Posted tagged ‘illegal aliens’

Health Care for Illegal Aliens

September 14, 2009

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.