× Debates, Issues & Talk

illegal immigration and impact on medical field

11 years 3 weeks ago #66158 by ddadoc
I know I'm opening up a can of worms with this topic. I even did a forum search assuming this topic was probably covered recently given all the recent legislation, demonstrations...
Any thought on the whole illegal immigration issue from a standpoint specifically on it's impact to the medical field, healthcare expenditure?
I try to be very objective, and I can understand the side of those demonstrating for the rights of the illegal immigrants... however, as a healthcare professional, it's frustrating to me to see how much money goes into unpaid medical expenses for visits to the ER, hospitalizations at University hospitals by undocumented people, etc, etc... I live in Texas and we obviously see it more than some other states. It was frustrating for me during residency and med school to be unable to communicate with quite a few patients because I don't speak spanish/having to rely on a translator to show up. people assume I speak spanish because i have a spanish last name, but it's a married name (my husband is half Mexican. Obviously, as healthcare professionals, our duty is to take care of the patient without judgement on other factors...

It's frustrating for me to see Americans in my clinic who do work hard but are struggling so hard with medical expenses because they have poor healthcare coverage, but don't qualify for other assistance. But you can go to a border town on the American side and the clinics there are filled with patients who somehow are all on Medicaid.

I know there is no easy answer... but I would like to limit this topic just specifically to how this affects the medical side of things... I don't anticipate that 12 million people will be sent back to their country... however, we have a significant number of people (and still will continue to grow) who will make minimum money, who will be unable to afford healthcare if something were to happen, who will eventually get older/sicker, etc.... our hospitals are already burdened by them, what's to happen in another 10 years?
11 years 3 weeks ago #66159 by Doc201X
Obvioulsy the US is going to have to make some changes to how it distrubutes healthcare. However, to look at the immigration issue as one that just effects healthcare is one sided and IMHO you can't fairly talk about the negaitive impact of immigration without looking at all the benefits. Immigrants are often willing and from what I've observed do a fantastic job of, performing jobs many in our society don't want so the tax monye they pay goes INTO the medicaid fund. And my personal belief is that any person working that pays into the system has a right to use it when it is necessary. It's simply the humane thing to do. Second, my quest to become a physician has been made much easier by a mexican immigrant nanny I occasionally share with a divorced Mom.

As for the language issue the way I see it, with the except of most slaves, we are ALL decendants of immigrants and so the language we should ALL be speaking is one of those that represents any of the Native American togues that were spoken here before their land was stolen/purchased at a ridiculously cheap price. I think it's just time to learn to speak spanish (which I can already do a little).

Yes, immigrants make minimal money now, but I imagine that in a generation of 2, they will eventually catch up. With few exceptions many immigrants that came through Ellis Island had nothing but the shirts off thier backs and they managed to within a generation or two, begin to prosper finanically. I have absolutely no reason to believe that current immigrants, if given citizenship will more the "make up" for whatver drain they have caused on the healthcare system.

My Scientist/Physician Journey
11 years 3 weeks ago #66160 by ddadoc
I think it's great that you're so idealistic and optimistic...

That said, in my ideal world, I'd have the time to learn Spanish... but frankly, it's just one of a hundred things on my list of things to do... and with 2 kids, job, etc, I just don't have the time, so I'll just have to deal with that myself. I don't think it should be necessary that we all need to learn spanish. (it'd be nice, but we shouldn't expect it)

And obviously, I know that this issue doesn't just affect the medical side... I just wanted us to focus on that aspect since the topic in itself is so broad and affects every part of our lives.

I do think that if we're going to allow everyone to stay whether they're legal or not... and they are in the lowest paying jobs... their options for healthcare are limited; do we need to start going ahead and offering them preventive care, routine check-ups, etc... so that we don't face more cost by their trips to the ER, chronic diseases in the future, etc?

I think like most Americans, I'm kinda in the middle on this topic. Obviously, illegal immigrants contribute a lot to our society... whether it evens out all the negative impact, I honestly don't know.
11 years 3 weeks ago #66161 by medstudent31
Do illegal immigrants really pay taxes? I thought they were paid under the table because no Social Security number, etc.

For God did not give us a spirit of fear - but of power, and of love, and a sound mind.
11 years 3 weeks ago #66162 by Doc201X

Originally posted by ddadoc:
I think it's great that you're so idealistic and optimistic...

Introducing arguements with these types of statements imply a lack of sense of what the true issues are in having with this discussion (there seems to be geenral theme here on mommd that premeds don't know anything :rolleyes: ). At almost 40 years old, I can assure that my arguements derive not from a naivete about how the real world works but primarily from the position of caring about the well being of others. Moreover, the consequesnces of not responding to the basic health care needs of a portion of our population often results on a bigger impact on the healthcare system than would normally have been seen.

Originally posted by medstudent31:
Do illegal immigrants really pay taxes? I thought they were paid under the table because no Social Security number, etc.

There are many, many articles on the internet discussing the fact the illegeal immigrants DO pay taxes. Here's one from CBS online:


Even with fake SSN's, they pay taxes.
The fact that many americans don't realize that the majority of illegeal immigrants pay taxes is part of a larger scheme to drum up support for their exclusion from society. But I say how can you exclude a group of people who are already here AND in great numbers?

So perhaps the answer for those who live in states that border the entryways of illigeal immigrants is to 1) Impress upon the politicians in states that border Mexico (since people don't seem to be complaining about immigrants form here than other places :rolleyes: ) to do more to secure the borders 2) Require that in border states, physicians be required to speak spanish in much the same way as board certification is required 3) Offer immigrants preventative services, routine check-ups ect for reasons mentioned above. 4) Develop programs for the admisison of mexican/spanish speaking students into med school with the requirements that they complete residencies/work/practice in states like Texas for a few years. 5) Require the IRS send a large portion of the money they collect in taxes back to those states with high numbers of illegal immigrants,like Texas and California. This one is HUGE.

The solution to this problem won't be easy and will require compromise from EVERYONE in some form or another, but with some compassion for the health and well being of others being the driving force, a viable one can be implemented.

My Scientist/Physician Journey
11 years 3 weeks ago #66163 by Maturin
Truly a can of worms, but I have to add my two cents. Illegal immigrants do, indeed put an undue burden on an already overtaxed healthcare system. Sure, some immigrants do pay taxes by obtaining a fake social security number, but most do not want to risk the chance of discovery and deportation (personal experience in the agriculture and construction industry). What the burden from illegal immigrants vs hard working legal Americans without healthcare is, I do not know, but I imagine they are about equal? This presents two problems for legislators: 1)Healthcare reform and 2)illegal immigrants. Which, leads us to this discussion. Certainly, we cannot turn an individual away if they are legal or illegal, as we have an obligation to the public to provide equal access to healthcare, but at what cost are we doing so.
I spent several years in a rural clinic, that had a moderate illegal patient base. The patients, who came to the clinic, payed their bills better than some Americans. Even in the workman's comp clinic, employers of the illegal immigrants were (mostly)very good about paying for procedures. The problem arises with hospital stays, surgical procedures, etc. This is where the healthcare field, really feels the crunch. Sure, alot can be written off, but that just helps with the hospitals tax burden, not actually paying staff. Another problem, too, is illegals often do not seek medical attention, until they have reached an advanced stage of their disease, making it more expensive and difficult to treat. I hate to be so wishy washy, but the reality seems to be this way. There is good and bad in everything.
One important thing to remember here as well, is that our country is at war with terrorism (whether you agree with it or not) security is at issue. If you look at our country during times of war, specifically world war II, when our country packed up the Japanese (legal and illegal) as they were seen as a security threat. I agree that as physicians, patients cannot be treated with any sort of prejudice, but in an era, where we (VA hospital) routinely undergo disaster training and drills, it is difficult not to be aware of the security threat. (Mexico and Canada are huge and easily penetrate borders). I am in no way implying that the Mexicans will somehow aid the radical Muslim groups, who so dislike western culture, but just saying it is something to think about.
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