Humor will not be tolerated!! -Portia

This question was about illegal immigrants and how they obtain emergency room care, among other things. habiba gives an interesting and informative answer and ends with this: "Part of the difficulty is that most illegals don't go to the emergency room unless it is the very last resort, when the cost of treatment is much higher than if they'd had preventative or early care. California estimates that in 2006, 80% of their emergency rooms operated at a loss because of either illegal or unable to pay patients."

I agree that this is a big problem, but I'd like to disagree in a minor point. From what I have seen and from what I have heard, the problem is not that they go to the emergency room as a last resort. You see the emergency rooms filled with people whose only complaint is a runny nose or cough, or some minor ailment. And it isn't just the illegal immigrants, it is all those who can't or don't want to pay for their medical expenses. So they take advantage of the system where the government makes the emergency rooms treat all patients, whether the patients can afford it or not, no questions asked. Why should they pay for their routine medical needs when they can get it for free? They go to the emergency room for health problems so minor I won't see a doctor for at all.

Yes, the cost of treatment in the emergency rooms is outrageously high. I don't remember all of the crazy expenses, but I do remember a quart of sterile salt water cost me $100 to wash out something in my eye that had swollen my eye shut. And that was in addition to hundreds of dollars in other charges. I've heard that they charge, for those who can pay, $25 for a simple $0.10 bandaide. The reason they charge so much is to make up for losses from those who don't pay anything. At least that is what the doctors tell me.

Vorpal Blade,

Probably not best to rely on anecdotal evidence here. A recent study found "foreign-born residents who are not U.S. citizens are among the least likely to use emergency rooms, at least for those health issues that could be treated in a clinic."

And illegal immigrants going to the hospital as a last resort is not "taking advantage of the system;" if anything these people are seriously disadvantaged by the system. Your characterization that they just use the Emergency Room like a free doctor's office is false. And for more serious issues, what else are they supposed to do?

These illegal immigrants aren't malicious. They just can't afford—or even get at all—insurance. The system is seriously, seriously, seriously messed up.

let's face it, american citizens can barely afford health insurance.

Waldorf and Sauron,

I followed the link you gave to Erin Carlyle’s blog. That blog reports the results of a study performed by Shannon McConville and Helen Lee. I carefully read that study as well. The conclusion I reach is that the data you referenced does not support your point of view.

The study does make the claim that “In particular, noncitizen Hispanics and Asians were, respectively, 3 percent and 6 percent less likely than U.S.-born whites to have visited an emergency department in the previous year,” referring to adults ages 18-64. The problem is that we don’t know what proportion of the noncitizens using emergency rooms are illegal immigrants. It is estimated that in 2007 there were 10 million foreign-born residents of California, of which 5.6 million are non-citizens. It is estimated that there are 2.8 million illegal immigrants in California. Therefore illegal immigrants could be using emergency rooms much more often than others, and yet the population of all “foreign-born residents who are not U.S. citizens” using emergency rooms could be a few percentage points below that of U.S.-born whites. And on the subject of foreign-born children the study is silent.

In California “undocumented immigrants” (illegal immigrants) have their emergency health care paid for by Medi-Cal. About “12 percent of the state’s 6.6 million Medi-Cal eligible patients were considered illegal immigrants.” So it is interesting to see whether Medi-Cal patients ever use emergency rooms for non emergency use. And the answer is yes, that over 60% of Medi-Cal visits by children younger than 18 were deemed “avoidable” by the principal diagnosis. “Avoidable visits include those that were classified as (1) non-emergent, (2) emergent, but treatable in a primary care setting, and (3) emergent, but avoidable with timely, well-managed care.” They don’t give the relative proportion of emergent and non-emergent.

I should add that for adults with Medi-Cal the amount of avoidable emergency room visits is closer to 50%. Also, those not on Medi-Cal have high rates of avoidable emergency room visits, but not as high as those with Medi-Cal.

In short, the data you referenced implies to me that most of the time illegal immigrants use emergency rooms like a free doctor’s office, and not as a last resort. Furthermore they could be using emergency rooms much more often than others, but the study doesn’t provide enough data to either confirm or deny that.

I think it is important to remember that illegal immigrants choose to be illegal immigrants. They gamble that the advantages gained by breaking the law are much greater than the disadvantages. They have no moral right to anything in the United States. They are not entitled to anything here, except what misguided politicians give them. They have no moral right to even be in our system.

You ask, “And for more serious issues, what else are they supposed to do?” The answer is they weren’t supposed to come here in the first place. The honest, morally right, legal thing for them to do is go home to their own countries. We welcome legal immigrants with open arms. But illegal immigrants should not be here, and in my opinion should not be using services paid for by tax dollars.

The honest and moral thing? They are not thinking about that, they are thinking about providing for their families, about having a better life. And the system that allows people in to immigrate is broken. Heck even getting a visa just to travel here is hard.

I have a friend who would like to come up for a visit, but the consulate office denied her a visa because being a twenty something female might get kidnapped or something, and not having enough funds in the bank to be allowed up even though she's attending a college down there and has a job.

So you answer me this, what should have those illegal immigrants done? Suffer through poverty? Wait patiently while they have no job to get permission to live here?

Heck, just to get a visa they have to pay $131 or so dollars, or over 1300 pesos, non refundable. Meaning if you apply and don't get your visa, you just lost a whole lot of money. Not to mention other hoops that have to be jumped through

So VB, you tell us. What should have the immigrants have done instead?

VB,

I haven't seen you present any evidence to back up your arguments. In fact, you made quite a logical leap in saying that since a) 60% of medi-cal visits are avoidable, and b)12 percent of medi-cal patients are illegal immigrants, therefore c) illegal immigrants usually make avoidable visits.

At least in the study's central figure regarding noncitizens, illegal immigrants constitute a majority. I'd love to see any evidence you have for your claims.

See also this article:
http://latimesblogs.latimes.com/lanow/2 ... edica.html

As for "The honest, morally right, legal thing for them to do is go home to their own countries. We welcome legal immigrants with open arms." Not to sound snarky, but that's certainly easy for you to say.

It's a little arrogant to say that Americans deserve health and prosperity more than other people just because we live on one side of an arbitrary political boundary.

Also, insurance companies are big-time scammers and they screw over both doctors and patients. So yeah, patients are going into debt to pay their medical bills, but also reimbursements from insurance companies to physicians keep declining, which is a side of the issue that not enough people consider. Remember, you have to pay people a lot to be doctors because at age 30, when most other people have already been making money for 5-10 years, doctors are $300,000 in debt and just starting to get paid at all. Plus, you need incentives like money to get the smartest people to want to be doctors, where they are desperately needed. Physician shortage is going to become such a huge, huge problem in the next 10 years.

Imogen wrote:let's face it, american citizens can barely afford health insurance.

My philosophy is that in most cases there is no situation so bad that further government involvement won't make it worse.

Sam,

I’m surprised they didn’t tell your friend what I often hear; they can’t let her go because while she is in the U.S. she might find an American who wants to marry her.

What should the illegal immigrants have done? I think the answer is easy, follow our Church leaders. What do our Church leaders tell us to do?
1. Pay tithing
2. Attend Church meetings
3. Do your duty in the Church and serve the Lord
4. Be honest in your dealings with your fellow men
5. Get as much education as you can. If necessary apply for a loan from the Perpetual Education Fund we are all contributing to. And for those in the U.S., if you are in a position to do so, and wish to help others out, give a more generous offering.
6. Work hard for your employer.
7. Obey the laws of the land
8. Stay in your own land. If inspired to move elsewhere, get in line and do all that is legally required of you.

My suggestion for non-members is to join the Church!

vorpal blade wrote: 8. Stay in your own land. If inspired to move elsewhere, get in line and do all that is legally required of you.

Dude, they said Zion is wherever you are, i.e. have the church where you are, cause many were leaving their homelands and moving to Utah.

And as far as immigration goes, legally or illegally, I don't think Church leaders have said anything about it. Especially since missionaries aren't banned from baptizing or converting illegal immigrants.

Waldorf and Sauron,

The data I’ve seen so far regarding illegal aliens is primarily guesswork and shaky assumptions. I haven’t spent any real time trying to find good sources of information to support my view. You might say, politically incorrectly, I’m too busy fighting alligators to drain the swamp. But it is more fun for me to try to shoot down the supposed facts of others.

Did you like that logic regarding the avoidable emergency room use of illegal immigrants? Sort of illustrates what I’m talking about, doesn’t it? Depends on your bias.

Well, I wouldn’t call 2.8/5.6 = 0.5 a majority, just half. Granted, half is more than 12%. There is a logical reason the illegal immigrants would use the emergency room services more often than the foreign-born noncitizens. Those here legally have to pay the high costs out of pocket, or with insurance. The illegal immigrants get it for free. If noncitizens here legally claim to be undocumented they could be deported if it were found out they lied.

You referenced an article in the liberal Los Angeles Times. The title of the article is “Doctor: Illegal immigrants not key reason for ER problems.” To support that claim the author, Kimi Yoshino, quotes Dr. Irv Edwards, who is part of a group of physicians suing the state for more funds. The key research study cited in Yoshino’s article is a Rand Corp survey where people were asked how much they spent for medical care. Reading the article you will note that no distinction was made between emergency room care and all other care. So the fact that undocumented immigrants make up 12% of the non-elderly adult population, but account for only 6% of the spending is interesting, but irrelevant. If in fact they are disproportionately using emergency room services instead of other medical services, which is logical given that they would not have to pay for the emergency room services, then one would expect their total medical care costs to be less.

Kimi Yoshino flatly states that “Illegal immigrants are not eligible for Medi-Cal.” She is flat out wrong. Which kind of puts in doubt the point she is trying to make.

“The honest, morally right, legal thing for them to do is go home to their own countries. We welcome legal immigrants with open arms." It is easy for me to say only because it is the right thing to say.

Darth Fedora,

Please don't put words in my mouth. It's unsanitary.

But just out of curiosity, why do you think Americans enjoy better health and prosperity than others, or do you?

vorpal blade wrote:Sam,

I’m surprised they didn’t tell your friend what I often hear; they can’t let her go because while she is in the U.S. she might find an American who wants to marry her.

What should the illegal immigrants have done? I think the answer is easy, follow our Church leaders. What do our Church leaders tell us to do?
1. Pay tithing
2. Attend Church meetings
3. Do your duty in the Church and serve the Lord
4. Be honest in your dealings with your fellow men
5. Get as much education as you can. If necessary apply for a loan from the Perpetual Education Fund we are all contributing to. And for those in the U.S., if you are in a position to do so, and wish to help others out, give a more generous offering.
6. Work hard for your employer.
7. Obey the laws of the land
8. Stay in your own land. If inspired to move elsewhere, get in line and do all that is legally required of you.

My suggestion for non-members is to join the Church!

great idea. i'll get right on the incredibly offensive advice right away...

vorpal blade wrote:Darth Fedora,

Please don't put words in my mouth. It's unsanitary.

But just out of curiosity, why do you think Americans enjoy better health and prosperity than others, or do you?

Let's review, homie. You said: "I think it is important to remember that illegal immigrants choose to be illegal immigrants... They have no moral right to anything in the United States. They are not entitled to anything here, except what misguided politicians give them. They have no moral right to even be in our system. "
I said: "It's a little arrogant to say that Americans deserve health and prosperity more than other people just because we live on one side of an arbitrary political boundary."

You said some people don't have a moral right to some things because they weren't born within these arbitrary political boundaries and came here anyway. I just disagreed with that.

But I certainly don't believe that Americans enjoy better health and prosperity than others because they're better people or more worthy. I happen to have those things because I happened to be born to a well-off family who could afford health care, and I happened to be born smart and without any major health problems, and I happened to have a lot of great opportunities for education. I earned none of those things, I just lucked out big time.
You can't take credit for us having a better government than other countries because you didn't do squat to form said government. You can't take credit for your parents being rich, or for your having good health, or for your being born in America. Where you had good luck, other people had crappy luck. That's no reason to hate them and try to deny them the blessings that you just walked into and did not earn.

also, let's remember that without illegal immigrants, who would pick our oranges for significantly less than minimum wage? Illegal immigrants have an important position in our economic system that I don't think would be easily filled (granted, it's a crappy one, but beggars can't be choosers?)

Last year, while I was making almost no money summer-selling, I developed a cough that became chronic. I started wheezing worse and worse due to summer allergies. I tried self medication, but that didn't help. It was only when I started suffocating in the shower that I got scared for my health and my girlfriend rushed me to the emergency room. I went on an albuterol nebulizer for 20 minutes and they gave me a little asthma-style inhaler to go on for a couple of weeks. Cleared the labored breathing right up, I tell you, it was very literally a great weight off my chest.

The bills totaled over a thousand dollars.

I'm still paying for it.

The funny thing is, even the cheapest insurance would cost me over a hundred dollars a month, which I simply can't afford as a young single adult without a degree. It practically makes more economic sense to take the credit hit than to pay medical bills.

I am thoroughly against government intervention in almost any facet of the economy, but you are lying to yourself if you truly believe the free market has figured this one out so far. Maybe if we quit spending dumptruckloads of money bailing out failed business models and incarcerating all the damn stoners, we could figure out a way to make health care work.

Cognoscente, I could kiss you. This liberal kid, who doesn't believe the government should take over healthcare (anymore), just wants to go on record as agreeing with literally every word Cognoscente just said, as well as every word Darth Fedora said about luck. Cheers.

Imogen wrote: great idea. i'll get right on the incredibly offensive advice right away...

I try to express, as inoffensively as I can, my deeply held beliefs and feelings. It saddens me that you find that offensive.

Darth Fedora,

Let me see if I can better explain myself by using an analogy. I realize that all analogies are imperfect, but please try to understand my point.

Let’s say that you have a problem. A group of people have broken in to your house, without your permission, and are living there. You’ve asked them to leave, but they like it there. They sit around and watch your TV; they take the food out of your refrigerator and eat it. They sleep where they want to. They freely use your showers and bathroom towels. Most of them try not to cause any trouble, but some of them are violent criminals. Many just want to find work in your home so they can send your money to their own homes, because they are very poor.

Now, Waldorf and Sauron say that taking your food without permission because they are hungry, as a last resort, is not taking advantage of you. If anything, claims Sauron, these interlopers are seriously disadvantaged by living in your home. Also, what else are they supposed to do?

You reply that you think it is important to remember that these interlopers choose to be interlopers. They have no moral right to anything in your house. They are not entitled to anything in your house, except what some misguided politicians say they can take from your house. They have no moral right to even be in your house.

Now suppose I say that it’s a little arrogant to say that the Fedoras deserve all the things in their house more than other people just because they live on one side of an arbitrary property line.

Okay, end of analogy. Did that help?

I’m not saying that we as individuals are better or more worthy than other people. I’m not saying that we deserve some things and they don’t, all else being equal except an arbitrary political boundary. I’m saying that illegal immigrants don’t have a right to our personal things, but they certainly do have the right to the same kinds of things, if they can obtain them legally.

In my opinion there is something about the way we do things in America that makes us more prosperous than many other countries. Many of those countries have natural resources equal to or greater than our own. What makes the difference in prosperity? Is it our government, cultural traditions, work ethic, institutions, heritage, or something else? We as a people must be doing something right. It’s not just luck. I’m not saying that we necessarily deserve as individuals the blessings we receive. And I certainly don’t hate foreigners or illegal immigrants. I love them, and want for them to have the same blessings I have received.

Going back to the analogy of your house, I’m sure your family is generous in helping others. But you choose how you are going to help them. You don’t want them just walking in and helping themselves. There is something about your family that has helped you to be as well-off as you are. A lot of unauthorized people in your house, who don’t have the same values and experiences as your family, can destroy that organization.

In the same way when we invite people into our country and help them to become American citizens, we have some control over teaching them the values, practices, and government that has helped us to become great. When people come into our country illegally they don’t come to learn what makes us great and to become assimilated into our way of life. The result of this flood of illegal immigrants is that we as a nation may very well be overwhelmed by millions of individuals who bring with them the same values and way of doing things that they learned in their home countries, which resulted in the poverty of those countries.

Whistler wrote:also, let's remember that without illegal immigrants, who would pick our oranges for significantly less than minimum wage? Illegal immigrants have an important position in our economic system that I don't think would be easily filled (granted, it's a crappy one, but beggars can't be choosers?)

I’ve picked a lot of oranges in my life. I love that kind of work. My children have been deprived of work opportunities growing up and in college because the kinds of work that illegal immigrants do my children would love to do, but could not get hired to do. One of my brothers, who is 58 years old, still picks fruit to supplement his meager income.

I understand that in some places it is hard to find itinerant field laborers. I also understand that some illegal immigrants make less than minimum wage. If we deported all the illegal immigrants and let market forces freely operate to set their wages, which I sincerely think we should do, then there would be sufficient number of workers willing to do the job. And there would be a lot less unemployment in this country.