Introduction: "Give me your tired, your poor, Your huddled masses yearning to breathe free, The wretched refuse of your teeming shore. Send these, the homeless, tempest-tost to me, I lift my lamp beside the golden door! " Emma Lazarus in 1883, in her poem “New Colossus”, where the Statue of Liberty seems to be beckoning to all the peoples of the world to come into her land and discover the golden opportunities within. The USA has indeed been a magnet attracting large numbers of immigrants both legal and illegal, from the world over, holding out a promise, a future of new equality and freedom for all people and race.
While the legal immigrants have a legitimate right to avail of the services accorded by the state funded by virtue of the their tax payments, the immigrants have shamelessly misused “America’s generosity to the feeble, the crippled, and the poor” (Cosman, 2005:7) and consequently, the generous nation is staggering, over-burdened by the virtue of its own benevolence. Illegal Immigration is one of the biggest problems that stare at the face of the Federal Governments of the USA, crying for immediate attention and reform This Site.
This writer shall examine some ways in which illegal immigration has affected the US Healthcare systems, especially implementing EMTALA, the Labor and childcare aspects of health care and its consequence. This essay shall also briefly touch on the views of the illegal immigrant, concluding with the need for a pragmatic solution to the increasing burden. Three Visible Impacts: There are at least three aspects in which the illegal immigration population has affected Health care services in the US.
They are: 2) the spread of infectious diseases 2) the erosion of the benefits enjoyed by the honest tax-paying citizen because of the implementation of EMTALA 3) the danger of increased ‘Anchor Babies’ also a drain on the State’s exchequer. Other indirect impact being, increased lawlessness and increased crime rate, and hence increased crime-related victims seeking ED or emergency department services of healthcare centers. When human beings travel or immigrate, they carry with them the entire blueprint of their ethnic strengths, weaknesses, diseases/infections, along with their cultural practices.
The fact that the US has been and continues to be the new home to people from different ethnicities and races, has made it vigilantly armed against many infectious diseases and hence successful in eradicating a number of them, like the TB. Years of hard work and break-through technologies in the medical field, now face a new threat – the threat of the resurgent and powerful strains of diseases proven to have been eradicated or kept under control in the US. The legal immigrants are thoroughly screened and documented, and most likely have insurance for healthcare.
In fact, Cosman (2005, p. 8) reports that legal immigrants had to strip and cough, for detection of infectious diseases and TB. But today, "Illegal aliens simply cross our borders medically unexamined, hiding in their bodies any number of communicable diseases" laments Cosman (2005, p. 8). Because of this undetected entries, the Phyllis Schlafly Report (2002) states that, diseases like the ‘West Nile Virus’, ‘Chagas’ disease, and TB are resurgent. “The Chagas disease in the United States has been traced to a Central American immigrant” the report states. Cosman (2005, p.8) reports that “Each illegal with MDR-TB coughs and infects 10 to 30 people” and is resistant to at least two drugs.
Leprosy, Dengue, Malaria, and Polio, Hepatitis A, B, and C strains are other diseases, almost eradicated in the US, but resurfacing now in significant numbers. If the damage done is not enough, the federal Emergency Medical Treatment and Active Labor Act, or the EMTALA by the US Government compound the problem. The Bush administration has, in fact been censured by the Cosman Report (2005, p 7) as “welcoming” the illegal immigrants because of its “reluctance to prosecute people who violate basic American law”.
While thousands of immigrants cross the common borders daily, to substitute as cheap labor force in the US, no monitoring is done to screen them. And the EMTALA STATUTE: 42 USC 1395 dd42 USC 1395dd with its ten mandatory rules, “requires that all patients who seek emergency treatment be given an adequate medical screening examination and prohibits discrimination on the basis of patients' ability to pay” (PubMed, 2002). Taking advantage of this situation, thousands of illegal immigrants cross borders to have their child delivered in the US.
Many illegal immigrant women termed ‘alien women’ go into labor within the vicinity of US healthcare centers and deliver their babies there, knowing fully well that children born in the US automatically qualify as citizens and thereby become the “anchors babies” of the parents and siblings, enabling them better their job and payment benefits in this country. Cosman (2005, p 7) illustrates with example how these anchor babies have become a profitable venture for the illegal immigrants: they “were paid $12,000 for being anchor babies” while their illegal parents earned $18,000 in apple picking.
Contrast this profit with the drain to the Government exchequer – “In 1994, 74,987 anchor babies in California hospital maternity units cost $215 million and constituted 36 percent of all Medi-Cal births” (2005, p 7). Additionally, the term ‘emergency’ itself is very broad and ambiguous. Now, herein arises the question ‘who pays for all this’? While most of the legal immigrants are covered by insurances such as Medicare or Medicaid, the illegal immigrants appear to be too poor to take up any health insurance. This is precisely the reason why EMTALA became a sort of a shield and dagger in for the illegal immigrants.
While allowing the ‘aliens’ free service to the ED of hospitals and imposing strict penalties for non-implementation, the government too did not pay for these services, since EMTALA “law was created as an unfunded mandate; the federal government and the state governments have never fully compensated both public and private hospitals for the full cost of such emergency charity care” (Wikipedia, 2006). The free medical aid thus offered, “has degraded and closed some of America’s finest emergency medical facilities, and caused hospital bankruptcies: 84 California hospitals are closing their doors” (Cosman, 2005:6).
However, Jennifer Gordon of Dallas Business Journal dated April 7th 2006, reports the names of various hospitals having “received $1. 1 million, $323,208 and $217,000” from the State. Cosman (2005, p. 8-9) offers some remedial measures to reduce this burden, which are worth consideration, namely: a) Ceiling the borders of America with fences and high-tech security devices, and military forces. b) Rescinding the citizenship of "anchor babies. " c) Making the aiding and abetting of illegal aliens a punishable crime. d) End amnesty programs. The illegal immigration population seem to perceive the whole issue quite differently.
Marianna Newman of the Newyork Times in an article titled Immigrants display boldness in U. S. rallies, dated 11th April, 2006, reports of that, “hundreds of thousands of immigrants and their supporters marched Monday in more than 100 cities across the United States, casting off the old fears of their illegal status to assert that they have a right to a humane life in this country”. Many of them perceive their wages as very low as compared to Americans; they work as janitors, restaurant cleaners, apple pickers, agriculture laborers, building workers etc and do the lowly jobs the Americans are unwilling to do at the lowest possible wages.
Conclusion: While this may have an element of truth in it, it is irrelevant in the justification of their illegal status and does not offer a solution to the whole lot of accompanying problems. Furthermore, it makes a mockery of genuine, law-abiding immigrants who have faithfully chosen to go through the legal immigration processes and validated their status in their chosen country. Hence the government should handle the issue carefully, and diplomatically, while keeping a strict check on the costs involved.
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