"How about hospitals refusing treatment for illegal Mexican workers?" Maurice asked.
"No," I opined. "The courts have ruled everyone is entitled to emergency trauma services."
"Okay," Maurice replied. "Deny them all those other freebies. You know, they're using the hospital emergency wards for hang nails, runny noses and minor stuff like that. Plus free drugs."
"You're onto something there," I said. "But what about those illegals who receive pay checks and pay their taxes like the rest of us?" I asked. "Seems to me there's a difference between them and those illegals who form our shadow economy and are paid in cash."
"Don't care," Maurice said. "You think for one minute you or me will get free medical service if we landed in a Mexican hospital? I don't think so."
We drove in silence until he dropped me off at my apartment. "Let me look into it," I said instead of thanking him for the ride.
What I learned shatters the myth Maurice and me presumed. According to the Pew Hispanic Research Center and other sources listed below:
Illegal immigrants can get emergency care through Medicaid, the federal-state program for the poor and people with disabilities. But they can't get non-emergency care unless they pay. They are ineligible for most other public benefits.
Data on health care costs for illegal immigrants are sketchy because hospitals and community health centers don't ask about patients' legal status. In California, a 2004 study by the Federation for American Immigration Reform put the state's annual cost at $1.4 billion. Similar studies in Colorado and Minnesota in 2005 came up with much smaller estimates: $31 million and $17 million, respectively.
One thing is clear: Undocumented immigrants are driving up the number of people without health insurance. The Pew Hispanic Center estimates that 59% of the nation's illegal immigrants are uninsured, compared with 25% of legal immigrants and 14% of U.S. citizens. Illegal immigrants represent about 15% of the nation's 47 million uninsured people.
The University of Texas Medical Branch in Galveston plans to deny cancer care to illegal immigrants whose hospital costs estimated by the state comptroller is $1.3 billion.
Oklahoma lawmakers in May restricted illegal immigrants from most public benefits, including health care and education.
Steven Camarota of the conservative Center for Immigration Studies says offering non-emergency Medicaid to illegal immigrants would be more expensive than leaving them uninsured and in need of occasional hospital care. In those cases, hospitals lose money, and taxpayers pick up the tab.
"Either you enforce the law and don't have so many illegals, or you shut up about the cost," he says.
At the state and local level, illegal immigrants already cost more in public services such as education and health care than they pay in taxes, the Congressional Budget Office reported recently. In 2000, counties along the Mexican border lost more than $800 million in health care services for which they were not paid; about 25% of that went to care for illegal immigrants, according to a report by the United States/Mexico Border Counties Coalition.
Since 2003, California's San Mateo County has used local tax dollars as well as money from hospitals and non-profit groups to provide health insurance to all low-income children, regardless of immigration status. "These children are in our schools. They're part of our community," says Beverly Thames, spokeswoman for the county health department. "It's just important that they have access to health care."
San Francisco goes further, adding adults at local expense. Some cities, including New York, encourage illegal immigrants to use public services such as health clinics without risking deportation.
For many illegal immigrants, the fear of deportation outweighs the pain of illness or injury, so they live with their afflictions rather than seeking help until their health problems become critical. That makes things worse — for them, for hospitals that eventually treat them, and for taxpayers who ultimately foot the bill.
"They're scared to see the doctors," says Genaro Diaz , a legal resident who, at 59, is a father figure to many of the mostly male farmworkers in Benson, North Carolina. "They think they'll send them back to Mexico."
"There simply isn't enough revenue to support the network of services which heretofore has been expected," says Robert Pestronk, executive director of National Association of County and City Health Officials (NACCHO).
The cost of health care for illegal immigrants consequently is only a bleep on the government's radar screen that faces a $1.8 trillion budget gap by the end of this fiscal year. Still, the illegals are easy marks for the ax-wielding budget-conscious governmental agencies.
I wonder what Maurice thinks about it now.