The Long Wait for Affordable Health Care

The health care debate is at a fever pitch as political voices are drowning out the common-sense principles that should be guiding the debate: fairness, dignity, and sound public health policy. Basic fairness dictates that if you pay your fair share, you should be able to receive what you pay for. Basic respect for human dignity requires that families and workers should not fear losing everything because of an unexpected illness or accident.

These principles should guide all aspects of health care reform. But for one large group of families, the health care system is deeply unfair. Legal immigrants are excluded from federal health care programs like Medicaid and Medicare for five years, even though they're paying the cost for these programs.

Most Americans believe that legal immigrants should be treated like citizens when it comes to health care services. However, current law requires that legal immigrants wait at least five years before they can apply for affordable health care coverage through Medicaid and Medicare -- coverage that is available to citizens with similar incomes. The policy is contrary to our national values of fairness and dignity and to the strength and prosperity of our nation.

These immigrants are working hard at difficult and often dangerous jobs, paying federal, state, and local taxes, and contributing to the social fabric of our communities. Like generations before them, they are making a crucial contribution to our nation, especially in these difficult economic times. And yet current federal policy singles them out for exclusion from systems designed to offer all of us affordable care in times of economic insecurity and old age. As a result, despite struggling to live the American dream, these workers and families live in fear that one accident or illness will leave them unable to care for themselves or their families.

The waiting period is especially unfair because these workers and families have paid into our Medicare and Medicaid systems, just as citizens have. They are doing all that's been asked of them, and yet they are being told to wait, at a time when the security afforded by these basic federal programs is especially important.

Because immigrants are a part of us--our neighbors, our co-workers, our friends and often our family members--excluding them from care harms not just individuals but our entire nation's health. That's why medical groups ranging from the American Academy of Pediatrics to the American Hospital Association have written to Congress and President Obama, imploring them to repeal this unfair and unworkable policy. They point out that immigrants subject to this waiting period are often uninsured, requiring them delay medical treatment until their condition worsens.

With fairness, dignity, and public health at stake, why has Congress failed to remove this waiting period? Proponents of the ban claim that it's necessary to discourage people from immigrating to the United States in order to receive government benefits. But that's a smokescreen. Ample research makes clear that immigrants come to the United States, as they have since the nation's founding, to pursue opportunity and freedom. In fact, new immigrants are less likely to use health care and related government services than are citizens, not more.

Earlier this year, Congress and President Obama recognized this reality and determined that five years was too long for legal immigrant children and pregnant women to wait for medical care. Removing the waiting period under the Medicaid and Children's Health Insurance Program allowed children and mothers to have access to vital medical services during these critical times, and has undoubtedly improved our nation's public health in the short and long-term.

It is now time to offer the same basic access to all legal immigrants as we do for all citizens. By making sure that everyone who contributes has equal access to health care, we will create a system that is fair and effective. No one should have to wait for five years before getting screened for cancer or treated for asthma. Removing the waiting period is a workable solution that will uphold our values and move us forward together.

 

Comments

[Averal]

Health care reform would actually be quite easy to achieve if the decisions made were based on verifiable facts and investigation.

Health care reform would LOWER costs by 800 billion a year instead of raising them.

Health care reform would be in the best interest of all. Democrat, Republican, Independent, Liberal, Conservative, everyone.

So why has the issue been turned into such a heated debate? Money.

The existing "players" don't have millions of dollars at stake, they have BILLIONS of dollars at stake.
There will always be those individuals that put wealth before everything. They will do whatever it takes to increase their status. They possess the power, influence, and the will to corrupt the legislative process to their own benefit. They will hire the best that money can buy to manipulate public opinion to their own ends. This is the vulnerability of a democracy. The "Big Lie" works, otherwise the term wouldn't exist.

Until the money flowing into congress is recognized for what is truly is (conflict of interest at least, out right bribery might be more accurate) political decisions will always be based on money rather then on simple facts and the good of the populace.

[JohnLloydScharf]

If health care is the problem, insurance is not the cause and government is not the answer.
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Of those "50 million," that lack insurance there were 45,000 who died without health care.
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WITH health care, 98,000 died FROM health care because of malpractice.
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The question is do we want to trust that largest corporation in the world, the U.S. Government. Do not expect house calls anytime soon.
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We have seen how well the government delivers on its promises and its bureaucracies pursue the money without giving us benefits on so many levels.
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Imagine another 111 bureacracies that only ultimately must listen to the Secretary of the Treasury - another "service" of which is the IRS.
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http://theprogressivecapitalist.blogspot.com/2009/10/affordable-health-care-for-america-act.html
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That blog of mine above has several .pdf connections (HR. 3962 and two summaries, a few videos, and page references for new taxes and other mandates).
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If you cannot use the link, google "Progressive Capitalist H.R. 3962."
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Don't worry. You'll run out of "rich" soon enough.
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We have at least a $12 trillion economy of which at least $1.8 trillion is spent on health care.
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If you read the bill, there are plenty of opportunities to soak the middle class, if you do not mind the 1.6 million made jobless.
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REPUBLICAN Affordable Health Care For America Act
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MAKING HEALTH Care Affordable For EVERY AmeriCAN
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http://docs.house.gov/rules/health/111_hr3962_boehner_sub.pdf

[MdeG]

When I got out of college, I didn't qualify for benefits. My parents took care of me in case of need. I didn't have insurance, but I was healthy, and didn't have to ask my parents for much help.

We recently sponsored a couple of frelatives for immigrant visas. We had to guarantee we'd stand in the breach for the first 5-10 years, until they'd worked enough to qualify for benefits, much as my parents did for me.

But there are differences. I live in Massachusetts, where residents are already required to have health insurance. My relatives *can't* go uninsured, as I did. They'd be fined. They can't be on our family policy, and they're not allowed the subsidized coverage that others in their income bracket can get. You know what private insurance costs, right? If health insurance is required & sponsors have to supply it, only the rich will be able to sponsor relatives.

Most immigrants struggle at first. One of my relatives is paid pennies over minimum wage, and they're keeping her schedule under full-time so to avoid giving her benefits. She works fast food, no sick time. There's an epidemic. People like her are in a position where they have high incentives to work when they're sick. This is bad public health policy.

The combination of required health insurance and a 5-year bar that's much broader for immigrants than it is for citizens strikes me as a really bad idea.

[devadasi]

I'm a progressive dem, but can't agree with your premise. It's still a privilege to live here in the U.S. and a five year waiting period is not that long. it's bad enough that Americans can't get jobs, even mid level jobs that have been taken up by immigrants. I was born here in the U.S. as were my parents, yet I 'm not old enuf for medicare, not poor enough for medicaid, but I can't afford health insurance. Immigrants will have to wait their turn, or they can return to their country of origin if they're not happy here.

The story line that immigrants take jobs that Americans don't want is a myth, and just plain propoganda. Everywhere I turn I see immigrants working and Americans out of work.

[readwithcare]

I'm shocked by the five year waiting period. These folks are legal immigrants, following in the footsteps of so many great Americans - not least the father of our president - who came to our country in the search of opportunity and political freedom. They pay the same taxes as citizens. And yet, because of the anti-immigrant histeria of the far right, we tell them they must live without a safety net.

This waiting period isn't just unfair - it's also bad policy. Most legal immigrant I know struggle a bit during there first few years in this country. They are working to learn English and establish a life and community here. Soon, of course, we know that most immigrants go on to be some of our most successful Americans. It's exactly during this early period that we need to support our newest neighbors.

And the point of health care reform is to reduce costs by ensuring that we get the care we need, when we need, rather than relying on wasteful emergency room visits. These folks are here to stay - and we've welcomed them - so why would we want to turn them away from preventative care? Imagine how much more costly it is to treat a heart problem or liver complication if we let it stew for five years (in my county, emergency room visits average FIVE TIMES the cost of a regular primary care vist).

Nobody should have to wait five years for health care!

[JohnLloydScharf]

USPS/IRS Health Care

If health care is the problem, insurance is not the cause and government is not the answer.
Of those "50 million," that lack insurance there were 45,000 who died without health care.

WITH health care, 98,000 died FROM health care because of malpractice.

The question is do we want to trust that largest corporation in the world, the U.S. Government.
Imagine another 111 bureacracies that only ultimately must listen to the Secretary of the Treasury - another "service" of which is the IRS.

http://theprogressivecapitalist.blogspot.com/2009/10/affordable-health-care-for-america-act.html

That blog of mine above has several .pdf connections (HR. 3962 and two summaries, a few videos, and page references for new taxes and other mandates).

If you cannot use the link, google "Progressive Capitalist H.R. 3962."

If you believe the promises of this bill, you have to deal with the lie that it fosters competition with a government option called the "Public Option" and establishes the government as a monopoly making its own rules.

We have at least a $12 trillion economy of which at least $1.8 trillion is spent on health care.
If you read the bill, there are plenty of opportunities to soak the middle class, if you do not mind the 1.6 million made jobless.

REPUBLICAN Affordable Health Care For America Act
MAKING HEALTH Care Affordable For EVERY AmeriCAN
http://thehill.com/images/stories/whitepapers/pdf/ainsfloor_01_xml.pdf

[drricklippin]

"NO NATION THAT PROFESSES TO BE KNOWN AS CIVIL OR MORAL SHOULD DENY BASIC HEALTH CARE TO ALL OF IT'S CITIZENS"-ral

AND FOR ILLEGAL IMMIGRANTS UNTIL IMMIGRATION REFORM OCCURS THEY NEED THE SAME

We in the US are way behind on this basic moral truism

Dr. Rick Lippin
Southampton,Pa

[sc300nc]

If what you mean by affordable is that someone else will pay for yours, that is coming I'm afraid.

If what you mean by affordable is that the rates you pay for your healthcare will be coming down, read the proposed legislation and think again.

[sonoffestus]

You are already paying for those that do not have health insurance.

[therational1]

We can all agree, I think, with the authors' statement that "common-sense principles that should be guiding the [health care] debate [are]: fairness, dignity, and sound public health policy."

The authors suggest that legal immigrants are being unfairly treated because current law requires that they wait at least five years before they can apply for affordable health care coverage through Medicaid and Medicare. The authors note that such coverage is available to citizens with similar incomes. The authors conclude that this policy is contrary to our national values of fairness and dignity and to the strength and prosperity of our nation.

In general, U.S. citizens are eligible for Medicare benefits if they have worked for at least ten years in a job that has paid money into the Medicare system.
U.S. citizens must also be 65 years or older to receive Medicare unless diagnosed with permanent disability or permanent kidney failure that requires dialysis or a kidney transplant.

So why is it unfair to make legal immigrants wait 5 years to be eligible?

[pooka47401]

I was a Medicaid Caseworker in Indiana for 18 years. ANY WOMAN WHO IS PREGNANT CAN GET MEDICAID. If she has just waded across the border into the US, she can apply and receive pregnancy medicaid, if she is income eligible. Alien status does not matter. In fact, we were not allowed to even attempt to verify citizenship status. All we had to verify was the pregnancy and the income. The Medicaid is pregnancy specific, no other coverage, and is supposed to be limited to the delivery itself. Doctors do find ways around the billing, so that the women can receive services during their pregnancy. Children can also receive Medicaid for emergencies only. So the other aliens are stuck with what the rest of the American Public is stuck with, health insurance if you are working, and nothing if you are not working.

My job was privatized. I had no health coverage for 18 months. Then I got a job, where any preexisting conditions are not covered for the first year. At my ripe old age of 59yrs, Everything is a pre-existing condition. So, even an American citizen, who has a job and health coverage, and is paying out $2400 per year, does not receive coverage.