Friday, July 06, 2012

Bioethics FAQ 3: "Illegals receive free health care"

Is it ethical when illegal immigrants receive free health care coverage when U.S. citizens are denied?
Some factual background will help put this in context. Undocumented immigrants who show up at an emergency room can have their care covered by Medicaid. As soon as the patient is physically able to leave the hospital, the coverage stops. This same coverage is available to citizens and legal aliens, if they have no other means to pay for emergency care. It is provided as a part of the general principle accepted by American society, that emergency rooms should treat all comers who need it. There are no other federal assistance medical programs that undocumented immigrants are eligible for, although there are some states will use their money to provide care for the children of undocumented immigrants.

This this USA Today article from a while back suggests that, because they are generally young and healthy, undocumented immigrants account for less than 2% of health care spending in the U.S. This article in the Journal of the American Medical Association looked at health care spending on undocumented immigrants in North Carolina between 2001 and 2004 and found that an overwhelming 91% of the hospitalizations were for pregnancy and complications of pregnancy. In fact, 95% of the people seeking emergency treatment in this study were female, even though most immigrants are male.

The bottom line is that undocumented immigrants don't have access to any kind of care being denied citizens. Even if that were the case, though, there would be two solutions to the problem. One would be to deny the benefit to the undocumented people. For instance, among the 48,391 people seeking treatment in the North Carolina study were 7 minors under 18 needing emergency treatment for lupus. If you thought that they were receiving some kind of care that lupus patients who are citizens couldn't get, you could bar those 7 kids from the hospital. The alternative solution would be to insure that lupus patients who are citizens have access to all the treatment available. The sense of injustice comes from thinking that someone has access to something you don't. Whenever that happens, it is good to ask yourself "do I want to deny this to the other person, or gain it myself?"

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