Immigrants and health care

What kind of people are we?

At the Un- and Underinsured Congress in December, Celinda Lake presented on the results of her focus groups.

She has found that when you ask Americans about their values in health care -- getting away from ideology and instead towards things like security and affordability -- she has found that in fact most Americans do support universal health care -- or, as she prefers, guaranteed, affordable choice.

However, she warned that she and her staff have in encountered a growing and ugly meanness towards immigrants when it comes to health care.

USA Today has a story today on that intersection between immigration and health care.

On a national level, an effort to add legal immigrant children to the State Children's Health Insurance Program was blocked in the Senate last year. Instead, lawmakers added language to ensure that illegal immigrants were excluded.

"The phrase 'illegal immigrant' is just radioactive at the moment," says Leighton Ku, a health analyst at the liberal Center on Budget and Policy Priorities. "Efforts to provide additional benefits for the undocumented would be essentially perceived as adding fuel to the fire."

You don't suppose Romney, Tancredo & Co. would exploit this, do you? Pander to people's ugliest sentiments of fear and hatred, rather than call them to their best?

Here's a clue from the story: "In a special election to fill the seat of the late Rep. Paul Gillmor, R-Ohio, last month, the National Republican Congressional Committee attacked Democrat Robin Weirauch for backing universal health insurance because it could extend taxpayer-funded health care to illegal immigrants. She lost the race."

Mandates won't help these families.

The sweeping overhauls of the nation's health care system proposed by Democrats Hillary Rodham Clinton, Barack Obama and John Edwards would not provide coverage for illegal immigrants. "Because the issue is so politically hot, people are staying away from it," says Cecilia Munoz, senior vice president at the National Council of La Raza, the nation's largest Hispanic advocacy group. Only Dennis Kucinich of Ohio, a Democratic long shot, proposes covering them.

That's likely to mean little change in undocumented immigrants' health care status, already the worst in the nation. Even among children, 53% are uninsured, according to Jeffrey Passel of the Pew Hispanic Center. That compares with 9% of U.S. citizens' children.

In North Carolina's rural Duplin County, more than one in four people are uninsured. The area's job growth is in low-wage agribusiness — "plucking chickens and gutting hogs," says Greg Bounds, chief executive officer of Goshen Medical Center, the area's largest group of community health centers. Businesses need the influx of illegal immigrants to take hard-to-fill jobs, but hospitals lose money when the workers need emergency care.

Until recently, most illegal immigrants here had one health care strategy. "They just weren't getting care before," Bounds says. "They were just suffering and dying."

Ezra Klein on insurance reform

Ezra Klein is the best. He's got a couple good posts today, one on the malicious side effects of our perverse health insurance industry, and the other on our cutting off our noses to spite our faces in not giving immigrants health care, which is a disaster for public health.

His post on the insurance market is a link to news that it just became impossible in Washington State for many more people -- including people who've had breast cancer -- to buy insurance on the individual market. Ezra writes,

This is the real problem with reform plans that lack a full coverage component (be it a mandate, voucher systems, automatic enrollment in a national market, or whatever). The issue isn't the folks who will be uninsured, but the damage that does to your ability to reform how insurers work. To create a working market you need to create a fair market. And that means setting up the rules such that neither insurers nor individuals can game the system.

It's probably obvious I think people concerned with single-payer should just go to Ezra's site on a daily basis. He's the best.

The businessman and the immigrant

A couple voices from the day —

I talked with a businessman based in Colorado Springs who said he was in favor of a 4 percent payroll tax in order to cover his employees — and that's even though he's not paying for health insurance now.

How about a 6 percent payroll tax?

Hell yes.

He said that right now his cost for employing his three employees was 25 percent of his budget. Not payroll, budget. He wants to insure his people, but who can spend 25 percent of their budget on it?

At the 208 Commission meeting yesterday, there was the clear implication that single-payer wouldn't be fair to small businesses, which couldn't afford a 6 percent payroll tax. It makes you wonder how many couldn't.

The San Francisco Chronicle has a piece today on businesses supporting single-payer. Turns out that 42 percent of them do. In fact, 55 percent would be willing to pay into a state fund to help cover their employees.

The other conversation was with an Englishman who had immigrated here. I didn't ask the circumstances, but he said he hadn't taken into consideration what losing the NHI would really mean in his life. He says that the enemies of single-payer make preposterous arguments. Nicely said.