielded limited conversation on the rights – including the health rights – of unauthorized im/migrants. In a Huffington Post commentary, human rights lawyer Chandra Bhatnagar discusses the United States’ ongoing failure to ratify the International Convention on the Protection of the Rights of All Migrant Workers and Members of Their Families. The convention stipulates, among other provisions, that migrant workers and their families be protected from discrimination in accessing healthcare. As a result of the U.S.’s failure to ratify or implement this treaty, Bhatnagar writes, “human rights abuses are happening in plain sight and repercussions extend far beyond the workplace…”

Sarah S. Willen, PhD, MPH is Assistant Professor of Anthropology at Southern Methodist University and a founding member of the ACCESS DENIED blog team.

Nolan Kline is a graduate student of anthropology at the University of South Florida and a founding member of the ACCESS DENIED blog team.

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