Health Care for Illegal Aliens

President Obama made the point in his speech this week that H.R. 3200, the leading health care bill in the House, specifically excludes coverage of non-citizens. That brought the infamous outburst, “You lie!” from South Carolina Republican Jim Wilson. Wilson’s outburst was inexcusable, and he rightly apologized. But what is the planned coverage for illegals, and what should it be?

While non-citizens are specifically excluded from the pending legislation, there is no provision for enforcing the restriction. The is no requirement to check citizenship status and no penalty for failure to report non-citizens. All the medical bills will be paid by the government. So while they are specifically excluded, they are implicitly included. For those who think receiving care and paying the bill is relevant, they are covered.

Illegal workers pay some taxes, but it amounts to only a third of the services they receive. Currently, they generally receive health care through the emergency room system. The Congressional Budget Office has proven that health care costs increase when emergency care is supplemented with general care. That’s for essentially the same reason that the long waits in national health care systems reduce costs: people endure pain as the alternative, they drop out of the system and seek private care, and some people die while waiting in the queue. Liberals easily confuse receiving care with not receiving care while waiting, but in practice that’s not a distinction.

Illegal workers are often employed in agriculture, construction, and the hospitality industry (hotels and restaurants). Because the taxes paid by illegal workers do not cover the government services they use, the rest of taxpayers subsidize the consumers who use the products and services provided by those industries. One could argue that “everyone” consumes manually harvested crops, uses hotel rooms, and enjoys restaurant meals. That’s not completely true, and more importantly some people get advantage from the subsidies a great deal more than others. Why should people who frequently stay in hotels be subsidized by those who do not? Why should those who eat labor-intensive lettuce be subsidized by those who eat mechanically harvested corn?

Beyond the inequity of some taxpayers subsidizing the consumption of others, providing a hidden subsidy distorts the market for those things. If the true costs of the labor were reflected in those markets we would expect less of the more expensive products to be consumed, legal labor to be more competitive with illegal labor, more automation to replace labor, and some products to be produced increasingly abroad.

For example, labor-intensive field crops may be produced more in Mexico and Chile and less in the United States. That is appropriate and it supports the economies of developing countries while freeing American capital to be applied to better uses.

The solution for this aspect of health care is to require the employers of non-citizens, legal or not, to provide for their workers’ health care. They can do that by providing health insurance for their workers and families of the workers or by being directly responsible for their health care expenses. Employers would pass the costs along to consumers, and markets would then be a better reflection of true costs.

Do we need comprehensive immigration reform first? No, we should make incremental improvements when possible. This gets back to the radical idea that nothing short of a revolution is acceptable. That is the false presumption of the Left, who care far more about accumulating government power than finding practical solutions to problems. That is a form of obstructionism.

As a consequence of Congressman Wilson’s outburst, there is now a move afoot to provide checking of citizenship to receive the proposed benefits. So was it true that President Obama was lying? Well, yes, it was true by any reasonable assessment. Obama certainly knew that there was no checking of citizenship, so he knew non-citizens would received de facto coverage. Nonetheless, the Congressman’s outburst was inexcusable. The end does not justify the means. There were other ways to make the point.

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3 Comments on “Health Care for Illegal Aliens”


  1. President Obama assures us his health care plan would not cover illegal aliens. While that statement is misleading, it cheered Democrats, who want to pass a health-care bill – any health care bill.
    Republican Representative Dean Heller said, “Congress should do everything within its power to curb abuse. Requiring citizenship verification for enrollment would ensure only citizens and legal residents receive taxpayer funded healthcare,” which cheered Republicans, who use the law and citizenship as excuses to exercise xenophobia.
    When Democrats and Republicans, liberals and conservatives, agree on a major principle, we all need to tremble. Here are some thoughts on this frightening situation:
    Despite all the claims, no one knows how many illegal aliens reside in America. Depending on whom you believe, the number could be anywhere between 12 million and 70 million – from 3% of the U.S. population to 17%.
    Despite all the claims, no one knows how much income tax, Medicare tax, Social Security tax, sales tax, property tax and all other taxes they pay. Some right-wingers claim the illegals pay no taxes, which is ridiculous on the face of it. No sales or property taxes? No income, Social Security or Medicare taxes withheld from their paychecks? No excise taxes, like gasoline tax? Please let me know their secret. We all might like to try it. Many illegal aliens pay taxes out of deportation fear. Many pay out of a sense of obligation and morality. Many pay for many reasons.
    Despite all the claims, no one knows the degree to which illegal aliens may or may not “steal” jobs from American citizens. Usually the jobs in question are at the low end. We don’t hear doctors or lawyers complaining that illegal aliens have stolen their jobs. Who does most of the low-end jobs in America? Disproportionately, blacks (aka African Americans) and Latinos (aka Mexican Americans). Who are the complainers? Mostly the right-wing whites, who wouldn’t take those jobs under any circumstances.
    Despite all the claims, no one knows the net economic contribution made by illegal aliens. Conservatives claim it’s very little. Liberals tell us about all the industries that depend on illegal aliens.
    So, despite much heat, shouting and claims, no one knows the fundamental facts of this debate. It’s like arguing religion. Everyone believes strongly, but no one has facts.
    We do know this, however. When illegal aliens don’t have insurance, they use emergency rooms, for which we citizens pay, or they get sick and become a burden on society, for which we also pay.
    We also know that people who pay tax are entitled to government services. So to deprive all illegal aliens of federal support is unconscionable and may be unconstitutional.
    We also know illegal aliens are not going home. They will be here with us until they die, as will their children and their children’s children. Of course many of these children, and most of the children’s children will be born-in-the-U.S.A. citizens. Shall we deny these American children health care? Shall we deport their parents?
    We also know illegal aliens are people. They have families. They love each other and they love God. They go to churches. They build; they clean; they bathe; they plant; they reap; they cook; they eat. They have hopes and fears and pride and regrets. They revere the living and mourn the dead. They are very much like you and me, except fate has not given them that piece of paper we were so fortunate to have received, most of us merely by the accident of being born in the right place. They are not monsters or criminals, any more than we are.
    Most right wingers are Christians. Are we naive to expect Christians to be more Christian toward their fellow human beings?
    We don’t know what President Obama really believes. He’s a politician. But it is sad to see a President pander to the xenophobes who espouse hatred of a minority, under the guise of law, especially when there is so much we don’t know.

    Rodger Malcolm Mitchell
    http://rodgermmitchell.wordpress.com/

    • roylatham Says:

      My proposal that employers pay the health care costs of illegal workers does not depend upon how many there are. Note that Obama started referring to 30 million uninsured citizens, implying the there are 17 million uninsured non-citizens. That’s higher than the 12 to 15 million number generally used.

      I used the best available data from Texas and California that I could find on the web to arrive at the estimate that illegals pay about one-third in taxes of what they receive in services. Whatever the number is, it is better to have the health care costs tied to the labor cost rather than the general taxpayer.


  2. “Best available data”? What makes it best? What makes it any good at all?

    How many undocumented workers have employers who don’t pay for anyone’s health care? You don’t know. I don’t know.

    The federal government has no idea how many undocumented workers there are. The guesstimates range from 12 million to 70 million. What makes you think Texas and California know? Anyway, what makes you think Texas and California are typical of anything?

    No one knows how many people there are, which people there are, how much tax they pay, which taxes they pay, and how much service and which service they receive and what their service costs. It’s total “toss-a-dart-at-a-board” stuff.

    It’s all vague non-data, that “experts” love to quote.

    Why is it better to add to company (aka the economy’s) expenses than to federal expenses (aka the deficit)?

    In that regard, deficits are not paid for by the taxpayer. That’s why they’re called “deficits.” If they were paid for by the taxpayer, they wouldn’t be deficits.

    One main points in my post: There is a lack of reliable data. Quoting unreliable data is worse than useless. It’s harmful.

    Rodger Malcolm Mitchell
    http://rodgermmitchell.wordpress.com/


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