What Would You Have Them Do?
Sometimes, when people complain about something, you have to stop and ask, “Well, what is the alternative?” Bear Creek Ledger points out a story from WATE (Knoxville tv news) addressing the fact that emergency rooms are required to treat women in labor and “The law also requires TennCare to reimburse hospitals for the emergency care they provide to people here illegally who would qualify for Medicaid as a U.S. citizen.” Dr. Heather Moss, OB/GYN is “is even more frustrated because some of her tax money is paying for illegal immigrants to give birth and she is delivering their babies.” The news station “found TennCare pays for approximately 60 immigrants a month. Most of those are for mothers in labor. That adds up to a cost of about $1.7 million, an average of nearly $15 million a year.” Says Moss “I’m frustrated that someone can come here illegally and basically benefit from our welfare system. A system that was set up to help the poor citizens of the state of Tennessee,” and she “plans to contact legislators in Washington, asking them to change the law.”
Says the author of Bear Creek Ledger, “Good luck on that! I don’t think Gov. Bredesen will be doing anything about that any time soon. I’d also bet that the number is a very low estimate.” So I ask, what exactly would you have him do?
As I can imagine it, in changing the law, you could do one or both of two things: 1) not require emergency rooms to care for women in labor; 2) not provide reimbursement to hospitals for providing care to laboring women who are illegal immigrants. Would you have illegal women who cannot pay what the story estimates as $10,000 for an uncomplicated delivery turned away, to labor on their own, in their homes, with no support? Would you have ERs continue to be required provide care in emergency situations (including labor), but provide them no reimbursement, and count on the illegal immigrants to pay the bills? Do you realize that, assuming illegal immigrants even make minimum wage, $10,000 would take 48.5 40-hour weeks to earn? If the bills don’t get paid, are you comfortable with what happens to the staffing, supplies, and morale at the ER you may need to visit one day? Should you or can you target only laboring women? In other words, are you thinking about the effects of a change, or just worried about “anchor babies?” Labor and delivery are hardly the only procedures for which emergency rooms and hospitals end up providing care (to non-citizens and citizens alike); Vanderbilt estimates that it provided $31 million in charity care in 2005, and $98.7 million in total uncompensated care. Do we want to add to that burden? If you change the law, it would likely address any emergency procedures, and the cascade effects for the healthcare system are difficult to imagine. And let’s just assume that we haven’t erected a magic pixie dust wall that will keep all illegal immigrants out of the country, and women will continue needing help and safety while birthing babies. It’s easy to say, “Let’s just cut them off, let’s reduce the incentive for coming here.” It’s much harder to do that in a way that doesn’t profoundly affect the healthcare system and society. So seriously, tell me what the solution is.