Tuesday, February 06, 2007

How Paternalistic and Patronizing Can You Get?

Some Americans can get very paternalistic and patronizing when it comes to medical care. How many news stories have you read of "some poor Mexican/whatever" who claims to have entered the US illegally "for medical care for my kid/grandma/whomever" -- some major sob story for the "human interest" below-the-fold front page. It's a lot of hooey!

While living in the "jungles of Borneo" - a rather remote area of rather impoverished Indonesia - a friend was seriously injured. The people who found him got him to a clinic, which rustled up a helicopter to take him to the nearest hospital (no road). I went to the hospital -- it looked like something out of Albert Schweitzer's Africa a century ago. But the doctors proved knowledgeable and the nursing care was unsurpassed. They got him stabilized and able to undertake the four-hour air ambulance flight to Singapore. Two weeks later, he was released, fit as the proverbial fiddle. The bill? Including helicopter and air ambulance, about a quarter of the cost of a trip to a US hospital if he'd had similar injuries here.

Californians have long trekked to Tiajuana to refill prescriptions at a fraction of US prices. I first ran into people doing that in 1973. Now northerners hike across the Canadian border, too. Americans go to India, Singapore, Thailand and elsewhere for major surgery, at as little as 10% of US costs.

So why do we listen to illegal immigrant advocates' pity ploys for free medical care for "poor" illegal aliens and rich "medical tourists" who come here? They only come here for care because if they are here illegally, it's free.

Mexico has national health insurance, $399 a year. How much does your insurance cost? The cheapest plan for a single (not provided by employer) in Connecticut is over $950 a month, about $100 a month more for both husband and wife. Dental, vision and prescriptions excluded.

Mexico does more kidney transplants per capita than the US, and their waiting list is shorter. So why the infamous Duke U. Hospital case of a few years back, where a Mexican teen was brought in by her father, who pleaded for donations, visas, housing and more? He sobbed that his daughter would die without surgery in the States -- and thousands of Americans sobbed with them, and coughed up cash. But the surgery really was cheaper and more readily available at home in Mexico.

We are being taken for fools. And it is our own paternalistic and patronizing attitudes -- the notion that good medical care is not available in "poorer" countries, or even "other countries" -- that allows us to be suckered.

I talked with some hospital administrators, nursing administrators, hospital purchasing heads and learned that at many hospitals across the US, a quarter of each hospital bill of paying patients consists of costs shifted from non-paying patients (predominently illegal aliens). For a genuinely poor American citizen, the hospital will help the patient apply for state medicaid programs. Any other American, they'll put a lien on your house or anything else to get paid. Legal permanent residents, who could lose their chance at citizenship if they are deemed "a public charge," will pay, period. Health care in the US is only "free" for illegal aliens because the hospital can do nothing to make them pay, hence, they refuse to pay no matter how many thousands of dollars they have stashed away in their home country.

Another quarter of each paying-patient's hospital bill is administrative costs -- completing a myriad of insurance forms, waiting for reimbursement, and calculating cost shifting for non-payers.

The result? American health care costs double what it should - and would if we put a stop to freebies for immigration-law violators.

The cure is simpler than the disease: any non-citizen who claims inability to pay their hospital bill must contact their consulate (or the hospital can do it for them) and arrange for funds transfer from home to pay the bill. Stabilize and transport. Send them home, at their expense, for the remainder of their care. Anyone who refuses gets turned over to ICE for immediate repatriation.

Any illegal caught by the Border Patrol within 100 miles of the border who needs medical attention should be transported straight to the border for their officials to transport to the nearest medical facility. It's cheaper - and offers them faster access to care - than shipping them up to Tucson or Phoenix.

Next time your medical or insurance bill fractures your budget, write your Senators and Representative demanding an end to "free" medical care for immigration-law violators and "medical tourists." They can get decent care for a fraction of the cost in their home countries so we can afford some decent care ourselves.

And above all, don't let paternalistic attitudes blind you to the Great Illegal Alien Health Care Scam.

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