Tuesday, September 22, 2009

The Expensive, Porous Fence

Last week the Government Accountability Office, which watches over the funding that Congress has voted, gave a scathing report on the "virtual" fence being built on the Southwestern border. It's way behind schedule, costs a lot more than expected, and doesn't do much good. Already determined immigrants have devise ways -- some unquestionably dangerous -- to get around it. As the New York Times editorializes fences are no solution to immigration problem, rather we need comprehensive immigration reform.

Evidence has been growing that the immigrant population, especially of undocumented, has been declining. Most experts attribute it to the recession. Fewer are trying to cross the borders and a few, though not all that many, are returning home. The Los Angeles Times reviewed the findings of the Census Bureau's annual American Community Survey and suggests the biggest impact of the decline has been in California -- as well as Arizona and Florida. These states have long been identified with large immigrant, mostly Hispanic, populations. Texas -- thanks to a healthy economy -- is still attracting immigrants, as well as the ancient doorway to the immigrant -- New York. The Times quotes experts on immigration flows to the effect that the current patterns are not entirely new because of the recession. Already in the 90s, immigrants -- especially the undocumented -- have shunned the ethnic enclaves East LA or South Phoenix for the more exotic climes of Minnesota and Iowa or Georgia and North Carolina. Georgia in fact continues to attract immigrants. In part the shift that started before the recession was due to aggressive enforcement of immigration law. But over the last year it has been in Connecticut, North Carolina, Colorado and Iowa that we witnessed the most aggressive factory raids. Immigrant have remained faithful to the new pattern, simply because -- even in hard times -- that's where the jobs are.

Friday, September 18, 2009

GAO Report Creates Doubts about the Fence

The Government Accountability Office, Congress's watchdog on program it finances, has a scathing report on "the fence" -- the jumble of cameras and sensors along the Mexican-US border known as the Secure Border Initiative. The reports finds the project seven years behind schedule, seriously overrunning costs, and no ideas on how to measure "success". (See New York Times article.)

Thursday, September 17, 2009

More on the Undocumented and Health Care Reform

Michael Hiltzik. a Los Angeles Times columnist, responded to the nay-sayers to health care reform who objected to the Census Bureau recent estimate of 46 million uninsured in the country. A 46 million figure gives urgency to reform, and so to defuse concern the nay-sayers explained away the numbers. Many of the uninsured are voluntary drop-outs of health insurance -- the young and wealth -- and many are too dump to know it's available -- the poor who qualitfy for Medicaid or Children Health Insurance System, but don't apply. Still others are only temporarily without health insurance. The undocumented, they say, don't deserve it. Hiltzik picks apart their specious arguments and misreading of the census figures to reveal the horror of 46 million uninsureed.

Wednesday, September 16, 2009

Push Back on Immigration Restriction in Health Care

Before Joe Wilson's outburst on the floor of Congress, most immigration advocates had seemingly accepted the exclusion of the undocumented from health care reform -- at least in so far as government payments or subsidies. But in an effort to quell nativists' suspicions that aid to the "illegals" will sneak into a government-run public option, President Barack Obama extended his exclusion to even banning the undocumented from the proposed insurance exchanges -- even when they out of their own pockets. That was too much for many Democrats and immigration activists. They are now organizing to make sure the Obama administration cannot automatically count on their votes. Their point is that it is not "a reward for breaking the law" in paying for something out of your own pocket. As it is, the undocumented underutilize the health system and in the insurance exchanges their money would be a wind-fall for the insurance companies. Immigrants are younger than the general population and so less of a risk for insurers. Also they tend to be more reliable when taking on financial obligations. But Obama's scruple seems to be a last straw for many immigration advocates and Democrats. (See Los Angeles Times article.)

Sunday, September 13, 2009

Senate Finance Committee Considers the Undocumented

The Senate Finance Committee, which is working up a version of health care reform expected to be "the compromise", began considering the issue of the undocumented alien and health care insurance. It's not a question of whether they will be eligible for any benefits -- with the exception of emergency room care -- but whether they can traffic for health insurance at the "exchanges" or "marketplaces" that would be created. A Republican idea, not yet accepted, is being discussed whic would require verification of status to purchase on the exchange -- even with cash out of the pocket. (See Los Angeles Times article.)

Saturday, September 12, 2009

Undocumented to be Barred from Health Insurance Exchanges

A White House aide said the Obama plan to establish an exchange for health care insurance would excluded the undocumented from purchasing a policy -- even at their own expense. All the congressional bills voted out of committee exclude most immigrants from subsidies, but one allows them to purchase insurance at their own expense. It seems the politics of the moment has won out over the morality of the issue. (See New York Times article.)

Friday, September 11, 2009

Some Common Sense on the Undocumented and Health Care

The rude interruption of a South Carolina representative during President Barack Obama's speech on health insurance reform has embarrassed the GOP and knocked them off their argument, The incident seems to have quieted the discussion around the eligibility of undocumented workers for federal support in health care reform. The New York Times addressed the issue "with common sense" in an editorial, but the issue must go beyond "common sense". The president shifted the discussion to moral and political grounds. Politically, it's not wise to advocate for benefits to those Illegally here. But I don't think you can argue that morally. While the Catholic bishops don't highlight care for the undocumented, by implication they believe some minimal benefits beyond caring for the undocumented in emergency rooms or allowing to purchase private insurance is not enough. Health care is not just an American right, but a human right. While it's not politic to bring up the issue at this time, any successful reform will eventually have to face up to care for all -- even those here illegally. Pragmatically it cost issue. Now much of the costs are swallowed by private medical providers who truly believe health care is a right for all. We don't know yet how reform will impinge on their charitable efforts. Even some counties and municipalities use their own tax dollars to provide a modicum of care with no questions asked. Other developed economies often provide health care even to visitors. (I had an in-grown and infected toe nail care -- gratis and with any fuss -- in England and Germany. Excluding the undocumented -- while good politics now -- will eventually have to be dealt with. And it will have to be more than just emergency-room care. Rep. Wilson, if for the wrong reasons, was on to something.