One of the many axes on which health care reform rests is whether illegal immigrants will have access to health care.  There appears to be unanimous outcry from Republicans bewailing the possibility that illegals might weasel access to health care.  Joe Wilson even breached congressional decorum by screaming “you lie!” at the President for stating that illegals will be denied such access.  Since then Democrats have been desperately assuring us that that Republican allegations about illegal immigrants getting a free ride on Americans’ dime is just not true.  If there’s bi-partisan support for anything in healthcare it is that illegals should not be able to get it.

Why?

It’s no secret that I have pretty radical ideas about immigrants, especially illegals. This matter cuts close to my heart. I support and fight for health care reform not because I see a problem in the health care market, not that I recognize health care as a scarce commodity which I want to equally distribute to the masses. I recognize health care as a right.  I also have a perspective on rights as being “human” rights rather than purely “American” rights. If health care is a right, then how can we deny access to that right to an individual based on which side of the river he happens to be on.

As it stands, illegal immigrants are not likely to see a doctor until they are in dire, medical straights. At this point the default health care provider is the emergency room.  Yet emergency rooms are becoming over crowded.  Among the reasons for overcrowding is lack of insurance and poverty, in which illegals often fall.  Research has demonstrated that illegal immigrants do not overuse the emergency room, and emergency medical costs for illegal immigrants is lower than it is for legal immigrants as well as natural born citizens.  Regardless, for millions of illegals, the emergency room is the primary care provider, and many emergency rooms claim to be overburdened with illegals.

How much of this burden could be lifted if medical services and programs were provided for illegals? I’ve not seen any such research.  According to the American Journal of Public Health, restrictions on undocumented immigrant’s access to health services is costly to local communities. Such restrictions add to the administrative and bureaucratic costs of running a health care facility, keep afflicted people from seeking health care when needed (until matters get out of hand), discourage preventative care such as pre-natal care and health screenings, and poses a danger to the community with regard to the spread of communicable diseases.

Then there’s the matter of ethics. Doctors are already conflicted with their professional ethics of caring for the sick without regard to status, and the legal restrictions put on them to do so.  The emergency room is one of the few places where illegals cannot be turned away. We as a society should also feel conflicted when human beings cannot get access to health care.

This is about “us” and the “other.” It’s about “deserving” and “not deserving.” All social groups identify their members as being deserving of the status and privileges of being a group member.  Those outside the group do not merit such rights. Illegals, and some might even suggest immigrants in general, are not deserving by virtue of the fact that they are not us, they are not Americans.  It’s not about money, as providing for illegals may be more cost effective than letting them languish.  It’s about group privilege. It’s a shame that we are still mired in the medieval barbarism of such group prejudices, but this debate could be a step toward true civilization.