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David Bier

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The Flawed Case Against Immigration

Posted: 05/15/2012 6:38 am

We all know the buzzwords--no amnesty, no unfunded mandates, no immigrant welfare. Opponents of sensible immigration policy repeat these lines so often you'd think that they really believed them. But when one examines their actual positions, it becomes clear that they are little more than intellectual cover for their real anti-immigrant agenda.

In 1986, President Ronald Reagan--revered hero of conservatives--signed the Emergency Medical Treatment and Active Labor Act (EMTALA), which required hospitals to provide "for such further medical examination and such treatment as may be required to stabilize the medical condition" of any individual regardless of ability to pay or immigration status (42 U.S.C. 1395dd).

The Act makes no provision for federal reimbursement, so it is rightly acknowledged as an unfunded mandate. Conservatives were right to protest this; the federal government shouldn't place financial burdens on the states or private institutions that it isn't willing to cover itself. But the leap to immigrants abusing the EMTALA isn't as easy to make.

Immigrants are more likely to be younger and male. They make fewer physician visits and have fewer health problems than the general population. In a massive study of over 44,000 Latinos, for example, "undocumented Mexicans had 1.6 fewer physician visits than U.S.-born Mexicans," and that "other undocumented Latinos had 2.1 fewer visits." (Archives of Internal Medicine, 2007)

A nationwide survey found that immigrants account for 55 percent fewer health care expenditures per person than native-born Americans. Even their children had 74 percent lower health care expenses. The authors conclude that their study "refutes the assumption that immigrants represent a disproportionate financial burden on the U.S. health care system" (American Journal of Public Health, 2005). Another major study of 12 major U.S. cities investigated the specific question of emergency department (ED) use and concluded that "noncitizens had much lower levels of ED use than citizens did (about 17 fewer visits per 100 people, on average), and the difference between poor citizens and noncitizens was almost twice as large" (Health Affairs, 2006).

Since immigrants don't impose disproportionate costs, the empirical case against immigration based on EMTALA's unfunded mandate holds no water. Moreover, immigration opponents aren't even consistent about unfunded mandates. Arizona's SB 1070 mandates local police to arrest individuals whom they have "probable cause" to suspect are undocumented. It forces local governments to pay all booking and jail fees. That is an unfunded mandate, as Mesa, Arizona, Mayor Scott Smith correctly noted. "This is not a cost-free endeavor," he said in 2010. "And depending on how it plays out, it could create significant financial costs to the city."

In fact, the vast majority of immigration laws impose unfunded mandates on businesses to act as de facto Immigration and Customs Enforcement agents under threat of fines or license suspensions. They require employers to monitor their employees and file reports on everything from their hours and wages to their housing, food, and travel situations. All this costs thousands of dollars. Just to hire one worker on an H-1B visa, for example, the employer usually pays around $3,000 for a consultant to help fill out the complicated paperwork correctly.

The online employment verification system E-Verify is an unfunded mandate that imposes significant costs on employers. Just last month, 60,000 Alabama employers missed their state's deadline to sign up for the program. But the state realizes it can't go after that many employers. Alabama Department of Homeland Security spokeswoman Katheryn Kennedy said, "Right now we're not penalizing businesses. We're trying to help them, to be a safe harbor." In other words, they're extending an "amnesty" to these businesses--an indirect admission of the law's unfeasibility and a direct contradiction of their "no amnesty" mantra.

Not only does the anti-immigration crowd not seem to care about unfunded mandates or amnesty when those suit their purposes, their claims that are trying to costs welfare are also dubious. Since Arizona's SB 1070 actually criminalizes work, or looking for work, even looking like you're looking for work in "a place where unlawfully present aliens are known to congregate," the law's actual effect is to create more destitute and needy families who might use public benefits. Of course, this may be the point--at least to bolster their flimsy case against immigration.

 
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spytheweb
Black Democrat
01:04 AM on 05/18/2012
Feb 11, 2012

"This week officials in California, the state with the largest concentration of illegal immigrants, joined the call for federal compensation after revealing that hospitals there spend about $1.25 billionannually to care for illegal aliens. The figure skyrocketed from $1.05 billion in 2007, according to California Hospital Association figures quoted in a local news report. The problem will only get worst, according to officials, who say the $1.25 billion for 2010 could actually be higher. They complain that federal law forces them to treat patients in emergency rooms regardless of immigration status yet they get stuck with the financial burden. This has forced many hospitals to curtail services or close beds and could ultimately compromise healthcare.

Nationwide, U.S. taxpayers spend tens of billions of dollars annually to provide free medical care for illegal immigrants with states that border Mexico taking the biggest hit. Adding to the problem is the fact that Mexico, the country that provides the largest amount of illegal immigrants in the U.S., has long promoted America’s generous public health centers. It even operates a Spanish-language program (Ventanillas de Salud, Health Windows) in about a dozen U.S. cities that refers its nationals—living in the country illegally—to publicly funded health centers where they can get free medical care without being turned over to immigration authorities."

http://snoremonster.wordpress.com/2012/02/11/california-hospitals-spend-1-25-bil-on-illegal-aliens-mostly-from-mexico/
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HUFFPOST SUPER USER
Jerry Bourbon
12:42 AM on 05/17/2012
Any study which, like this one, fails to differentiate between LEGAL immigrants and illegal aliens is worse than worthless; it is fraudulant.

Legal immigrants to the US tend to be significantly younger than the American population overall, and if they have any congenitive diseases which would be expensive to treat, they will not be approved for residency in the first place.
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andreabeth7
01:02 PM on 05/16/2012
This information has already been deleted once. I will try again.

This is from the American College of Emergency Physicians:

'In some hospitals, as much as two-thirds of total operating costs are for uncompensated care for illegal aliens. As a result, hundreds of emergency departments have closed. In Los Angeles, for example, 10 hospitals have closed in the past five years because of uncompensated care"

http://www.acep.org/content.aspx?id=25206
12:44 PM on 05/16/2012
I find it odd that in the debate over illegal immigration and all that encompasses, there is little discussion about dual citizenship. I'm not saying that dual citizenship is the answer to the multilayered issue of illegal immigration, but it is a discussion point that I've not yet heard. But it seems that if it is a viable option for those whose ancestors hailed from northern and western Europe, then a pathway to dual citizenship might also be viable for those whose ancestors hail from south of our border.

There is a certain lack of duality about these discussions.

http://goodethoughts.blogspot.com
11:55 AM on 05/16/2012
Here's an excerpt from a letter that was sent to President Obama by Richard Umbdenstock, president of the American Hospital Association (AHA):

http://www.aha.org/advocacy-issues/letter/2011/110607-let-umbdenstock-obama.pdf

"The most recent statistics shows that America's hospitals provided nearly $40 billion in uncompensated care in 2009".

That's $40 BILLION DOLLARS in "cost-shifting".
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voyager48
Illegitimi Non Carborundum
06:20 PM on 05/16/2012
And illegals get a total of $4bn in tax refunds. Often $11k refunds on around a $20 k filing so there is no way they are paying their way!

http://www.wthr.com/video?clipId=7054149&autostart=true
12:00 AM on 05/17/2012
Supposing that could be passed on to? The president, vice president, congressmen/women, scotus? No it is passed on to the other hospital patients who never have figured out that they get to pay for themselves and the millions of illegals also. JOE WILSON WAS RIGHT.
08:28 AM on 05/16/2012
Leave the poor people alone!!!!
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iuriggs6
Sure thing. Shoot, Timmy.
11:53 AM on 05/16/2012
You mean the ones breaking laws by living here illegally?
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HUFFPOST SUPER USER
BiggpussJr
pissin em off one comment at a time.
02:23 PM on 05/16/2012
I agree. Please leave the poor people alone. Because every illegal immigrant TAKES from the poor. The poor are the ones that suffer most from illegals. Great Point.
12:55 AM on 05/16/2012
"Immigrants account for 55 percent fewer health care expenditures per person than native-born Americans. "
Um.. could it have something to do the fact that the illegal migrants don't buy health insurance.
nah, of course not....
HUFFPOST SUPER USER
andreabeth7
01:10 PM on 05/16/2012
Illegal immigrants also cannot be tracked down when they do not pay their bills. Since they do not have a SSN, they do not have the paper trail that a hospital or collecting agency can follow in an attempt to work out a payment plan. They may be using a forged or stolen ID which further complicates matters and last but not least, many simply view 'free' health care as something they are entitled to and have no intention of paying their medical bills. This attitude of entitlement is cultivated by the various ethnic advocacy groups who continually remind them that their land was 'stolen' and other excuses.
12:19 AM on 05/17/2012
There is at this moment in time pandemics in both WA and CA of whooping cough in the barrios and ag workers housing areas because the illegals are too dumb and cheap to get vaccinations for their scads of kids. The United States hasn't seen this bad a number of whooping cough cases in decades. Now that we are inundated with this criminals we get the whooping for innocent American babies from the illegals.
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markspence
09:59 PM on 05/15/2012
Ordinarily, I attack the message, not the messenger; however, I will make an exception in the present case.

The Competitive Enterprise Institute is a fringe libertarian organization with a fringe libertarian agenda.
09:53 PM on 05/15/2012
Perhaps you haven't followed what hospitals in Texas and California will tell you. In many cases, over half the births are to illegal immigrant women. Your stats were probably true at some point in the past, but can't possibly still be true. Talk to some hospitals. You are basing your conclusions on data that is 5-10 years old, I'm guessing.
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HUFFPOST SUPER USER
FranklySpoken
I cannot believe you said that…
01:37 PM on 05/17/2012
Note that they focused on visits NOT average cost. So a visit for 2 stitches is equivalent to a complicated child birth costing over $100k. Neat trick!
08:14 PM on 05/15/2012
"sensible immigration policy"

The favored "sensible" policy of business special interest groups is unlimited immigration and guest workers. I guess the vast majority of American citizens lack good sense then. I mean, why don't they want to create a permanent glut in the domestic labor market, destroy the environement through overpopulation, etc.? OBVIOUSLY, these concerns are just "intellectual cover for their real anti-immigrant agenda" (whatever that is). Please tell us what our REAL "anti-immigrant" agenda is.
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Snake1994
Snakebite!
03:37 PM on 05/15/2012
If Ronald Reagan were alive today I'm sure he would have regretted everything he did in 1986.
02:42 PM on 05/15/2012
While tomato and lettuce pickers are often quoted as jobs for illegals, the reality is that only 3% of illegals work in agriculture, according to USA Today, 2006. There are about 12 million illegals in the country and 13 million citizens currently unemployed.

In additon to the 3% agriculture jobs are: 21% service, 19% constuction, 15% manufacturing, 12% sales, 10% management and 8% transportation. The balance is unknown but could be gang members terrorizing neighborhoods or drug dealers, nobody knows. Local property owners are the ones who get stuck with the tab for welfare, healthcare and education for illegals. People who are uninvited are also unwanted.
01:45 PM on 05/15/2012
Nicely spun. You made it sound that because illegals go the the hospital less often, they cost less. What you failed to include was who was paying for medical services. Just another example of how the illegal supporters will do anything to justify letting law breakers stay in this country.
12:40 AM on 05/17/2012
Obama, biden, holder, big sis, morrow etc no congress member, no scotus members pay for those sick or injured illegals, we the honest American xitixens pay for the illegals and their millons of kids.
12:26 PM on 05/15/2012
American citizens have a sovereign right to make and enforce laws regulating foreign nationals on U.S. sovereign territory.
No foreign national shall be exempt from those laws.

And no amount of data massaging and sophistry will change that.
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TggerJen
Protect at snowleopard.org
04:41 PM on 05/15/2012
Excellent comment!! F&F BIG!
12:49 AM on 05/17/2012
Sounds good, looks good on paper but the reality is obama , holder, napolitano and morrow have circumvented those sovereign laws and allowed 300,000 already arrested illegals to ignore their trials and roam the country with nice new work permits from the us gov coursty of obama, holder, napolitano and morrow who have totally now have their own new court system.of 'obama chicago style amnesty for the illegals .
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HUFFPOST SUPER USER
dtairtime
It is what it is
12:07 PM on 05/15/2012
http://cei.org/

This is who tha author represents.

PLEASE - any wsupporter of illegals and our current record massive and unsustainable immigration levels explain HOW a group like this one can be the basis for your side in this debate while you try desperately to cling to liberal values.

Fact - immigration is a free market, 1%, profit driven ideal. It has NOTHING to do with humanitarian issues, ra/ce, or ANY other liberal ideal. In fact it is the EXACT opposite of most other liberal ideals.
1. We can help the poor of other countries FAR better and with far less money if they stay in their own countries.
2. We only drive up world comsumption of all natural resources by allowing any immigratin to this country. Once here ALL immigrants use far more then if they stayed home.
3. Not only does the importation of labor (what David loves) drive down wages, it keeps the poor at that level because the limited social programs are split that much thinner.

Think for a second WHY all ultra conservative groups like the chamber of commerce, big business groups of all kinds, the wall street journal, etc all support immigration - both legal and amnesty for illegals. Do you really think they have an altrustic bone in their bodies?
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TggerJen
Protect at snowleopard.org
04:42 PM on 05/15/2012
Thanks for posting that excellent comment!!