Thetopic of undocumented immigrants is heavily debated across the United States.Furthermore, the concept of these undocumentedimmigrants receiving subsidized healthcare is an even more highlycontroversial matter. The conflicting sides are significantly divided eventhough the United States of America was founded upon the notion of freedom andthe melting pot ideology. This paper will examine the dilemma of undocumentedimmigrants and access to subsidized healthcare; yield a few attainablesolutions in addition to some recommendations for the future on how this issuemay be solved. Immigrationhas been around in the United States of America since the colonial times.
Alongwith those immigrants come many other issues, including healthcare. Many of themillions of immigrants presently in the United States are without insurance.This paper will discuss how important it is for us as Americans to providethose who are uninsured and here illegally with some form of subsidized care.Additionally, this article will inform readers on reasons why this shouldderive from an ethical stand point and due to the associated health risk thatcan come about for those who are here legally. The multiplying constituencybase includes healthcare providers, consumers, and buyers. There is a greatimportance to these individuals regarding the assurance of a more equitable andaccountable system of healthcare (Kaiser Family Foundation).
The terms “illegal immigration” and”undocumented immigration” are often used in an interchangeable manner.”Illegal immigration is the movement of a person from his native country toforeign country, with an intent to find a lively hood and settle down withoutthe permission of the government. Illegal immigration is an offense with legal consequencesfrom the state’s criminal code.” (Buzzle.com) Undocumented immigrants are notall settled into the United States of America under the same circumstances. Inthe vicinity of 55% of the undocumented immigrant population are people whomade entrance into the United States without permission.
The other 45% of thepopulation are people that originally had permission to be a part of the UnitedStates. However, these individuals remained in the country past the amount oftime they were given according to their visa (Theadvocatesforhumanrights.org). Immigrationin the United States dates back to colonial times circa 1607 and still occurstoday (ProCon.
org, “Historical Timeline”). Along with the long history ofimmigration in the United States, healthcare has always been viewed as a rightand not a privilege here. The adoption of a system of social insurance forAmerican use proved that healthcare and well being should be a right of thepeople. Today, the United States has a very diverse population of people, manyof them being immigrants from other countries. “Immigrants are a large andrapidly growing segment of the United States population, and theydisproportionately lack health insurance.
” (Goldman, Smith, and Sood 1640) Thepeople that come to the United States legally are not the significance of theissue. However, those that come illegally have brought about numerous issues ofconcern to the citizens of the United States. The United States of America has areputation of being a land of freedom, and immigrants mainly come here lookingto have a better life for themselves and their families. Opposed to what manymay believe, immigrants come to America because of the greater economicopportunities, to move away from a lower socioeconomic status, for a betterquality of life, and to escape poverty. Often times, there is over populationin their home country. Furthermore,many are seeking family reunification, fleeing war, or looking for asylum. Citizens inother countries do not always have all of the freedom and liberties offeredhere in the United States so they come here looking for that opportunity ofliving the American dream of living in a free land. Issue onImmigrants and Healthcare: Therefusal to provide millions of undocumented immigrants with subsidizedhealthcare is unethical and will only ensure the American citizens will have amore significant problem in the future.
Denying these people accessiblehealthcare will only force them to utilize emergency services more and drive upthe cost of care. According to some research conducted by the Kaiser FamilyFoundation, “when compared with the insured, the uninsured are less likely tohave a regular doctor or to get timely and routine care, and are more likely tobe hospitalized for preventable conditions.” (3) Furthermore, this issue willsoon threaten the health of the public because of the risk that is associatedwith communicable diseases that go untreated. Alongwith the previous issues at hand, there will be the, the ethical dilemmas thatnurses may face if they have to use the citizenship status of the patients todetermine his or her eligibility for emergency medical care, and violation ofEMTALA Laws (Grim and Wells). The stigma that immigrants may soon face willmost likely have an effect on the well being of children who are United Statescitizens but live in immigrant households. Manyimmigrants who come here to the United States come with nothing and have nohealth coverage. Studies show that the majority of undocumented immigrants thatlive in the United States are from Mexico and Latinos have the highest rate ofun-insurance. Latinos are at a greater risk of developing health complicationslater in life, such as diabetes and obesity.
These conditions will only worsenwithout access to healthcare. Though many Americans are against undocumentedimmigrants receiving subsidized healthcare, many fail to see the manycontributions that immigrants make to our society(Theadvocatesforhumanrights.org). Immigrants are net contributors to economyand treasury, and play an essential role in maintaining the Social Securitysystem via their employment deductions. Despite these contributions, the SocialSecurity system is a program that they have no access to. Unauthorizedimmigrants pay taxes and also represent 5% of the United States labor force(www.
ProCon.org, “Is Illegal Immigration an Economic Burden to America?”).United States employers benefit from the cheap labor that immigrants provideand they help fuel the United States economy through hard work andentrepreneurship (Theadvocatesforhumanrights.org). EthicalDilemmas: Nursesand other hospital workers may encounter ethical dilemmas if they have to usethe citizenship status of the patients to determine his or her eligibility foremergency medical care.
Oftentimes, the status of the immigrants are used in investigations to differentiateimmigrants and the other patients. The researchers, in addition to thephysicians, are held accountable to disconnect their personal and politicalopinions and their professional obligations. (Achkar and Macklin)Unfortunately, the political climate of the United States increasingly holds anegative stigmatization upon the population of undocumented immigrants.Ethically, an individual may question if the publication of these inquisitionswould cause the population at large to have a stronger reaction towards theseundocumented immigrants. Additionally, the immigrants involved may wonder iftheir information would be given to the authorities for their removal from thecountry. (Achkar and Macklin) Thepossible violation of EMTALA laws is a constant struggle for medical facilitiesthat receive federal funding. “Congress enacted the Emergency Medical Treatmentand Active Labor Act (“EMTALA”) in 1986″ due to various hospitals refusingtreatment on patients without insurance (Smith 310).
EMTALA forces hospitals totreat any individual that becomes a patient through the emergency departmentthat are experiencing medical conditions of an emergency nature until they havestabilized in their status. Furthermore,EMTALA is referred to the Patient Anti-Dumping Act. Therefore, this orderprohibits hospitals from “denying treatment to emergency patients orinappropriately transferring (including discharging) patients in unstableconditions to other hospitals.” (Smith 310) Despite this movement, hospitalsuse their own funding to fly the patients back to their native lands ofGuatemala, Honduras, and Mexico where they eventually passed away due to theirinability to pay for healthcare services.
(Smith 310) Currently, there are no legislativeguidelines to enforce upon the hospitals that privately fly patients to theirnative homelands. “Congress must enact federal legislation to ensure that Americanhospitals are not engaging in international patient dumping.” (Smith 311) Eventhough EMTALA is federally mandated, the movement is not federally funded. “Thefunding should come from the billions of dollars in taxes that undocumentedimmigrants pay yearly for services and benefits that they will never recoup.”(Smith 311) Moreover, the “Patient Protection and Affordability Act” became lawunder the rule of President Barack Obama. (Smith 311) This act is seen as amove of great importance. However, undocumented immigrants are not entitled tothe benefits of this legislative move. (Smith) According to the Kaiser FamilyFoundation, eliminating the ethnic and racial disparities in regards to healthcare are “politically sensitive and challenging in part because their causesare intertwined with a contentious history of race relations in America” (1).
The conflicts surrounding the racial tensions and ethnic disparities extend tothe formation of the United States of America. “Undocumented immigrants are a voicelesspeople, and thus, Americans easily find fault with their presence in the UnitedStates while simultaneously overlooking their overwhelming contributions to thecountry.” (Smith 333) The healthcare system of the United States has anabundance of problems due to the lack of a universal health policy.
Therefore,the blame of the obstacles faced by the various hospitals and the emergencydepartments can easily be placed on undocumented immigrants. (Smith) Policymakershave increased the amount of attention given to the disparities in health careon how to resolve these differences. The Congress of the United States”…provided leadership on the issue by legislatively mandating the institute ofMedicine study on health care disparities and creating in statute, the NationalCenter on Minority Health and Health Disparities at the National Institutes ofHealth” (Kaiser Family Foundation 2). The Institute of Medicine study was areview of inquisitions that have taken place between the years of 1984 to 2001.According to these investigations, evidence of difference has been found in thequality of care for individuals that have equivalent insurance and the sameillness (Kaiser Family Foundation). Furthermore, there are costly ramificationsto the citizens of a population on a social level in addition to the healthrelated consequences when there is a specific group of people to become ill andunable to receive health care services. These issues include the decrease inproductivity in the services they provide.
According to Francine J. Lipman,”Unauthorized workers are a critical component of our micro and macro economiestoday and in the projected next several decades as almost 78 million boomersprepare to retire and leave the work force” (ProCon.org, “IllegalImmigration”). Additionally, the costs of emergency care can be more expensivefor serious illness than if the patient had been seen for preventative care.The multiplying constituency base includes healthcare providers, consumers, andbuyers. There is a great importance to these individuals regarding theassurance of a more equitable and accountable system of healthcare (Kaiser FamilyFoundation).
TheAmerican Civil Liberties Union has addressed the controversy of immigrantsbeing criminalized by state and local government. An Issue Brief was releasedby the Immigrants’ Right Project due to the increasing amounts of criminalcharges being imposed on undocumented immigrants. Even though the federalgovernment has progressively selected to use criminal charges to prosecuteundocumented immigrants instead of the civil procedures used to enforce thefederal laws on immigration, the localities and the states are not permitted toexecute these federal laws to manage immigration. (American Civil LibertiesUnion) Resourcesin the law enforcement and judicial system have been taken away from thesignificant crimes involving property and violence in the state and other localagencies due to the majority of the resources being utilized to prosecuteimmigration violations.
This may impact their effectiveness on public safety.”As federal prosecutions for immigration law crimes such as illegal entry haveincreased dramatically, with prosecutors choosing to pursue 97 percent of allsuch crimes referred to them, federal prosecutors have had less time forprosecutions for gun trafficking, public corruption, organized crime, andwhite-collar crimes” (American Civil Liberties Union). Governmentleaders from both the Democratic and the Republican sides are in agreementthere needs to be more focus placed upon the ethnic disparities in healthcare.Despite the topic of racial differences in medical coverage becoming apolitical agenda, other circumstances may have an effect on the ability to accomplishthis goal.
“Issues of national security, the federal deficit, and rising healthcare costs appear to be deferring prospects for a major federal role on thisissue.” (Kaiser Family Foundation). Legislators of the United States attemptedto ensure they would be re-elected in the next election. Therefore, theseofficials made the decision to exclude the undocumented immigrants in thehealthcare legislation they passed in an effort to seek their vote forre-election.
(Smith) TheUnited States of America is presently in a state of controversy as the citizensand interest groups debate whether Undocumented Immigrants should receivesubsidized healthcare. Despite the United States being established surroundingthe melting pot ideology, and being the land of the free, there are conflictingsides on this matter. This paper explored the predicament of access tosubsidized healthcare if you are an undocumented immigrant. Furthermore, thereis discussion on possible resolutions and suggestions for solving this issuefor the future. Immigration began in the United States of America since thecolonial times. There are a number of issues, including healthcare, surroundingthe immigrants that migrate here. A number of the immigrants currently livingin the United States are with no insurance.
This paper discussed how importantit is for us as Americans to provide those who are uninsured and here illegallywith some form of subsidized care. In addition, this article informed thereaders on causes for why this should derive from an ethical stand point anddue to the associated health risk that can come about for those who are herelegally. The increasing constituency base includes healthcare buyers,consumers, and providers.
The assurance of a more equal and responsiblehealthcare system is important to these individuals. Works Cited Achkar, J. M., and Macklin, R. Ethicalconsiderations about Reporting Research Results with Potential for FurtherStigmatization of Undocumented Immigrants.
National Institutes of Health. (May 1, 2009): 1-6, Print. American Civil Liberties Union.Criminalizing Immigrants: Unlawful and Harmful to the Public. Issue Brief., February 2010.
Web. 20 March2015. Buzzle.com: Intelligent Life on theInternet, 2010. Web. 11 March 2015.
Goldman, D. P., Smith, J. P.
, and Sood, N.Legal Status and Health Insurance Among Immigrants. Health Affairs, 24, no. 6(2005): 1640 – 1653, Print. Grim, J. W.
, and Wells, J. L. IllegalImmigrants in the Emergency Department: An Ethical Dilemma for Nurses. 2009.Web. 11 March 2015. ProCon.org.
Illegal ImmigrationProCon.org, February 14, 2011. Web.
11 March 2015. ProCon.org. Historical Timeline, September27, 2010. Web. 11 March 2015. ProCon.
org. Is Illegal Immigration anEconomic Burden to America?, August 11, 2009. Web. 20 March 2015. Smith, J. “Screen, Stabilize, and Ship:EMTALA, U.S.
Hospitals, and Undocumented Immigrants.” Houston Journal of Healthand Law Policy 10, 2010: 309-358. Web. 20 March 2015. The Henry J. Kaiser Family Foundation.Race, Ethnicity, and Health Care Issue Brief: Policy Challenges andOpportunities in Closing the Racial/Ethnic Divide in Health Care, March 2005. Web.
11 March 2015. Theadvocatesforhumanrights.org The Facts:Undocumented Immigrants.
The Advocates for Human Rights, 2006. Web. 11 March 2015.< http://www.energyofanation.org/ sites/25elf498-741c-478a-8a08aa486d8533a5/uploads/undocumented_immigrants_3.pdf>