Tuesday, December 8, 2009

Coverage Without Borders

The New York Times




December 8, 2009

Op-Ed Contributor

Coverage Without Borders



AS the leaders of the United States Conference of Catholic Bishops noted last month, the current health care reform bills in Congress are fundamentally flawed because they fall short in three critical areas: the prohibition of federal financing for abortions and the protection of current conscience laws; the inclusion of meaningful provisions to ensure affordability; and the defense of immigrants’ rights to health care.


Although all three areas are critical for this proposed legislation to be acceptable to the Catholic Church in our country, I would like to focus on the lack of adequate health care for immigrants who live in our midst but who do not yet have legal standing.


The two bills are quite different. The Senate bill bars undocumented immigrants from using even their own money to buy health insurance in the government-sponsored marketplace, or exchange, being proposed. The House bill allows undocumented immigrants to purchase health insurance from the exchange, if they use their own money and receive no federal subsidy.


Most studies estimate that more than 10 million undocumented immigrants live in our country. Many have been here for decades. The majority of these immigrants live in “mixed families” — some members of the family were born here, while other relatives are here without documents. It is unrealistic to think that these millions of people with roots deep in their communities are somehow going to pack up and move back to their country of origin — whether that is Korea, the Philippines, Russia, England, France or Mexico. Most have their children in local schools, the vast majority of them have jobs here, and all are contributing to the betterment of our nation.


It makes no sense to deny this large population necessary health care services. It certainly does not help Americans as a whole to remain healthy when millions of people, including schoolchildren, cannot get basic preventive care like immunizations and medications.


When undocumented immigrants are intentionally excluded from health care coverage, they are forced to go to the only place where they will be accepted for care: trauma centers and emergency rooms — the most expensive health care delivery systems in the country. What a foolish waste of money, particularly in a time of economic stress for everyone.


Using their own money, undocumented immigrants could receive basic health services through less expensive community clinics and doctors’ offices. Studies have shown that immigrants are generally younger and healthier than citizens, and use health care facilities and resources less frequently. Giving them access to less costly preventive care would help keep them that way. And by paying into the system, immigrants would make health care less pricey for all by spreading the risks and costs among a larger pool of participants.


At least the House bill allows undocumented immigrants to purchase health insurance from the proposed exchange. It’s difficult to understand anti-immigrant groups’ objections to this provision. No one would be rewarded for lacking proper documentation, since undocumented immigrants wouldn’t be eligible for subsidies.


The Senate bill takes us in the opposite direction and needs to be changed. 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?


In many conversations with people around the country, I have found that the dreadful anti-immigrant rhetoric that dominates talk shows does not represent the views of a majority of Americans, who do not reject immigrants out of hand as a burden. Instead, they want to find a way for these people to emerge from the shadows and to begin down a path to legal status.


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. We should pass health care reform that provides access to all, in the interests of the common good. We must also enact comprehensive immigration reform that better balances our country’s need for a stable work force with the orderly flow of immigrants to help bring greater prosperity to all Americans.


Otherwise, in our country there will remain a permanent underclass left standing in the waiting room, asking for a doctor’s visit that will never come.


Roger Mahony is the cardinal archbishop of Los Angeles.



Copyright 2009 The New York Times Company


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"The master class has always declared the wars; the subject class has always fought the battles. The master class has had all to gain and nothing to lose, while the subject class has had nothing to gain and everything to lose--especially their lives." Eugene Victor Debs


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