SCFI 2009
Immigration Health Aff
Project Mayhem
___ of ___
Aff Index
1AC – Inherency ............................................................................................................................................ 3
1AC – Plans................................................................................................................................................... 7
1AC – Solvency ............................................................................................................................................. 8
1AC – Disease............................................................................................................................................. 11
1AC – Soft Power ........................................................................................................................................ 15
1AC – Dignity............................................................................................................................................... 19
Economy Advantage.................................................................................................................................... 21
Relations Add-on ......................................................................................................................................... 23
Inherency ..................................................................................................................................................... 24
Inherency – Hospitals .................................................................................................................................. 26
Inherency – States Failing ........................................................................................................................... 29
Inherency – No Services.............................................................................................................................. 32
Inherency – Immigration Increasing ............................................................................................................. 34
Inherency – Immigrant Bias ......................................................................................................................... 37
Inherency – SCHIP ...................................................................................................................................... 38
Harms – States ............................................................................................................................................ 39
Harms – Hospital Costs ............................................................................................................................... 40
Harms – Health............................................................................................................................................ 41
Harms – Human Right ................................................................................................................................. 44
Harms – Morality ......................................................................................................................................... 47
Harms – Human Rights ............................................................................................................................... 49
Harms – Justice ........................................................................................................................................... 50
Harms -- Soft Power .................................................................................................................................... 51
Harms – Economy ....................................................................................................................................... 56
Hospitals Key to the Economy ..................................................................................................................... 61
Harms – Disease ......................................................................................................................................... 62
Harms – TB ................................................................................................................................................. 67
Harms – Racism .......................................................................................................................................... 70
Solvency ...................................................................................................................................................... 72
Solvency – Feds Key ................................................................................................................................... 75
A2: States .................................................................................................................................................... 78
A2 Immigrants wouldn’t use ......................................................................................................................... 80
A2: Magnet DA ............................................................................................................................................ 82
The first rule of Project Mayhem is that you do not ask questions.
1
SCFI 2009
Immigration Health Aff
Project Mayhem
___ of ___
Negative Index
Inherency Take-Outs ................................................................................................................................... 84
Economy Take-Outs .................................................................................................................................... 85
Solvency Take-Outs .................................................................................................................................... 88
States CP Solvency ..................................................................................................................................... 93
Free Market CP Solvency ............................................................................................................................ 94
Open the Border CP .................................................................................................................................... 95
Politics DA Links .......................................................................................................................................... 96
Spending DA Links ...................................................................................................................................... 97
Magnet DA 1NC .......................................................................................................................................... 98
Magnet DA – Uniqueness .......................................................................................................................... 100
Magnet DA – Links .................................................................................................................................... 101
Magnet DA – Impacts ................................................................................................................................ 104
Magnet DA Impact ..................................................................................................................................... 105
Biopower Links .......................................................................................................................................... 106
The first rule of Project Mayhem is that you do not ask questions.
2
SCFI 2009
Immigration Health Aff
Project Mayhem
___ of ___
1AC – Inherency
Observation One:
First, undocumented immigrants are some of the most impoverished groups in
America. Despite their need for health care, immigrants either have no access to
services or are reluctant to seek it due to a lack of insurance and fear of deportation
Knutson 08 (Boston College Third World Law Journal Spring, 2008 28 B.C. Third World L.J. 40 NOTE: DEPRIVATION OF CARE: ARE FEDERAL LAWS
RESTRICTING THE PROVISION OF MEDICAL CARE TO IMMIGRANTS WORKING AS PLANNED?NAME: RYAN KNUTSON*)
Despite accounting for only 12.1% of the total population, immigrants and their U.S. born children account for nearly
one in four of those living in poverty in America. n51 As can be imagined, immigrants' incomes are approximately twenty-five percent lower than
natives. n52 Correspondingly, immigrants are also less likely to have health insurance. n53 One third of all immigrants lack health insurance
compared to only thirteen percent of native-born citizens. n54 [*409] Undocumented immigrants fare even worse with an estimated
sixty-five percent lacking health insurance. n55 Given the stark educational and economic hurdles, it is not surprising that immigrants use public
benefit programs more often than native citizens. n56 However, despite their greater need for public benefits, recent studies have
shown that low-income immigrants are actually less likely to have access to regular health care. n57
In fact, immigrants use relatively fewer health services in comparison to their native-born citizen counterparts. n58 A recent
study by the Rand Corporation revealed that being an immigrant correlated to a "substantial and significant reduction in access" to health care compared to
native citizens. n59 Lack
of health insurance, language barriers, and fear of deportation are all cited as contributing factors
that inhibit immigrants from seeking medical care. n60 Researchers for the Rand study found that being a non-citizen adult or child resulted in
dramatic reductions in a person's actual number of doctor and emergency room visits compared to both native-born and naturalized citizens. n61 When [*410]
immigrants did seek medical treatment, community clinics and hospital outpatient departments accounted for the
most frequent sources of care. n62
In 2000, a subsequent study completed by Rand revealed that due to reduced medical care access, immigrants accounted for only a small fraction of total health
care expenditures in the United States. n63 The 2000 study found that despite comprising approximately 13% of the total population,
immigrants accounted for only 8.5% of total medical expenditures. n64 Moreover, immigrants accounted for an even
smaller percentage of total public spending on health care. n65 The native-born accounted for 93.3% of the total public spending on health
care compared with 6.6% for the foreign-born. n66 Focusing on undocumented immigrants revealed that only 1.5% of total national health care expenditures
went to the undocumented. n67 Public supported health care for immigrants totaled only $ 1.1 billion, or 1.3% of the total $ 88.5 billion in publicly funded care.
n68 Studies
evidencing immigrants' lower use and overall expenditures of medical care suggest that policy makers
have been incorrect in charging that immigrants place an unduly high burden on taxpayers via their use of the
medical system. n69
The first rule of Project Mayhem is that you do not ask questions.
3
SCFI 2009
Immigration Health Aff
Project Mayhem
___ of ___
1AC - Inherency
And, Undocumented immigrants are excluded from health services in the status quo
– economic hardships are causing states to make drastic cuts in social services.
Immigrants are literally being turned away by hospitals.
Daniel B. Wood March 24, 2009 Staff writer of The Christian Science Monitor
A day laborer since 1986, Mr. Cedillo has received notice from a Los Angeles County hospital that he must start paying out of pocket for the treatment he will need. "I have no choice
The recession - and a big
leading some California counties to cut back on nonemergency health services to illegal immigrants. In
others, cutbacks in services for the uninsured are hitting illegal immigrants especially hard. The problem is socking California
because it is home to the lion's share of US immigrants, both legal and illegal. The latter are often eligible for healthcare provided to the poor. But health departments
across the country are facing budget pressures that are leading to slashed services - and that could reignite the
debate over providing medical care to illegal immigrants. "There simply isn't enough revenue to support the network of services which heretofore has
because I have no insurance and can't work while I'm taking these treatments," he says, sitting in the tiny apartment he shares with his wife, a janitor.
state deficit Â-- is
been expected," says Robert Pestronk, executive director of National Association of County and City Health Officials (NACCHO).
budget cuts mean reduced funding for the uninsured, many of whom are immigrants and low-income
families. In Arizona, a $13 million cut from the state budget eliminated funds partly used to reimburse hospitals for caring for the uninsured. About 64 percent of illegal immigrants
In many states,
nationwide Â-- 7.2 million Â-- are uninsured, according to the Washington-based, Center for Immigration Studies (CIS). "The states and local governments tend to bear the brunt of
illegal immigration," says Steve Camarota, statistician and demographer for CIS. Now, with revenues falling well short of predictions, services to undocumented immigrants are getting
the ax in an effort to preserve other programs, from infrastructure to schools to the environment. The cutbacks could potentially refire the debate over providing social services such as
healthcare for illegal immigrants. In 2007, several state legislatures introduced bills that sought to limit social service benefits including healthcare to illegal immigrants. An LA
Times/Bloomberg survey in December 2007 found that one in three Americans wanted to deny social services, including public schooling and emergency-room healthcare, to illegal
immigrants. In California, two counties are pulling back on health services for illegal immigrants. Sacramento County closed two health
clinics that serve the poor and ended services with various mental health contractors in early February, saving nearly $6 million in an effort to close a $55 million general fund shortfall.
In Contra Costa County, a proposed plan would screen out illegal immigrants - except for children and pregnant women - from nonemergency healthcare services that are provided to
low-income residents who cannot get insurance. The
county is looking at cutting services to an estimated 5,500 illegal immigrants they
serve annually, to tally a savings of $6 million. "The pressure is purely economic," says Dorothy Sansoe, senior deputy county
administrator for Contra Costa County. Her county has already cut $90 million from its general purpose budget and has to cut another $56 million by July 1. "Here, many hospitals are
cutting services and staff just to survive," says Randy Ertll, who has served on the board of several Los Angeles County hospitals and is now Executive Director of the El Centro de
The issue is not just one of documented vs.
undocumented immigrants, he says, but one of affordability in an economy where more and more people are losing
their jobs and often their insurance, too. "Even many US citizens can't afford health insurance in the current recession," Mr. Ertll says. But such cuts are
shortsighted, immigrant support groups say, because neglecting primary healthcare only means that hospitals will have to
spend more on emergency or acute-care treatment in the future. “If you send someone home who is ill, that person is
only going to get worse or infect others in which case you have a larger, more expensive situation on your hands," says
Accion Social, or Center for Social Action, a nonprofit agency that promotes cultural understanding in Pasadena.
Angelica Salas, executive director of the Coalition for Human Rights of Los Angeles (CHIRLA).The dilemma highlights the costs of illegal immigration to society, immigration reform
groups counter. "We would like to give great healthcare to everyone but we just can't," says Ira Mehlman, spokesman for the Federation for American Immigration Reform.
And, current federal law excludes all non-citizens from healthcare and places the
cost burden on the states and hospitals.
Adrianne Ortega 2009 American Society of Law, Medicine & Ethics, Inc., and Boston University
American Journal of Law & Medicine, And Health Care For All: Immigrants in the Shadow of the Promise of Universal Health Care
President Obama's ambitious universal health care plan aims to provide affordable and accessible health care
for all n1 The plan to
cover the estimated 46.5 million uninsured, however, ignores the over thirty million non-citizens living in the United States. n2 If the
United States passes universal health care coverage, Congress should repeal the prohibitions of the Welfare Reform Act, extend Medicaid coverage to noncitizens, and allow non-citizens to purchase employer-based insurance coverage.
President Obama's plan follows the lead of state universal health care legislation by retaining private, employer-sponsored insurance coverage and expanding
the eligibility requirements of the Medicaid program. n3 This strategy will not aid uninsured immigrants or overburdened states and
hospitals, though, because current law excludes most non-citizens from non-emergency health care services. n4
Federal law requires that hospitals screen and treat all patients in an emergency, but non-emergency care remains a
[*186] patchwork of illogical policies. n5 Undocumented immigrants are excluded from non-emergency Medicare and
Medicaid, while most documented immigrants are excluded from non-emergency Medicare and Medicaid for five
years. n6 In fact, prison is often the only place undocumented immigrants may receive non-emergency health care
services. n7 States and hospitals, therefore, shoulder the burden of caring for non-citizens without assistance from the
federal government. n8
The first rule of Project Mayhem is that you do not ask questions.
4
SCFI 2009
Immigration Health Aff
Project Mayhem
___ of ___
1AC - Inherency
Specifically, the Welfare Reform Act and two sections of the Immigration Reform Law
prevent access and application of needed health services for illegal immigrants.
Park, 4 – J.D. Candidate, Florida State University College of Law (Seam, Georgetown Immigration Law Journal, “Substantial Barriers in Illegal Immigrant
Access to Publicly-Funded Health Care: Reasons and Recommendations for Change,” Spring 2004, 18 Geo. Immigr. L.J. 567)
According to the Center for Immigration Studies ,
out of the 33.1 million immigrants in the United States, nearly 8 to 9 million are here
illegally. n1 In addition, this number is expected to increase at a rate of nearly 500,000 people annually. n2 With this rapid
growth in the number of illegal immigrants, more attention has been given to the problems created by this undocumented segment of the population. These problems include the
considerable financial burden that has been placed on many states to provide this population with social services. In response to this growing financial burden, many legal residents
question whether illegal immigrants should be provided with essential social services, such as health care. n3 Residents and legislators argue that denying social services would
provide a disincentive for potential illegal migrants and send a signal to the current illegal immigrant community that they are not welcome. However, for an already desperate
community, excessive barriers to health care and other essential social services should be removed, not created.
Illegal aliens require undeterred access to publicly funded medical care for a variety of reasons. These reasons include the difficulties created by cultural,
financial, and language-related barriers. n4 As a result of these barriers, illegal aliens tend make up a relatively large portion of the
impoverished, uninsured, and vulnerable population. n5 Furthermore, illegal immigrants are often prohibited from receiving public health
insurance and unable to obtain medical insurance through their places of employment because these jobs often consist of working in "low-wage, low benefit jobs
in the agricultural and service sectors." n6 Many in this impoverished group are undocumented workers such as farm laborers who do not even receive health
insurance as a [*569] fringe benefit. n7 These low-paying jobs often consist of grueling manual labor, where short-term and long-term injuries are often
sustained. n8 Since these employers do not provide their illegal immigrant employees with health care benefits and the rest of the population is generally without
health insurance, publicly funded health care is a necessity. A recent study indicates that the poverty level for illegal aliens is two-
thirds higher than that of natives and their children. n9 Directly correlated with high poverty levels are poor living
conditions among the illegal immigrant community. n10 These less than ideal living environments, combined with the fact that many illegal
immigrants migrate from countries with higher risks for infectious diseases, create a strong potential for a public health crisis among both the illegal immigrant
and general communities. The potential risk imposed among the general population is one of many compelling reasons why illegal immigrants require undeterred
access to publicly funded health care.
The purpose of this Comment is to examine how current
federal legislation has left illegal immigrants -- a growing, significant portion of the United States
reasonable access to any publicly funded health care because it is either unavailable or because
they fear deportation when attempting to access it. After examining such legislation, this Comment will identify both current and potential problems that
population -- without
could arise if illegal immigrants are continued to be denied health care or confronted with substantial barriers to its access. With these problems in mind, this Comment will address why
federal, state, and local governments should take affirmative steps to provide illegal immigrants with undeterred access to health care. Lastly, this Comment will issue recommendations
discussing how federal, state and local governments can act together to accomplish this goal.
Federal legislation, particularly the Welfare Reform Act of 1996 and sections of the Immigration Reform Law, have
placed illegal immigrants in a helpless situation. n11 The Welfare Reform Act took away all federally funded
preventative health care for illegal immigrants, while providing access only for emergency services and treatment for
communicable diseases. n12 Illegal immigrants, therefore, have not officially been denied access to every form of
health care. These remaining services are arguably undesirable to illegal immigrants because Section 434 of the Welfare Reform Act and Section 632 of the
Immigration Reform Law ban states from providing illegal immigrant patients with security against having their undocumented status reported to the Immigration
and Naturalization Service ("INS"), thus creating a fear of [*570] potential deportation. n13
Under the Welfare Reform Act, states have been granted the option of passing affirmative legislation to provide statefunded health care for illegal immigrants. n14 Some states have decided to take advantage of this option, while others have not. The combined effect
of Section 434 of the Welfare Reform Act and Section 632 of the Immigration Reform Law, however, nullifies the
potential effectiveness of this provision because even if states decide to make state-funded preventive health care
available, illegal immigrants must remain fearful of having their immigration status reported to the INS. n15 Therefore,
federal legislation leaves an often impoverished and uninsured portion of the population without reasonable access to
any health care, whether it is state-funded preventative care, federally-funded emergency services, or treatment for
communicable disease.
The first rule of Project Mayhem is that you do not ask questions.
5
SCFI 2009
Immigration Health Aff
Project Mayhem
___ of ___
1AC - Inherency
And, the number of illegal immigrants is up to 11.9 million and will only increase.
N.C.
Aizenman 08; Washington Post Staff Writer October 3, 2008 Friday
Despite the slowdown, the
number of illegal immigrants remains at an all-time high, up more than 40 percent from about 8.4
million in 2000 to 11.9 million in March, according to the Pew study. Illegal immigrants make up about 4 percent of the U.S.
population and about 30 percent of its foreign-born residents. More than four out of 10, or 5.3 million, arrived since
the start of the decade.
About four out of five illegal immigrants come from Latin American countries, mainly Mexico. Since last year, the number from
Mexico appears to have leveled off at 7 million, and the number from other Latin American countries has fallen.
Finally, Health care for illegal immigrants is inevitable – they are receiving emergency
services. The question is whether they will get preventative treatment or play the
dangerous and expensive game of emergency room service.
Morgan Greenspon July 14 2009 Student, Loyola University Chicago School of Law, Class of 2009. Ms. Greenspon is a staff member of
Annals of Health Law.
The Personal Responsibility and Work Opportunity Reconciliation Act of 1996 prevents certain groups of legal
immigrants, and all undocumented immigrants, from receiving Medicaid benefits. n31 However, aliens who would otherwise
qualify for Medicaid, if not for their immigration status, remain eligible for Emergency Medicaid; these undocumented aliens are entitled to receive
emergency services that are necessary for the treatment of an emergency medical condition. Thus, "the current legislation ... takes a back-end
approach by providing illegal immigrants health care access by providing emergency services." Under Emergency
Medicaid, a hospital may be compensated for providing care to undocumented aliens experiencing a medical
emergency such as childbirth, labor, or another condition that may threaten an individual's life. However, if the patient does
not qualify for Emergency Medicaid, then a hospital may go completely uncompensated. Additionally, if the federal government would help fund
preventative care, there is a good chance the overall amount of money spent on medical care for undocumented
aliens would decrease "because it is more expensive to provide emergency care than it is to take a front-end
approach by providing preventative care."
The first rule of Project Mayhem is that you do not ask questions.
6
SCFI 2009
Immigration Health Aff
Project Mayhem
___ of ___
1AC – Plans
Plan:
The United States Federal Government should substantially increase social services
for persons living in poverty in the United States by repealing the Personal
Responsibility and Work Opportunity Act (PRWOA), section 642 of the Immigration
Reform Law and Section 434 of the Welfare Reform Act.
Plan:
The United States Federal Government should substantially increase social services
by removing the restrictions on non-citizen persons living in poverty from having
access to federally funded healthcare.
Plan:
The United States federal government should no longer require individuals applying
for Medicaid to disclose their citizenship or immigration status.
The first rule of Project Mayhem is that you do not ask questions.
7
SCFI 2009
Immigration Health Aff
Project Mayhem
___ of ___
1AC – Solvency
Observation Two: Solvency
Repealing PRWOA’s restriction on immigrant’s access to health services solves.
RYAN KNUTSON Spring, 2008 Articles Editor, BOSTON COLLEGE THIRD WORLD LAW JOURNAL (2007-2008).
A natural first step in improving both immigrant health access and hospital solvency is to repeal PRWOA's provision
restricting immigrant access to public benefits, specifically publicly funded preventive health care. PRWOA is an
unnecessary piece of legislation that restricts hospitals and medical providers from providing the best possible
medical care to immigrants. Repealing PRWOA would reinstate a medical practitioner's right to choose to provide
preventive care to any patient who seeks such care. Repealing PRWOA would not create an affirmative duty on practitioners to provide preventive care to all immigrants. Rather, repeal comports
with the reality that medical providers at the local level are in a better position to anticipate the medical needs of their own communities than the federal government. However, Admittedly, PRWOA already allows states to override the restriction
on providing public benefits to immigrants by affirmatively passing a subsequent state law. a more prudent approach is to recognize that PRWOA is bad policy and
repeal its anti-immigrant provisions outright. By allowing states to opt out of PRWOA's mandate, PRWOA does not create an absolute ban on providing medical care to immigrants. Rather, it simply, but
unfortunately, mandates the passage of affirmative legislation to allow practitioners to continue to provide medical care to
immigrants. This creates a significant and unnecessary burden on local and state governments to spend valuable resources and energy in order to pass legislation, the ultimate effect of which is to maintain the status quo. Furthermore, because
it appears that many medical providers are simply ignoring PRWOA and providing non-emergency care to immigrants regardless of whether they are "qualified aliens," the effectiveness of the PRWOA statutory regime is questionable. While repeal of PRWOA
, the federal government must also commit additional funding to hospitals and other medical centers that provide
care to immigrants. Even if states, reacting to PRWOA, reaffirmed practitioners' ability to provide preventive care to non-qualified
immigrants, inadequate federal funding limits the capacity of local communities to provide the authorized care. Given that the current federal funding system does not provide adequate reimbursement for the mandated level of care under
is an important first step
EMTALA, any attempt at solving increasing hospital insolvency requires a more firm commitment from the federal government to fund medical care. An important first step for the federal government in helping to meet the economic void that has resulted
under PRWOA is to invest in community-based programs that aim to reduce long-term health care costs, as well as improve health outcomes.
The Personal Responsibility and Work Opportunity Act of 1996 unnecessarily eliminated the ability of many
immigrants to access public benefits. Because PRWOA forbids hospitals and medical practitioners from providing
publicly supported preventive care, immigrants' minor medical conditions are more likely to turn into emergency
conditions resulting in the need for an emergency room visit. Emergency care is expensive and many providers are
unable to obtain adequate reimbursement for services rendered in compliance with the federal EMTALA mandate. Given this economic
reality, fundamental change is needed in the federal government's approach to solving the issues surrounding
immigrant medical care access. Repealing PRWOA and allowing for greater flexibility in providing preventive care to
immigrants, coupled with increases in federal funding, may provide a more appropriate and workable solution than
the current statutory framework.
Giving healthcare to noncitizens makes the system much more efficient. It will solve
the burdens on hospitals and ensure adequate preventative care.
Pagan in 2007 – Professor of Economics and Director of the Institute for Population Health Policy in the Department of Economics and Finance at the
University of Texas-Pan American (Jose A. Pagan, Immigration Reform and Health, December 2007,
http://www.reforminstitute.org/uploads/publications/JoseAPagan.pdf)
Comprehensive immigration reform is necessary if we want to improve the way in which immigrants access health care resources. Mainstreaming
immigrants into the U.S. health care system will improve the functioning of our health care system by allowing
immigrants to access the services they really need more effectively. Improving access to health care for immigrants has the
added benefit of increasing the quality of care that we all receive, particularly if we reside in communities with
relatively large uninsured immigrant populations. Uninsurance forces many immigrants to reduce the quantity and
quality of health care demanded, which in turn reduces health care quality and availability for everyone else residing
in communities where immigrants concentrate. It is important to point out that the overall burden immigrants place in our health care system is
rather small. About half of documented immigrants are uninsured and the proportion of undocumented immigrants who are uninsured is certainly much higher.
Immigrants’ lack of health insurance implies not only lower rates of overall health care utilization, but also a less efficient use of the health care system.
The first rule of Project Mayhem is that you do not ask questions.
8
SCFI 2009
Immigration Health Aff
Project Mayhem
___ of ___
1AC – Solvency
Even if the states wanted to act, they couldn’t. The federal government is necessary
in noncitizen healthcare because of conflicting laws, uniformity, and jurisdiction.
Janet Calvo, 2008 (Professor, City University School of Law. “The Consequences of Restricted Health Care Access for Immigrants: Lessons from
Medicaid and SCHIP.” 17 Ann. Health L. 175//ZE)
The economic benefits of immigration generally flow to the federal government, but the costs of new and increased populations are often absorbed by states and
localities as they are primarily responsible for their residents' health and welfare. Federal law and practice inhibit states' ability to obtain
federal financial contributions for immigrant health care through Medicaid and SCHIP. n246 The controversies about the
definition of emergency care described above illustrate this idea; promised federal funds for state Medicaid programs have been
revoked because the federal authorities disagreed with the states on the definition of an emergency medical
condition. n247 State and federal governments have clashed over health care access for noncitizens. On a policy level, states and localities
can argue that health care for noncitizens is ultimately a federal responsibility because the federal government can
decide which noncitizens can enter and stay in the country. Within the current Medicaid system, states contend that the federal
government should pay a share of healthcare costs for noncitizens and should not impede state and local public health [*207] objectives by forcing state and
localities to solely bear the expense of providing for noncitizens. n248 Examples from New York, Texas, and Colorado illustrate some of the conflicts between
federal standards and state and local requirements. In New York, for example, an interpretation of federal legislative restrictions on noncitizen eligibility for
Medicaid by the Second Circuit resulted in the dissolution of a long-standing injunction in that state, which had protected access to pre-natal health care and
required federal funding regardless of the immigration status of pregnant women. n249 At about the same time, the New York Court of Appeals interpreted the
state and federal constitutions to require state medical assistance for several categories of noncitizens. n250 The State of New York therefore had an obligation
In a Texas community, doctors included all residents in a preventive
medical program designed to improve public health and limit emergency room costs. n251 The State Attorney General
asserted that this program violated federal law because it did not restrict the access of undocumented aliens. n252
to provide medical care without receiving federal contributions.
Legal scholars, however, asserted that the federal law violated the Tenth Amendment. n253 The doctors argued that restrictions would undermine the public
health and fiscal objectives of the program. n254 The State of Colorado responded to the pressure of state budget restrictions for Medicaid by excluding all
immigrants from the Medicaid program, even those allowed to be included by federal law. n255 However, in 2005, the Colorado legislature passed a bill that
Lifting the restrictions based on noncitizen status in the current
Medicaid/SCHIP system would relieve states and localities of some burdens and would enable them to obtain federal
financial contribution for [*208] the health services they provide. In the broader context of health care reform, inclusion
of noncitizens is necessary to avoid similar federal-state conflicts.
restored Medicaid eligibility for several categories of immigrants. n256
Repealing the Welfare reform act would give all undocumented immigrants access to
Medicare and Medicaid solving all health concerns.
Adrianne Ortega, 2009 (J.D. Boston U, M.P.H. Boston U School of Public Health. “. . . And Health Care For All: Immigrants in the Shadow of the Promise
of Universal Health Care.” 35 Am. J. L. and Med. 185//ZE)
President Obama's
ambitious universal health care plan aims to provide affordable and accessible health care for all n1 The plan to cover the
the over thirty million non-citizens living in the United States. n2 If the United States
passes universal health care coverage, Congress should repeal the prohibitions of the Welfare Reform Act, extend Medicaid
coverage to non-citizens, and allow non-citizens to purchase employer-based insurance coverage. President Obama's
plan follows the lead of state universal health care legislation by retaining private, employer-sponsored insurance
coverage and expanding the eligibility requirements of the Medicaid program. n3 This strategy will not aid uninsured
immigrants or overburdened states and hospitals, though, because current law excludes most non-citizens from nonemergency health care services. n4 Federal law requires that hospitals screen and treat all patients in an emergency,
but non-emergency care remains a [*186] patchwork of illogical policies. n5 Undocumented immigrants are excluded
from non-emergency Medicare and Medicaid, while most documented immigrants are excluded from non-emergency
Medicare and Medicaid for five years. n6 In fact, prison is often the only place undocumented immigrants may receive non-emergency health care
services. n7 States and hospitals, therefore, shoulder the burden of caring for non-citizens without assistance from the federal
government. n8
estimated 46.5 million uninsured, however, ignores
The first rule of Project Mayhem is that you do not ask questions.
9
SCFI 2009
Immigration Health Aff
Project Mayhem
___ of ___
1AC – Solvency
Each law must be repealed. Repealing Section 434 of the WRA and Section 642 of the
IRL is necessary for immigrants to access health funds.
Park 04 Georgetown Immigration Law Journal Spring, 2004
NOTE: SUBSTANTIAL BARRIERS IN ILLEGAL IMMIGRANT ACCESS TO PUBLICLY-FUNDED HEALTH CARE: REASONS AND RECOMMENDATIONS FOR
CHANGE SEAM PARK (B.B.A., Emory University, 2001; J.D. Candidate, Florida State University College of Law, May 2005.)
The first, and most essential step of the recommendation process requires Congress to repeal Section 434 of the
Welfare Reform Act and Section 642 of the Immigration Reform Law. n121 This step is of vital importance because
these sections have created an indirect roadblock for illegal immigrants accessing federally or state funded health
care because they are not shielded from having their immigration status reported to the INS by health care officials.
n122 Repealing this legislation is the touchstone of providing illegal immigrants with undeterred publicly funded health care because if
these sections remain in existence, states will not have the ability to provide illegal immigrants with security when
they choose to access the available federally funded care and nor will states be effectively granted the power to
provide illegal immigrants with preventive care. Congress should not have a problem repealing these sections
because the [*586] objectives behind this legislation are unjustifiable. n123 Legislation proposing the reporting of immigration status of
illegal immigrants when they attempt to access public, social services has a myriad of objectives. These objectives include:
Legislative action is critical.
Park 04 Georgetown Immigration Law Journal Spring, 2004
NOTE: SUBSTANTIAL BARRIERS IN ILLEGAL IMMIGRANT ACCESS TO PUBLICLY-FUNDED HEALTH CARE: REASONS AND RECOMMENDATIONS FOR
CHANGE SEAM PARK (B.B.A., Emory University, 2001; J.D. Candidate, Florida State University College of Law, May 2005.)
Legislative reform can help solve the numerous problems associated with illegal immigrants and their inability to
access health care. Reform must start with the federal government by repealing legislation that bans state officials
from preventing their state officials from sharing information with the INS. Next, states must utilize this regained authority and pass
limited cooperation ordinances in order to provide security for illegal immigrants that desire to access care. Finally, states should utilize their authority and pass
legislation providing, at least, prenatal care and treatment for chronic and debilitating diseases. It should be duly noted that legislative reform is not going to be a
"cure-all" for every problem associated with illegal immigrants and their ability to access and receive proper health care by any means. However, legislative
reform would provide part of the solution to arguably the most important problem regarding health care for the illegal
immigrants, barriers to access.
The first rule of Project Mayhem is that you do not ask questions.
10
SCFI 2009
Immigration Health Aff
Project Mayhem
___ of ___
1AC – Disease
Advantage One: Disease
First, current restrictions on immigrant health care ensure communicable disease
outbreaks. Illegal immigrants are forgoing preventative treatment and hospitals are
too overburdened to respond.
Park 04 Georgetown Immigration Law Journal Spring, 2004
NOTE: SUBSTANTIAL BARRIERS IN ILLEGAL IMMIGRANT ACCESS TO PUBLICLY-FUNDED HEALTH CARE: REASONS AND RECOMMENDATIONS FOR
CHANGE SEAM PARK (B.B.A., Emory University, 2001; J.D. Candidate, Florida State University College of Law, May 2005.)
Avoidable, and undesirable public health problems could arise for a number of reasons if illegal aliens are denied
access to preventive health care. Among these reasons is that illegal aliens often come from regions where communicable
diseases are more prevalent than the United States. n70 Furthermore, when combined with the fact that illegal aliens are
more likely to live in "high-risk communities where poverty, poor housing conditions and poor conditions are
prevalent," n71 it creates a potential breeding ground for contracting and spreading of communicable diseases for not
only the illegal immigrant population, but for the general population as well. n72 The situation appears even worse
considering many illegal immigrants are migrant workers, who have a higher tendency to suffer "respiratory, infective
and digestive diseases than the rest of the population," n73 and often work as farm hands or in food services where
they come in contact with the general population. n74 Although conditions for potential outbreaks of communicable disease are at a heightened
level for the illegal alien population n75, the combined effect of the Welfare Reform Act and the Immigration Reform Law makes
preventive treatment unavailable and deters illegal immigrants from seeking available treatment for communicable
diseases. Even if states decide to pass legislation providing state-funded preventive care, illegal aliens must remain fearful of [*580] deportation if they
desire to access this care. This is counterintuitive to controlling the potential spread of communicable diseases, which, arguably, would be "facilitated by
immunization and early detection efforts." n76 Although it is true that the current legislation provides emergency services and treatment for communicable
diseases, the dangers of transmission are heightened because it does not provide testing and treatment during the early
stages of communicable diseases. n77 And even if states decided to provide preventive health care in an attempt to
address the possibility of the potential spread of an infectious disease, the legislation that facilitates deportation
"provides an even greater incentive for undocumented immigrants to avoid revealing their presence to entities that
they perceive as agents for the government, meaning they are unlikely to seek treatment even with active
[communicable diseases]." n78 Since illegal aliens live with the fear of deportation because they are illegally residing in the United States, they are
unlikely to access health care until their "medical situations have elevated to a crisis." n79 This fear of deportation creates delay
in accessing this available care, which in turn creates a much greater likelihood of spreading the infectious disease to others. n80 By the time illegal
immigrants decide to risk deportation in accessing care, many others, including the general population, may have
already been exposed.
And, Excluding non-citizens ensures infectious disease outbreaks.
Deterding, 08 David J., Lawyer in St. Louis, Missouri, Associate, Saint Louis University School of Law Saint Louis University Law Journal Spring, 2008
52 St. Louis L.J. 951 L/N)
It is also evident that denying
health care to undocumented children can create serious adverse health consequences for
the rest of the country. n255 By deferring the treatment of non-citizen children until an emergency situation arises, these children could expose numerous
other individuals to communicable diseases. n256 For example, the rate of tuberculosis and many other infectious diseases is ten to
thirty times higher in the country of origin for many immigrants than in the United States. n257 Diseases such as tuberculosis can
remain dormant for long periods of time thus making detection improbable without continuous access to medical treatment and care. n258 However, if access
to preventative medical care is given, doctors will be able to protect U.S. citizens from the dangers of diseases which
originate abroad by eliminating infectious diseases before they can spread. For these reasons, it is in the interests of Congress to
make sure diseases within the illegal immigrant community are diagnosed and treated early in order to preserve the health of both immigrants and U.S. citizens.
This objective cannot be accomplished unless the current statutory denial of publicly funded preventative health care to unqualified non-citizen children is altered
or revoked.
The first rule of Project Mayhem is that you do not ask questions.
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Specifically, giving healthcare access to noncitizens is key to controlling
tuberculosis.
Janet Calvo, 2008 (Professor, City University School of Law. “The Consequences of Restricted Health Care Access for Immigrants: Lessons from
Medicaid and SCHIP.” 17 Ann. Health L. 175//ZE)
Control of TB necessitates screening. Screening is especially important for at-risk groups, which include foreign-born
persons. Treatment of latent TB is recommended to decrease the risk of the development of active TB. n155 However, active TB can also be treated. n156 A
fully administered drug treatment results in cure rates of 95%, but because treatment is specific and sometimes lengthy, it must be supervised and facilitated by a
healthcare worker. n157 While
TB has been on the decline in the United States, it continues to increase in foreign-born
persons. n158 In the United States in 2006, the number of TB cases among foreign-born persons increased. The TB rate in foreign-born
persons in the United States in 2006 was 9.5 times greater than that of native-born [*196] persons. n159 These numbers
illustrate that it is crucial for noncitizens to have access to screening. Elimination of TB is an important public health goal. n160 In the 1960's and 1970's,
declining TB rates in the United States led to a dismantling of prevention and treatment programs. n161 The consequence was increased TB infection rates with
drug-resistant strains emerging. n162 It was estimated that the monetary costs of losing control of TB exceeded one billion
dollars in New York City alone. n163
Of particular current concern is the control of multidrug-resistant and extensively drug-resistant TB, n164 which
are significantly more difficult to treat. Others can become infected by breathing in the air containing these TB germs. n165 Multidrug-resistant
TB
disproportionately affects foreign born persons. They accounted for 81.5% of these cases in 2005. n166 From 2000-2006,
73% of the extensively drug-resistant TB cases occurred in foreign-born persons. n167 Control of multidrug-resistant TB first requires appropriate testing and
screening. The treatment of the disease requires appropriate medication and monitoring to assure that the therapy is completed. n168 Access
to health
care for prevention, screening, early diagnoses, and treatment are necessary to prevent the increase of drugresistant TB and the associated costs. Drug-resistant TB also occurs in patients with active TB who are initially treated with medication, but do not
get their full course of treatment. n169 When drug-resistant TB develops, the treatment required is much more extensive and expensive. Treatment for multidrugresistant TB requires a minimum of eighteen to twenty- [*197] four months; in-patient costs for someone with extensively drug-resistant TB can be $ 600,000.
n170 Providing health care access to noncitizens is therefore important in meeting the public health goal of controlling
and hopefully eliminating this disease. While treatment programs are targeted to help treat and curtail the spread of TB, general health care access
is essential. As with many diseases, TB presents with common symptoms such as a cough and fatigue at the early stages when it is easiest to treat and
contagion can be best controlled. n171
Leaving TB untreated leads to a plague that will devastate the world
Kimberly A. Johns and Christos Varkoutas, (Journal of Contemporary Health Law & Policy, “The Tuberculosis Crisis: The Deadly
Consequence of Immigration Policies and Welfare Reform,” Fall 1998, 15 J. Contemp. Health L. & Pol'y 101, JMP)
Under the current direction of government policy, once TB becomes a problem large enough for our lawmakers to address, it may be too late to fashion an
effective and palatable response. For, as drug-resistant TB spreads unchecked, the country will have no choice but to return
to
the pre-drug days of quarantine. Without prompt, effective government action, the nation and the world will be faced
with a deadly TB epidemic. Despite continuing medical progress, drug-resistant TB will make treatment with drug therapy
incapable of curing sufferers or preventing the spread of the disease. The remaining option of quarantine, which will be
abhorred and resisted if it can be enforced at all, will be able to do little more than its past, limited success in preventing the further
spread of TB. We will then be reliving the thought-to-be-forgotten days when the "White Plague" devastated the
world. If care is not taken today, tomorrow we may just find ourselves faced with the grim scenes of yesteryear.
The first rule of Project Mayhem is that you do not ask questions.
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The emergence of a new virus is a real possibility—failure to contain its spread will
cause extinction.
South China Morning Post, 1/4/96
Despite the importance of the discovery of the "facilitating" cell, it is not what Dr Ben-Abraham wants to talk about. There is
a much more pressing
medical crisis at hand - one he believes the world must be alerted to: the possibility of a virus deadlier than HIV. If this makes Dr BenAbraham sound like a prophet of doom, then he makes no apology for it. AIDS, the Ebola outbreak which killed more than 100 people in Africa last
year, the flu epidemic that has now affected 200,000 in the former Soviet Union - they all, according to Dr Ben-Abraham, the "tip of the
iceberg". Two decades of intensive study and research in the field of virology have convinced him of one thing: in
place of natural and man-made disasters or nuclear warfare, humanity could face extinction because of a single
virus, deadlier than HIV."An airborne virus is a lively, complex and dangerous organism," he said. "It can come from a
rare animal or from anywhere and can mutate constantly. If there is no cure, it affects one person and then there is a
chain reaction and it is unstoppable. It is a tragedy waiting to happen."That may sound like a far-fetched plot for a Hollywood film, but Dr Ben Abraham said history has already proven his theory. Fifteen years ago, few could have predicted the impact of AIDS
on the world. Ebola has had sporadic outbreaks over the past 20 years and the only way the deadly virus - which
turns internal organs into liquid - could be contained was because it was killed before it had a chance to spread.
Imagine, he says, if it was closer to home: an outbreak of that scale in London, New York or Hong Kong. It could happen anytime in the next 20
years - theoretically, it could happen tomorrow. The shock of the AIDS epidemic has prompted virus experts to admit
"that something new is indeed happening and that the threat of a deadly viral outbreak is imminent", said Joshua
Lederberg of the Rockefeller University in New York, at a recent conference. He added that the problem was "very serious and is getting worse".
Dr Ben-Abraham said: "Nature isn't benign. The survival of the human species is not a preordained evolutionary
programme. Abundant sources of genetic variation exist for viruses to learn how to mutate and evade the immune
system."He cites the 1968 Hong Kong flu outbreak as an example of how viruses have outsmarted human intelligence. And as new "mega-cities" are
being developed in the Third World and rainforests are destroyed, disease-carrying animals and insects are forced
into areas of human habitation. "This raises the very real possibility that lethal, mysterious viruses would, for the first
time, infect humanity at a large scale and imperil the survival of the human race," he said.
are
This outweighs nuclear war
Dalton 01 (Alastair, journalist, “Deadly Virus Will Destroy Life on Earth,” THE SCOTSMAN, October 17, 2001, LN.)
HUMANS will have to move to other planets to survive a biological catastrophe that will hit the Earth within the next 1,000 years, Professor Stephen Hawking
warned yesterday. The
world's most famous physicist said he was more worried about a virus than nuclear weapons
destroying life and said future generations would have to face living in space. Prof Hawking said he was optimistic life would continue, but warned
the danger of extinction remained because of man's aggressive nature. Other leading scientists agreed that humans would
have to take action to avoid being wiped out like previous dominant Earth species, such as the dinosaurs, but said there
was no need for any immediate panic.
The first rule of Project Mayhem is that you do not ask questions.
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Independently, a pandemic would lead to a collapse of the economy and of society
Mike Adams, the Health Ranger, NaturalNews Editor April 27, 2006
Sixty-eight percent of poll respondents -- that is, over two-thirds -- said they would stay home and keep their children
at home while the outbreak lasted. This is huge. If this many people actually do this, the U.S. economy will all but
collapse. Think about this very carefully: If two-thirds of the people stay home, don't go to work, don't go out and
spend money, don't go and produce something, this country will experience severe economic consequences. Not just
a recession, not just a depression -- but a sharp, and hopefully only temporary, collapse of basic economic activities.
That's what we're looking at, and let me translate this into real terms for you. This means two-thirds of the people who run the oil refineries won't go to work. Twothirds of the people who run the power plants and the water plants, who drive trucks and deliver all the goods and food across this country, won't go to work.
Two-thirds of the schoolteachers; two-thirds of government workers; two-thirds of your local police officers, firemen and ambulance workers; two-thirds of the
hospital workers -- the doctors, the nurses, the anesthesiologists; two-thirds of bridge maintenance workers and street repairman -- none of these people will go
to work. You get the idea here. What happens if two-thirds of the workers in all these basic infrastructure services are suddenly missing because they're staying
home, attempting to save their families from the bird flu outbreak? I'll tell you what happens: We will experience a shutdown of essential
services in this country. And following that, have no illusions, we will see a declaration of martial law because the
military will have to be called in to run some of these basic services and establish order. If two-thirds of the police
officers are not on the street, then somebody has to be brought in to prevent mass uprisings, mass protests and
mass chaos. You saw what happened with Hurricane Katrina. Caught in the chaos without any real help from FEMA, many New Orleans police officers
said, "This isn't worth a paycheck!" They turned in their badges and left town. If I remember correctly, over a hundred police officers quit. What do you think is
going to happen when a low-level police officer -- who makes $25,000, maybe $35,000 a year -- has to choose between staying on the job and facing potentially
armed rioters vs. staying at home and protecting his family? What do you think he is going to choose? He's going to quit his job and stay home to protect his
family, and this is going to happen across the board. It's a no-brainer. This is not to say anything bad about police officers. I have great respect
for the law enforcement professionals who help keep the peace today, but you cannot expect them to sacrifice the safety of their families for what is essentially a
job. It's an unreasonable expectation. In fact, anyone who wants to reduce his or her risk of contracting the disease will stay
home, regardless of what they do for a living.
Economic collapse will cause a new round of global wars.
Walter Russell Mead, Henry A. Kissinger senior fellow for U.S. foreign policy at the Council on Foreign Relations, 2/4/2009, The New Republic, “Only
Makes You Stronger,” http://www.tnr.com/politics/story.html?id=571cbbb9-2887-4d81-8542-92e83915f5f8&p=2
So far, such half-hearted experiments not only have failed to work; they have left the societies that have tried them in a development has fallen farther behind
that of the Baltic states and Central Europe. Frequently, the crisis has weakened the power of the merchants, industrialists, financiers, and professionals who
want to develop a liberal capitalist society integrated into the world. Crisis can also strengthen the hand of religious extremists, populist
radicals, or authoritarian traditionalists who are determined to resist liberal capitalist society for a variety of reasons.
Meanwhile, the companies and banks based in these societies are often less established and more vulnerable to the consequences of a financial crisis than
more established firms in wealthier societies. As a result, developing countries and countries where capitalism has relatively recent and shallow roots tend to
suffer greater economic and political damage when crisis strikes--as, inevitably, it does. And, consequently, financial crises often reinforce
rather than challenge the global distribution of power and wealth. This may be happening yet again. None of which means that we can
just sit back and enjoy the recession. History may suggest that financial crises actually help capitalist great powers maintain their leads--but it has other, less
reassuring messages as well. If financial crises have been a normal part of life during the 300-year rise of the liberal capitalist
system under the Anglophone powers, so has war. The wars of the League of Augsburg and the Spanish Succession; the Seven Years War;
the American Revolution; the Napoleonic Wars; the two World Wars; the cold war: The list of wars is almost as long as the list of financial crises. Bad
economic times can breed wars. Europe was a pretty peaceful place in 1928, but the Depression poisoned German
public opinion and helped bring Adolf Hitler to power. If the current crisis turns into a depression, what rough beasts
might start slouching toward Moscow, Karachi, Beijing, or New Delhi to be born? The United States may not, yet,
decline, but, if we can't get the world economy back on track, we may still have to fight.
The first rule of Project Mayhem is that you do not ask questions.
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Advantage Two: Soft Power
Current denial of basic human rights to immigrants is spurring an international
backlash against the U.S. international agenda. This is preventing cooperation
necessary to solve every major impact.
LESLEY
WEXLER (Assistant Professor, Florida State University College of Law, “HUMAN RIGHTS IMPACT STATEMENTS: AN IMMIGRATION CASE
STUDY” Georgetown Immigration Law Journal Georgetown Immigration Law Journal Winter, 2008, Lexus)
The development of a human rights strategy to protect migrants yields several benefits that a purely constitutional framework
lacks. First, the use of human rights treaties and discourse creates links to the international movement to protect human rights. These links can strengthen
protections at home in two ways: by drawing international attention and pressure to bear on domestic efforts n46 and providing a shared language and
understanding for domestic advocates to interact with, and learn from, international experiences. n47 A s
many countries face similar immigration
issues, the shared wisdom of an international approach may be particularly useful in this area. Such international
interactions might also facilitate the transmission of human rights assessments and impact statements throughout the
world. Human rights review might complement U.N. efforts to mainstream human rights and integrate them at an operational level. n48 The visibility and
leadership capabilities of the United States make it particularly able to promote the use of human rights assessments. n49 Just as the United States'
development and implementation of environmental impact statements has shaped environmental policy in a
significant number of countries, n50 the United States could also reinvigorate its human rights policy through its
leadership and assist other countries in developing a stronger commitment to human rights. n51 Impact assessment provides other countries with an
opportunity [*292] to embrace the importance of human rights without making a strong commitment to a treaty regime they might be unwilling to or be incapable
of enforcing. Human rights impact statements and other review mechanisms might also be used as evidence of good faith domestic treaty compliance. To the
extent that the United States already implicitly complies with reporting requirements under the human rights treaties it has ratified and implemented, foreign
countries find America's disinclination to use human rights language problematic. n52 Thus, instead of using a constitutional metric
to determine violations when collecting information on police brutality, for example, U.S. states could do so instead by documenting the issue in terms of human
rights. By adding treaty language to the assessment process, transmitting our efforts at compliance across the globe becomes easier. Enhancing our reputation
for human rights compliance is especially important given current political realities. Many countries hold a declining opinion of the United States. n53 The
international community would welcome America's affirmation of the continuing importance of human rights in the
wake of many post-September 11th actions such as torture, extraordinary rendition, increased domestic surveillance,
and harsher and more frequent detention of immigrants. Moreover, the international community would benefit from the assurance that the
concept of "human rights" means more than a justification for regime change. n54 American exceptionalism to human rights law angers our
allies and complicates efforts to secure their cooperation. n55 Not surprisingly, many countries view the United States'
silence about its own human rights failings as hypocritical. n56 In particular, the international community strongly criticizes
the State Department's annual human rights reports for omitting an assessment of domestic performance as well as omitting "actions by
governments taken at the request of the United States or with the expressed support of the United States . . . ." n57 Human rights advocates suggest
that U.S. leadership on human rights faces a severe [*293] credibility gap--for instance, other countries perceive the
United States as a laggard on human rights treaty compliance in regards to migrants n58 --but that repudiation of
past abuses and momentum for policy changes could restore its leadership. n59 As many have suggested, good
international relations are vital to winning the War on Terror. n60 Moreover, international cooperation is essential to
address immigration related issues such as human trafficking. A visible commitment to migrants' human rights might
bolster the United States' credibility when it seeks better treatment for the approximately 2 million American emigres.
n61 Other international problems, such as climate change and related environmental issues, also require cooperation
and leadership. An increased willingness to participate in global human rights discourse and demonstrate adherence
to human rights treaties might enhance our ability to lead and participate in other arenas.
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And, Extending healthcare to immigrants is the strongest way to demonstrate a
commitment to international standards and improve our legitimacy and leadership
worldwide.
Marcela X. Berdion SMU Law Review Association SMU Law Review J.D. Candidage 2008, SMU Dedman School of Law; B.A., Business & Political Law,
cum laude, Southwestern University. http://www.lexisnexis.com/us/lnacademic/results/docview/docview.do?start=25&sort=BOOLEAN&format
=GNBFI&risb=21_T6960714436
Immigrants of all legal statuses should have the same human right to health as all other people in the United States
and in the world according to international standards, but many may not receive adequate care if the country's policy makers see health
care as merely a privilege. Immigrants therefore provide a fitting lens through which the status of health care in the United
States may be examined, as they provide an example of a group of perpetually marginalized people who face multiple barriers to accessing health care.
Since the true measure of a country's commitment to human rights is best seen by examining the rights of those who are
most disenfranchised, the level of health care access provided to immigrants demonstrates the position of health care in
the United States along the spectrum of a mere privilege versus a human right. Additionally, the federal government's categorization of
immigrants according to legal status for health care benefits and the steady increase in the numbers of people immigrating both legally and illegally makes
immigrants an appropriate group to demonstrate the dangerous consequences of considering health care as a privilege when more and more people in the
United States are systematically left without medical care due to their legal status and indigence. The
United States, as the most powerful and
resourceful country in the world, should meet international health care standards as well as honor its
commitments to provide a human right to health for all people within its borders, including all immigrants. The health
care debate should move away from a dialogue about who should qualify for care and the associated costs toward a discussion on the best way for every person
to receive medical attention. Once health
care is recognized as a human right among policy makers and individuals in the
United States, this discussion can take place and the country can work towards achieving a high level of human
health among all people, rather than apportioning who may receive what care and thus failing millions of people's
human rights. The purpose of this Comment is to examine the attitudes towards health care provision in the United States
against the backdrop of international human rights health standards and obligations. Part I provides an overview of
the status of health as a human right in the international context, as seen through multiple international treaties,
and contrasts this paradigm with the one present in the United States, as seen through the framework of Supreme Court decisions, as well as legislative and
executive actions, suggesting that health care is a privilege in America. Part II uses the health care rights of immigrants as a lens to examine the level of rights
federal policies have bestowed on one of the most disenfranchised groups in the country and
discusses the policy barriers immigrants face in
physically accessing both emergency and non-emergency health care, as well as the barriers impeding access to
meaningful care as prescribed by international standards. Part III proposes small policy changes Texas can make in order
to pave the way for immigrants to receive greater physical and meaningful access to health care while waiting for the
federal government to meet the international standards for human health care rights.
This soft power is key to overall US primacy.
Nye in 2008 (Joseph S, Harvard IR prof., p. 7, http://ann.sagepub.com/cgi/content/abstract/616/1/94)
Promoting positive images of one’s country is not new, but the conditions for projecting soft power have transformed
dramatically in recent years. For one thing, nearly half the countries in the world are now democracies. The competi- tive cold war model has become
less relevant as a guide for public diplomacy. While there is still a need to provide accurate information to populations in coun- tries like Burma or Syria, where
the government controls information, there is a new need to garner favorable public opinion in countries like Mexico and
Turkey, where parliaments can now affect decision making. For example, when the United States sought support for
the Iraq war, such as Mexico’s vote in the UN or Turkey’s permission for American troops to cross its territory, the
decline of American soft power created a disabling rather than an enabling environment for its policies. Shaping public
opinion becomes even more important where author- itarian governments have been replaced. Public support was not so important when the United States
successfully sought the use of bases in authoritarian countries, but it turned out to be crucial under the new democratic conditions in Mexico and Turkey. Even
when foreign leaders are friendly, their leeway may be limited if their publics and parliaments have a negative image
of the United States. In such circumstances, diplomacy aimed at public opinion can become as important to outcomes as the traditional classified
diplomatic communications among leaders.
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Failure to maintain US leadership ensures extinction
Kagan 07 - senior fellow at the Carnegie Endowment for International Peace (Robert, “End of Dreams, Return of History”, 7/19,
http://www.realclearpolitics.com/articles/2007/07/end_of_dreams_return_of_histor.html)
Finally, there is the United States itself. As a matter of national policy stretching back across numerous administrations, Democratic and Republican, liberal and
conservative, Americans have insisted on preserving regional predominance in East Asia; the Middle East; the Western Hemisphere; until recently, Europe; and
now, increasingly, Central Asia. This was its goal after the Second World War, and since the end of the Cold War, beginning with the first Bush administration
and continuing through the Clinton years, the United States did not retract but expanded its influence eastward across Europe
and into the Middle East, Central Asia, and the Caucasus. Even as it maintains its position as the predominant global
power, it is also engaged in hegemonic competitions in these regions with China in East and Central Asia, with Iran in the Middle
East and Central Asia, and with Russia in Eastern Europe, Central Asia, and the Caucasus. The United States, too, is more of a traditional than a
postmodern power, and though Americans are loath to acknowledge it, they generally prefer their global place as “No. 1” and are equally loath to relinquish it.
Once having entered a region, whether for practical or idealistic reasons, they are remarkably slow to withdraw from it until they believe they have substantially
transformed it in their own image. They profess indifference to the world and claim they just want to be left alone even as they seek daily to shape the behavior of
billions of people around the globe.
The jostling for status and influence among these ambitious nations and would-be nations is a second defining
feature of the new post-Cold War international system. Nationalism in all its forms is back, if it ever went away, and so is
international competition for power, influence, honor, and status. American predominance prevents these rivalries from intensifying — its
regional as well as its global predominance. Were the United States to diminish its influence in the regions where it is currently the strongest
power, the other nations would settle disputes as great and lesser powers have done in the past: sometimes through diplomacy and accommodation
but often through confrontation and wars of varying scope, intensity, and destructiveness. One novel aspect of such a multipolar
world is that most of these powers would possess nuclear weapons. That could make wars between them less likely, or it could simply
make them more catastrophic.
It is easy but also dangerous to underestimate the role the United States plays in providing a measure of stability in the world even as it also disrupts stability. For
instance, the United States is the dominant naval power everywhere, such that other nations cannot compete with it even in their home waters. They either
happily or grudgingly allow the United States Navy to be the guarantor of international waterways and trade routes, of international access to markets and raw
materials such as oil. Even when the United States engages in a war, it is able to play its role as guardian of the waterways. In a more genuinely multipolar world,
however, it would not. Nations would compete for naval dominance at least in their own regions and possibly beyond. Conflict between nations would involve
struggles on the oceans as well as on land. Armed embargos, of the kind used in World War i and other major conflicts, would disrupt trade flows in a way that is
now impossible.
Such order as exists in the world rests not only on the goodwill of peoples but also on American power.
Such order
as exists in the world rests not merely on the goodwill of peoples but on a foundation provided by American
power. Even the European Union, that great geopolitical miracle, owes its founding to American power, for without it the European nations after World War ii
would never have felt secure enough to reintegrate Germany. Most Europeans recoil at the thought, but even today Europe’s stability depends on
the guarantee, however distant and one hopes unnecessary, that the United States could step in to check any
dangerous development on the continent. In a genuinely multipolar world, that would not be possible without
renewing the danger of world war.
People who believe greater equality among nations would be preferable to the present American predominance often
succumb to a basic logical fallacy. They believe the order the world enjoys today exists independently of American
power. They imagine that in a world where American power was diminished, the aspects of international order that they like would remain in place. But that ’s
not the way it works. International order does not rest on ideas and institutions. It is shaped by configurations of power. The international
order we know today reflects the distribution of power in the world since World War ii, and especially since the end of the Cold War. A different configuration of
Continued…
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Continued…
power, a
multipolar world in which the poles were Russia, China, the United States, India, and Europe, would produce
its own kind of order, with different rules and norms reflecting the interests of the powerful states that would have a hand in shaping it. Would
that international order be an improvement? Perhaps for Beijing and Moscow it would. But it is doubtful that it would suit the tastes of
enlightenment liberals in the United States and Europe.
The current order, of course, is not only far from perfect but also offers no guarantee against major conflict among the world ’s great powers. Even under the
umbrella of unipolarity, regional conflicts involving the large powers may erupt. War could erupt between China and Taiwan and draw in both the
United States and Japan. War could erupt between Russia
and Georgia, forcing the United States and its European allies to decide whether to intervene
and Pakistan remains possible, as does conflict between Iran and Israel or
other Middle Eastern states. These, too, could draw in other great powers, including the United States.
Such conflicts may be unavoidable no matter what policies the United States pursues. But they are more likely to erupt if the United
States weakens or withdraws from its positions of regional dominance. This is especially true in East Asia, where most nations agree
that a reliable American power has a stabilizing and pacific effect on the region. That is certainly the view of most of China ’s neighbors. But even China,
which seeks gradually to supplant the United States as the dominant power in the region, faces the dilemma that an American withdrawal
could unleash an ambitious, independent, nationalist Japan.
or suffer the consequences of a Russian victory. Conflict between India
Conflicts are more likely to erupt if the United States withdraws from its positions of regional dominance.
In Europe, too, the departure of the United States from the scene — even if it remained the world’s most powerful nation — could be
destabilizing. It could tempt Russia to an even more overbearing and potentially forceful approach to unruly nations on its periphery.
Although some realist theorists seem to imagine that the disappearance of the Soviet Union put an end to the possibility of confrontation between Russia and the
West, and therefore to the need for a permanent American role in Europe, history suggests that conflicts in Europe involving Russia are possible even without
Soviet communism. If
the United States withdrew from Europe — if it adopted what some call a strategy of “offshore balancing” — this
could in time increase the likelihood of conflict involving Russia and its near neighbors, which could in turn draw the United
States back in under unfavorable circumstances.
It is also optimistic to imagine that a retrenchment of the American position in the Middle East and the assumption of a more passive, “offshore” role would lead to
greater stability there. The vital interest the United States has in access to oil and the role it plays in keeping access open to other nations in Europe and Asia
make it unlikely that American leaders could or would stand back and hope for the best while the powers in the region battle it out. Nor would a more “evenhanded” policy toward Israel, which some see as the magic key to unlocking peace, stability, and comity in the Middle East, obviate the need to come to Israel ’s
aid if its security became threatened. That commitment, paired with the American commitment to protect strategic oil supplies for most of the world, practically
ensures a heavy American military presence in the region, both on the seas and on the ground.
The subtraction of American power from any region would not end conflict but would simply change the equation. In the Middle East, competition for
influence among powers both inside and outside the region has raged for at least two centuries. The rise of Islamic
fundamentalism doesn ’t change this. It only adds a new and more threatening dimension to the competition, which
neither a sudden end to the conflict between Israel and the Palestinians nor an immediate American withdrawal from
Iraq would change. The alternative to American predominance in the region is not balance and peace. It is further
competition. The region and the states within it remain relatively weak. A diminution of American influence would not
be followed by a diminution of other external influences. One could expect deeper involvement by both China and
Russia, if only to secure their interests. 18 And one could also expect the more powerful states of the region, particularly Iran, to expand and fill the vacuum. It
is doubtful that any American administration would voluntarily take actions that could shift the balance of power in the Middle East further toward Russia, China,
or Iran. The world hasn ’t changed that much. An American withdrawal from Iraq will not return things to “normal” or to a new kind of stability in the region. It will
produce a new instability, one likely to draw the United States back in again. The alternative to American regional predominance in the Middle East and
elsewhere is not a new regional stability. In an era of burgeoning nationalism, the future is likely to be one of intensified competition among nations and
nationalist movements. Difficult as it may be to extend American predominance into the future, no
one should imagine that a reduction of
American power or a retraction of American influence and global involvement will provide an easier path.
The first rule of Project Mayhem is that you do not ask questions.
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1AC – Dignity
Advantage Three: Human Dignity
First, the status quo’s denial of health services to undocumented immigrants is a
cruel violation of the American ethical code.
International Social Science Review; 2006 (Marietta, Melissa. Vol. 81 Issue 1/2, p61-66, 6p. EBSCOhost.
http://search.ebscohost.com/login.aspx?direct=true&db=aph&AN=21409437&loginpage=login.asp&site=ehost-live)
If undocumented immigrants are denied social services, the quality of health, education, and safety of entire communities will suffer.
Providing access to basic services may prevent problems from expanding into something communities cannot ignore and eventually cost more to remedy in the
future. Services currently offered to undocumented immigrants include medical care, education, and benefits such as food stamps. Undocumented workers may
also qualify for workers' compensation and veterans' benefits. By denying these services to undocumented immigrants, the United States will simply
create another subclass of people in its society. Many of the bills under consideration by various state legislatures seek to deny emergency
medical treatment and education to undocumented workers. This violates the Emergency Medical Treatment and Labor Act (1986) which states that any patient
cannot be denied emergency medical care based on his/her ability to pay. In addition, the U.S. Supreme Court, in Plyler v Doe (1982), ruled that public education
(K-12) must be provided to all children.[ 3] With two new U.S. Supreme Court justices, John Roberts and Samuel Alito, many anti-immigrant groups are hoping
that this law and court decision will be reversed, but Americans must understand that these services create an educated and healthy populous necessary for the
country to prosper.The Need for Education Education is an important social service available to everyone who resides in the United States because the
government regards it as the most important credential one can bring to the labor market. The current national shortage of teachers and nurses can be partially
remedied by immigrants. Yet, legislation is pending in some states to limit education opportunities for undocumented immigrants and their children. For example,
the Georgia General Assembly, during its 2006 legislative session, considered several bills to that effect, including Senate Bill 171 that would require proof of
American citizenship to attend state colleges and universities. Another proposal. House Resolution 256, seeks to amend the state Constitution in order to ban all
undocumented children from public schools.[ 4] Bills denying educational opportunity will likely result in an increase in crime and poverty. The Importance of
Healthcare Many immigrants do not receive needed Healthcare because they fear deportation. Denying healthcare to any segment of the population can lead to
more extreme ailments that become more expensive to treat. Dr. Hogai Nassery, a physician who practices in Chamblee, GA, states: it's less expensive to
provide prenatal care for an undocumented woman than to provide medical care for her premature infant and it's more economical to regulate a man's high blood
pressure than to take care of him after a massive stroke. A cut in access to primary health care will simply lead to more uninsured patients in our already
overburdened emergency rooms.[5] Reality dictates that millions of undocumented immigrants plan to remain in the United States. Denying them healthcare
services will lead to increased instances of infectious, yet treatable diseases. The state legislatures of Georgia and Oklahoma nonetheless are trying to bar
undocumented immigrants from receiving any medical care, including emergency room services.[ 6] This overlooks the fact that most undocumented immigrants
in the U.S. are younger workers. Since younger people tend to use less Healthcare than the elderly, healthcare cost estimates for undocumented aliens tend to
be exaggerated.[ 7] The denial of healthcare is not only bad policy, it is unrealistic, cruel, and violates medical ethics.
Should an undocumented worker involved in an accident be denied healthcare and left in front of a hospital to die?
Most physicians have ignored the laws and treated patients regardless of their immigration status. America has the moral obligation to care for
those who reside here. Americans pride themselves on providing a moral compass for the rest of the world. They
believe that every human life is precious and important. Denying any individual healthcare based on citizenship
contradicts that belief.
And, denying care is inhumane and immoral.
Neill, 02 ALEXANDER VIVERO, Doctor of Jurisprudence/Juris Doctor (J.D.) spring 2002, The Scholar: St.Mary's Law Review on Minority Issues, The
Scholar: St.Mary's Law Review on Minority Issues4 SCHOLAR 405, HUMAN RIGHTS DON'T STOP AT THE BORDER: WHY TEXAS SHOULD PROVIDE
PREVENTATIVE HEALTH CARE FOR UNDOCUMENTED IMMIGRANTS, L/N
To allow a serious illness to go untreated until it requires emergency hospitalization is to subject the sufferer to the
danger of a substantial and irrevocable deterioration in his health. Cancer, heart disease, or respiratory illness, if untreated for a year,
may become all but irreversible paths to pain, disability, and even loss of life. The denial of medical care is all the more cruel in this
context, falling as it does on indigents who are often without the means to obtain alternative treatment. n144How is this
denial of preventative health care any less cruel when the victim is an undocumented alien? To say the denial of this
care is proper solely because undocumented immigrants are not citizens and are present in this country illegally
denies their essential worth and dignity as human beings by forcing them into an "irreversible path to pain, disability
and even loss of life." n145 Once undocumented immigrants are present in this country, we have a moral obligation to
provide them with this basic necessity of human life. In addition, not only do these undocumented aliens reside in this country, they also work
here.
The first rule of Project Mayhem is that you do not ask questions.
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1AC – Dignity
And, our discrimination of illegal immigrants creates a disposable community that
kills democracy and is dehumanizing.
Knapp, 08 (Kathy, professor University of Connecticut. “'AIN'T NO FRIEND OF MINE': IMMIGRATION POLICY,THE GATED COMMUNITY, AND THE
PROBLEM WITH THE DISPOSABLE WORKER IN TC. BOYLE'S TORTILLA CURTAIN. Atenea; dic2008, Vol. 28 Issue 2, p121-134, 14p
http://search.ebscohost.com/login.aspx?direct=true&db=aph&AN=37263483&loginpage=login.asp&site=ehost-live)
In a similar vein, the assumption that workers doing "immigrant" labor are illegal whether they are or not legitimates
our determination that they have become a burden on our school and healthcare systems, a bottomless drain of our tax
dollars, and must be sent back whence they came. Thus, I further argue that the Common Interest Development or gated
community, like the United States' erratic immigration policy, depends upon a labor force that is disposable in order to
preserve its false sense of itself as a democratic community, which can be defined as a group that allows for a broadly shared opportunity
to participate, a broadly felt responsibility for its members, and a genuine sense of belonging. The construction of gates and walls and the formation
of private homeowners' associations effectively insure that although gardeners, housekeepers, nannies, and elder-caregivers may live nearby and oftentimes
live-in, they are not really members of the community. Both locally and globally, in other words, Americans have
regarded their neighbors not as neighbors, but as mere disposable commodities. In an article entitled "The Figure of
the Neighbor: Los Angeles Past and Future," Dana Cuff asserts that the neighbor is a "mediation between self and
other: one must be one to have one"(62). The Self, in this sense, cannot exist without the Other. The willful disposal of our neighbor
is nothing less than the willing sacrifice of our own humanity.
Dehumanization is the root cause of all existential impacts, it devalues life and must
always be rejected.
Berube 1997 June-July, David, professor of communication at the University of Carolina, Nanotechnological Prolongevity: The Down Side
http://www.cas.sc.edu/engl/faculty/ berube/prolong.htm
This seems likely when much of the control over the technology would be in the hands of the nanotechnologists, though assuredly some have broad backs and
pelvises. Assuming we are able to predict who or what are optimized humans, this entire resultant worldview smacks of eugenics and Nazi racial science. This
would involve valuing people as means. Moreover, there would always be a superhuman more super than the current ones, humans would never be able to
escape their treatment as means to an always further and distant end. This means-ends dispute is at the core of Montagu and Matson's treatise
on the dehumanization
of humanity. They warn: "its destructive toll is already greater than that of any war, plague, famine,
or natural calamity on record - - and its potential danger to the quality of life and the fabric of civilized society is
beyond calculation. For that reason this sickness of the soul might well be called the Fifth Horseman of the Apocalypse....
Behind the genocide of the holocaust lay a dehumanized thought; beneath the menticide of deviants and dissidents...
in the cuckoo's nest of America, lies a dehumanized image of man (Montagu & Matson, 1983, p. xi-xii). While it may never be possible to quantify
the impact dehumanizing ethics may have had on humanity, it is safe to conclude the foundations of humanness offer great opportunities which would be
foregone. When
we calculate the actual losses and the virtual benefits, we approach a nearly inestimable value greater
than any tools which we can currently use to measure it. Dehumanization is nuclear war, environmental apocalypse,
and international genocide. When people become things, they become dispensable. When people are dispensable,
any and every atrocity can be justified. Once justified, they seem to be inevitable for every epoch has evil and
dehumanization is evil's most powerful weapon.
The first rule of Project Mayhem is that you do not ask questions.
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Economy Advantage 1/
First, the economy is on the verge of a downward spiral. New health services will
needed to prevent a collapse.
CEPR (Mark Weisbrot Chair co-director of the Center for Economic and Policy Research in Washington, D.C. “Health Care Reform Is Needed Now More than
Ever,” 7/11/2009, http://www.cepr.net/index.php/op-eds-&-columns/op-eds-&-columns/health-care-reform-is-needed-now-more-than-ever/
With the U.S. economy’s downward spiral still accelerating and the federal government looking at its largest budget
deficits since World War II, some are saying that this is not the time to expand health care coverage to all Americans. But this is exactly the
time for the Obama administration to move boldly on its campaign promise to implement a universal health care
system. Obama wants spending that stimulates the economy in the short term, but he also wants to reduce the longterm deficit problem after the economy recovers. This is exactly what health care reform will do. In the short run, health
care spending, like, creates other government spending on goods and services jobs and generates income. This will
help arrest the economy’s downward spiral. With the collapse of private spending, the federal government must act
as the consumer of last resort – hence the vital importance of the $787 billion stimulus package that Congress passed last week.
And, our plan ensures economic recovery. Immigration is the lynchpin of our labor
force and most immigrants contribute billions taxes.
Patrice Hill, (“How immigrants make economy grow; Pool of workers fills gap left by declining U.S. birthrates”
THE WASHINGTON TIMES)06
Immigrant labor - both legal and illegal - has been an important force propelling U.S. economic growth for years
.Growth in the native population has been in decline since the 1970s, so immigrant workers have filled in, providing half
of the growth in the U.S. labor force since 1990. A basic rule of economics dictates that the economy in the long run can grow only as fast as the
increase in the pool of workers, plus the growth in their productivity - or output per worker. Immigrant workers, like all American workers, not only
contribute their labor but further propel growth by liberally spending the wages they earn on a host of items, from food to cars to clothing. Their presence
has been a significant factor fueling growth in key sectors from banking to agriculture and housing - many of which have been booming and
underpinning the health the rest of the economy. of Activists have organized a boycott, dubbed "A Day Without an Immigrant," encouraging immigrants
to skip work today to demonstrate their importance to the U.S. economy. While the role of immigrants in the U.S. economy already is
substantial, it promises to be even more important in the future as baby boomers retire and the number of American
workers shrinks more rapidly. "Immigration will be vital for long-run economic growth in the United States," said
Augustine Faucher, analyst with Economy.com. He estimates that average yearly economic growth will fall to about 2 percent in the next 30
years from 3 percent today - even with a continued flow of about 800,000 new legal and illegal immigrant workers a year - because of retirements. The
expected slowing of growth will usher in a host of other problems, most notably funding promised Social Security and
Medicare benefits for retirees out of payroll taxes on a declining pool of workers. "The problem would be a lot worse
were it not for immigration,"
The first rule of Project Mayhem is that you do not ask questions.
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Economy Advantage 2/
Noncitizens improve business competitiveness and pay a significant contribution to
Social Security. The plan is key to long-term economic growth.
Marietta 06 [Melissa, Writer for the International Social Science Review, “Undocumented immigrants should receive social services,” International Social
Science Review, Spring-Summer, 2006, <http://findarticles.com/p/articles/mi_m0IMR/is_1-2_81/ai_n16599310/?tag=content;col1>
Americans need to recognize the contributions undocumented immigrants make to the U.S. economy. Their labor
allows American citizens to live in affordable houses and eat food at lower prices. Their labor also helps American
businesses compete in a global economy. Additionally, immigrants pay a variety of taxes to the government (i.e., sales
tax, income tax, property tax, Social Security, and user fees). Some undocumented immigrants have even served in the armed forces. U.S. Marine Lance
Corporal Jose Gutierrez, an undocumented immigrant, gave his life for this country during the Iraq war. (12) If the military allows undocumented immigrants to
enlist and put their life on the line for the U.S., then they deserve the same veterans' benefits given to any soldier. Given these circumstances, undocumented
immigrants should receive the benefits of government services when needed. Undocumented immigrants contribute to the American economy through their
purchasing power and by helping American companies compete in foreign markets. Employers pay less for unskilled labor which allows
them to offer savings to the American consumer. Some anti-immigrant advocates complain that undocumented immigrants are driving down
wages for unskilled American citizens, but Douglas Holtz-Eakin, director of the Congressional Budget Office (CBO), disagrees. A CBO report on the economic
impact of immigration shows that, in the short term, immigration creates a small negative effect, but over the long term, the American economy is able to adjust.
He attributes this to "the flexibility of the American labor market in which there are a variety of [economic] adjustments that can take place in response to an influx
of immigration. Additional capital and incentives for the native born to acquire more education are two of those key adjustments." (13)There are many reasons
why undocumented immigrants should receive government services. They pay taxes to the government, but unlike many
American citizens, they will never receive a Social Security check or other benefits. At present, the Social Security
Administration has over $400 billion that has been accumulated under fraudulent Social Security numbers. (14) Much of
that money has been generated by undocumented immigrants working regular jobs, paying taxes, but receiving no benefits. Their contribution to the
Social Security fund is especially important since Americans are having fewer children, meaning that future
generations will make smaller contributions to the fund thus reducing the payment of future benefits. (15)
Continued economic decline will cause a new round of global wars.
Walter Russell Mead, Henry A. Kissinger senior fellow for U.S. foreign policy at the Council on Foreign Relations, 2/4/2009, The New Republic, “Only
Makes You Stronger,” http://www.tnr.com/politics/story.html?id=571cbbb9-2887-4d81-8542-92e83915f5f8&p=2
So far, such half-hearted experiments not only have failed to work; they have left the societies that have tried them in a development has fallen farther behind
that of the Baltic states and Central Europe. Frequently, the crisis has weakened the power of the merchants, industrialists, financiers, and professionals who
want to develop a liberal capitalist society integrated into the world. Crisis
can also strengthen the hand of religious extremists, populist
radicals, or authoritarian traditionalists who are determined to resist liberal capitalist society for a variety of reasons.
Meanwhile, the companies and banks based in these societies are often less established and more vulnerable to the consequences of a financial crisis than
more established firms in wealthier societies. As a result, developing countries and countries where capitalism has relatively recent and shallow roots tend to
suffer greater economic and political damage when crisis strikes--as, inevitably, it does. And, consequently,
financial crises often reinforce
rather than challenge the global distribution of power and wealth. This may be happening yet again. None of which means that we can
just sit back and enjoy the recession. History may suggest that financial crises actually help capitalist great powers maintain their leads--but it has other, less
reassuring messages as well. If
financial crises have been a normal part of life during the 300-year rise of the liberal capitalist
system under the Anglophone powers, so has war. The wars of the League of Augsburg and the Spanish Succession; the Seven Years War;
the American Revolution; the Napoleonic Wars; the two World Wars; the cold war: The list of wars is almost as long as the list of financial crises. Bad
economic times can breed wars. Europe was a pretty peaceful place in 1928, but the Depression poisoned German
public opinion and helped bring Adolf Hitler to power. If the current crisis turns into a depression, what rough beasts
might start slouching toward Moscow, Karachi, Beijing, or New Delhi to be born? The United States may not, yet,
decline, but, if we can't get the world economy back on track, we may still have to fight.
The first rule of Project Mayhem is that you do not ask questions.
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Relations Add-on
Anti-immigrant sentiment offends foreign governments and complicates U.S. foreign
relations.
Nick Robinson 2006. ARTICLE: Citizens Not Subjects: U.S. Foreign Relations Law and the Decentralization of Foreign Policy Yale Law School, J.D.
Currently Fox Fellow at Jawaharlal Nehru University, New Delhi. http://www.lexisnexis.com/us/lnacademic/results/docview/docview.do?docLinkInd
=true&risb=21_T6960714436&format=GNBFI&sort=BOOLEAN&startDocNo=1&resultsUrlKey=29_T6960714439&cisb=22_T6960714438&treeMax=true&treeWid
th=0&csi=156180&docNo=1
States' differing stances on illegal immigrants directly affect relations with foreign citizens and their countries. States
have taken different positions on whether illegal immigrants will be eligible for non-emergency health care, certain labor rights, instate college tuition rates, legal services, voting, identification cards, and other public benefits. Some states have also specifically
trained state officials to arrest illegal immigrants. In others, state officials make no coordinated effort to track or arrest
illegal immigrants. Such actions and anti-immigrant sentiment fueled by local politicians can offend foreign
governments and complicate U.S. foreign relations.
The first rule of Project Mayhem is that you do not ask questions.
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Inherency
Currently in the status quo the PRWOA restricts states to provide non-emergency
care to unqualified and undocumented immigrants, and hospitals are forbidden from
providing the most effective medical care.
RYAN KNUTSON Spring, 2008 Articles Editor, BOSTON COLLEGE THIRD WORLD LAW JOURNAL (2007-2008).
One of PRWOA's most important changes is its dramatic shift in transferring decisions regarding immigrant eligibility for public benefits from the federal to the state level. Along with this
PRWOA
restricts states' ability to provide non-emergency care to unqualified and undocumented immigrants, hospitals are
forbidden from providing the most cost- and medically-effective care. PRWOA's financial strain on U.S. hospitals is
illustrated through the steady increase in uncompensated care and underpayment of care, that are, in part,
symptoms of a growing immigrant population. Certainly, states are free to pass post-PRWOA affirmative laws that can restore the ability of hospitals and
decision-making authority, PRWOA brought about significant cost-shifting from the federal to the local level in the provision of medical care to immigrants. Because
medical centers to provide non-emergency care to immigrants. However, given the current anti-immigrant political climate, it is unlikely that many states will do so. Furthermore,
because non-emergency care must be funded without any federal funds, states and local governments will nevertheless carry the burden of providing preventive care should a state
decide to pass an affirmative law. Congress's current funding programs, and the resulting administrative hurdles, have been unable to alleviate the immense cost-shift to the local level.
As the congressional opponents to PRWOA correctly hypothesized, the Act
has effectuated an unfunded mandate that requires the states to
carry the financial burden of an inadequate federal immigration policy.
The current PRWOA is flawed. The USFG must repeal and increase funding for
Alliance Family and Group Care programs.
RYAN KNUTSON Spring, 2008 Articles Editor, BOSTON COLLEGE THIRD WORLD LAW JOURNAL (2007-2008).
PRWOA is a major public health blunder. One commentator has remarked that identifying a growing population known to have high communicable disease and fertility rates, denying
PRWOA is
flawed in two respects: first, its prohibition on preventive care unnecessarily restricts local medical providers from
providing the most meaningful care; and second, inadequate federal funding has resulted in significant economic
distress for America's public health care providers. It is time to end PRWOA's draconian restrictions on providing
public benefits to immigrants; the federal government must increase funding so as to provide hospitals and
community health care centers with appropriate resources to address this country's growing health care crisis. Through
them access to care other than emergency services, and devoting as little funding as possible "sounds like every public health practitioner's worst nightmare."
an analysis of a workable alternative to the current statutory regime, this note concludes by highlighting the need for flexibility that will be essential in addressing the complex issues
associated with providing and funding immigrant medical care.
The first rule of Project Mayhem is that you do not ask questions.
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Inherency
Illegal workers must avoid medical services because they lack ID.
Clark, Surry and Contino, 2009 (By: Clark, Peter A an Associate Technical Fellow in the Intelligent Information Systems Group within Boeing's
Mathematics and Computing Technology Organization in Seattle, Washington. Surry, Luke Contino, Krysta, Internet Journal of Health, 15288315, 2009, Vol. 8,
Issue 2. “Health Care Access For Migrant Farmworkers: A Paradigm For Better Health.” EBSCO)
An added obstacle in providing the most beneficial care to migrant workers is the Hispanic culture that encourages the use of lay healers, which may provide
patients with teas, herbal remedies, and even creams that are thought to heal many types of ailments. It is commonplace for patients to see a healer rather than
a physician for two reasons. First, many workers are unable to afford the cost of a doctor visit. The second reason for seeking help from
healers rather than from physicians is the fear of being reported to INS and consequently being deported. Now, there are two known lay healers (who practice
traditional medicine) living and working in Bridgeton along with one store that makes traditional herbal remedies native to the Hispanic culture available to the
public. Because of low wages, most farm workers cannot afford insurance and are therefore, required to pay for office visits, treatments, and prescriptions from
their own resources. Those
who are in the country illegally avoid going to any location or institution where they are made to
present identification or where a record of the visit can be documented, which prevents many individuals from
seeking proper medical care [ 23]. consequently, little preventative care is provided to their patients.
We need a good comprehensible plan for immigrant healthcare
Hank Hernandez and Michael A. Anaya Sr. El Paso, Aug. 6, 2008 The writers are, respectively, president and president-elect of the board of
directors of the National Forum for Latino Healthcare Executives
It's our hope at the National Forum for Latino Healthcare Executives that the patient care the article describes is not, and will not be, representative of all
hospitals in the United States. That practice is a stark and disturbing departure from our hospitals' longstanding tradition of care. We are acutely aware of the
financial burdens that caring for uninsured illegal immigrants can present. But the
solution to immigration and health care problems doesn't
lie in penalizing and deporting suffering patients. The United States needs and deserves workable, humane
immigration reform that is comprehensive and reasonably enforceable (not by health organizations), with legal paths for
future workers and those seeking citizenship. As we grapple with health care reform, the public and private sectors must come together to
devise a system of care that is truly representative of our noble American character.
Undocumented immigrants will not be included in universal healthcare
By JIM LANDERS / The Dallas Morning News May 22, 2009
Health care reforms aiming for universal coverage won't provide insurance for illegal immigrants and may not
address the cost to state and local governments for providing medical care to this large group of the uninsured, the
chairman of the Senate Finance Committee said Thursday. "We're not going to cover undocumented aliens,
undocumented workers," Sen. Max Baucus, D-Mont., said at a meeting with reporters. "That's too politically explosive." Universal health insurance is a
key aim of health reform proposals backed by President Barack Obama and key Democrats in Congress, and bills being assembled in House and Senate
committees are aiming to reach that goal through a mix of incentives and mandates. Illegal immigrants, however, account for between 15 and 22
percent of the estimated 47 million U.S. residents without health insurance, according to analyses by the Center for Immigration
Studies and the U.S. Census Bureau. The cost of providing such care has rocked budgets and politics in Texas for several years. About 1.68 million illegal
immigrants live in Texas, according to estimates from the Department of Homeland Security. Many of the uninsured in the Dallas area seek medical treatment at
Parkland Health & Hospital System, which reported $512 million in uncompensated expenses for uninsured patients in 2007. The federal government provides
some compensation for hospitals that treat disproportionate numbers of low-income, uninsured patients, but Baucus said his committee has not grappled with
whether that should be expanded to cover more of the costs for treating uninsured illegal immigrants. "I don't have a good answer yet to undocumented workers,
illegal aliens," he told reporters at a briefing at the Kaiser Family Foundation in Washington. "There will still be charity care. It's very politically charged." Some
immigration advocates have argued health care reform will be incomplete if it does not extend coverage to illegal immigrants. "In light of what's happening right
now with the flu pandemic, it's pretty clear that, for any health care system to work, it has to cover everyone residing in the United States," said Dr. Jamie Torres,
a New York-based podiatrist who is director of Latinos for National Health Insurance. Margie McHugh of the Migration Policy Institute pointed to Baucus'
admission that both coverage and compensation are politically difficult. "I can't imagine anybody thinks this is true health care reform or a smart element of how
to approach the health care reform issue, but it really is just the politics," she said. If the legislation fails to provide more compensation for health care providers in
states like Texas and California, she said, "you really have to wonder if the states are going to stand by and let that happen."
The first rule of Project Mayhem is that you do not ask questions.
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Inherency – Hospitals
The treatment of uninsured patients puts a strain on already tight resources and
forces hospitals to close.
Brietta R. Clark 08
2008 Loyola University Chicago School of Law, Beazley Institute for Health Law and Policy Annals of Health Law Summer, 2008The Immigrant Health Care
Narrative and What it Tells Us About the U.S. Health Care SystemProfessor of Law, Loyola Law School, Los Angeles; J.D., University of Southern California Law
School; B.A., University of Chicago.
This need for prioritizing claims in ways that exclude immigrants becomes more compelling as one considers the current healthcare financing crisis and the
dwindling supply of quality healthcare providers. Healthcare financing is critical for people to be able to access care and for healthcare professionals and facilities
to continue to operate and provide necessary [*249] care. Our current system
provides public health insurance only to select
groups: the poorest children and their parents (including pregnant women), the disabled, elderly, and government
employees and veterans. n113 We rely on private insurance, primarily through employment, to cover the rest of society. n114 However, employers are
not required to provide coverage and increasingly employers are either offering coverage at a cost that is too high for the employees to afford or choosing not to
offer coverage at all. n115 In the individual insurance market, insurance companies have so much discretion that the individuals who are most in need of
insurance are often priced out of the market, leaving millions of people in the United States uninsured. n116
Shrinking financial resources also affect the ability and willingness of quality providers to serve communities with the greatest need. Growing numbers of
uninsureds and declining reimbursement rates have led to nursing and physician shortages in hospitals, especially in
emergency rooms. n117 It has also led to a financial strain causing many public and private hospital closures and
relocations to more affluent communities. n118 While these shortages occur disproportionately in areas with lower socioeconomic status, higher
minority populations, and high need, they can create a cascade effect that increases the burden on remaining hospitals which must absorb these patients. n119
In essence, limited healthcare financing and a dwindling healthcare safety net mean that many people are vying for
ever-shrinking resources. n120
It is against this backdrop of a financial crisis that a
picture is created of immigrants as a threat to the already fragile health system
on which citizens currently depend. n121 Indeed, the mere presence of immigrants who are not [*250] entitled to be here
or who are admitted on the condition that they not become public charges, seems to threaten public resources,
because many immigrants are uninsured n122 and are more likely to serve in dangerous jobs with an increased
likelihood of workplace injury or illness. n123 For example, one article by the Center for Immigration Studies, known for advocating immigration
control and reduction, highlighted these concerns. n124 The Center for Immigration Studies reported that 30% of all immigrants and their children
lack health insurance and receive some kind of public assistance, while immigrant families account for almost 75% of
the increase in the uninsured in the past fifteen years. n125
The picture of immigrants as an economic drain is reinforced with statistics about the cost of hospital care for
undocumented immigrants. For example, the L.A. Times quoted an estimated annual cost of $ 200 million for facilities in California,
Arizona, New Mexico, and Texas and described the cost as "staggering." n126 Restrictionists have blamed the financial crisis in health care on
unauthorized immigrants, predicting that care for unauthorized immigrants will force hospitals already on the verge of bankruptcy
to close their doors. n127
Recently, the argument has shifted to a more imminent, direct healthcare threat in the form of hospital emergency room closures. Hospital closures are the most
visible example of the implications of shrinking healthcare resources and the implications for our health. Rates of hospital closures have exploded in the last
decade, especially public hospitals and hospitals treating a high proportion of uninsured patients. n128 As hospitals close, remaining hospital emergency rooms
become overcrowded and qualified physicians often refuse to serve on-call or [*251] they leave the community altogether, thereby
jeopardizing access and quality of care for everyone. n129
Consider the story of a man from San Diego, California, one of many people concerned about whether Senator Clinton's healthcare plan will provide coverage for
unauthorized immigrants and the effect this will have citizens' access:
The first rule of Project Mayhem is that you do not ask questions.
26
SCFI 2009
Immigration Health Aff
Project Mayhem
___ of ___
Inherency – Hospitals
EMTALA places a great financial burden on hospitals, especially inner-city and rural
ones, causing them to cut staff, undergo restructuring, or even completely shut
down.
Svetlana Lebedinski 05
Fall, 2005 EMTALA: TREATMENT OF UNDOCUMENTED ALIENS AND THE FINANCIAL BURDEN IT PLACES ON HOSPITALS 2005 Wayne State University
The Journal of Law in Society
Two major drawbacks of the EMTALA are the imposition of great financial burden on the hospitals because the
statute is not separately funded by the government and the disproportionate allocation of uncompensated care to
inner-city and public hospitals. n52 Increased health care costs alone force not-for-profit hospitals to trim staff and
overhead. Most not-for-profits operate on a meager 4.7% profit margin. n53 Increased numbers of the uninsured members of the
population and Medicare recipients who seek medical care at the emergency rooms instead of physicians' offices,
impose even greater financial drain. n54 The number of the uninsured increased by 14.6 million in 23 years, [*155]
registering at 43.6 million in 2002. n55 Many emergency departments and, in some situations, hospitals had to close due to
escalating costs that the uncompensated medical care imposes. For example, in Los Angeles, ten of eighteen trauma centers have
closed in the past fifteen years. n56 Even closer to home, Sinai-Grace Hospital in Detroit had to close, in part due to its disproportionate share of the
uncompensated care. Other inner-city hospitals, primarily DMC, are at great risk of the closure, although major restructuring
and
the size of the organization help to counter-balance accelerating costs of providing care to indigents.
EMTALA disproportionately puts a heavier burden on inner-city, rural and public hospitals. n57 Even though federal government
provides subsidies for these hospitals, oftentimes they are inadequate "because it does not appropriately compensate the hospitals that treat a disproportionate
share of indigents." n58 Additionally, poor hospitals do not have resources that they can allocate in order to secure subsidies, whereas hospitals that treat a
much smaller amount of indigents receive subsidies that they do not necessarily need. n59 The unfortunate result is the closure of inner-city, rural or public
hospital resulting from lack of funds to treat indigents and lack of resources to seek federal subsidies.
The cost of caring for the uninsured is forcing hospitals to close.
The Philadelphia Inquirer February 6, 2009 Friday Letters to the Editor EDITORIAL; Inq Opinion & Editorial; Pg. A18
Now that Tom Daschle has withdrawn his nomination, we can consider who might be best-suited for reforming our health-care system. The task is daunting.
More than 47 million Americans are uninsured; millions are losing jobs and unable to afford COBRA insurance. Many others are underinsured.
Other nations rank above us in the quality of health care, yet we spend more. Hospitals
are closing because of the costs to care for the
uninsured. We have a shortage of nurses and primary-care physicians.
So, whom shall we choose? A lawyer or a politician? How about an economist? A banker? I hope President Obama chooses a doctor.
The first rule of Project Mayhem is that you do not ask questions.
27
SCFI 2009
Immigration Health Aff
Project Mayhem
___ of ___
Inherency – Hospitals
Hospitals are so overburdened that they are repatriating noncitizens.
Adrianne Ortega, 2009 (J.D. Boston U, M.P.H. Boston U School of Public Health. “. . . And Health Care For All: Immigrants in the Shadow of the Promise of
Universal Health Care.” 35 Am. J. L. and Med. 185//ZE)
Federal legislation creates a heavy burden on hospitals which then transfer social costs to the state. n96 Hospitals
often treat non-citizen patients after stabilization in the emergency room while arranging an appropriate discharge. n97
Hospitals largely absorb the cost of this expensive treatment. n98 A recent survey estimated that hospitals are collectively
spending about $ 2 billion a year in unpaid medical expenses to treat undocumented [*196] immigrants. n99 One hospital
spent $ 1.5 million on one patient alone. n100 Sixty California hospitals were forced to close between 1993 and 2003 due to outstanding bills for services
rendered. n101 400 emergency rooms closed between 1993 and 1998, and after the enactment of EMTALA, one of six trauma centers decertified. n102 In 2008,
the California Medicaid program spent an estimated $ 20 million on about 460 patients. n103 In a New York City public nursing home, undocumented immigrants
occupy roughly one fifth of 1,389 beds. n104 Hospitals transfer these financial burdens to the states in the form of social costs.
n105 For example, if a hospital in an urban area must close for financial reasons, the individuals served by that hospital must seek treatment at other local
hospitals. As one hospital administrator put it, "We're unable to provide adequate care for our own citizens . . . . A full bed is a full bed." n106 Closures, therefore,
affect those in surrounding areas with insurance and become a social problem for the state. n107 The high cost of treating non-citizens after
emergencies leads hospitals to go to great lengths to get rid of expensive, undocumented patients. n108 A recent New York
Times article, Immigrants Facing Deportation by U.S. Hospitals, details the process by which United States hospitals are "repatriating the sick."
n109 Tactics include flying or driving undocumented patients back to their country of origin. n110 Once a hospital
repatriates a patient, the patient "is out of sight . . . out of mind" and the hospital fails to follow-up with the patient. n111
Startling statistics revealed in the article include: Some 96 immigrants a year repatriated by St. Joseph's Hospital in Phoenix; 6 to 8 patients a year flown to
their homelands from Broward General Medical Center in Fort Lauderdale, Fla.; 10 returned to Honduras from Chicago hospitals since early 2007; some 87
medical cases involving Mexican immigrants -- and 265 involving people injured crossing the border -- handled by the Mexican consulate in San Diego last year,
most but not all of which ended in repatriation. n112 [*197] Some label this type of international patient dumping a "death sentence," because most home
countries lack the facilities to treat the patients' often complex diagnoses. n113 For example, a Phoenix hospital repatriated an uninsured farm worker, Antonio
Torres, to Mexico when he was comatose and connected to a ventilator. n114 "For days, Torres languished in a busy emergency room . . . but his parents . . .
found a hospital in California willing to treat him, loaded him in a donated ambulance, and drove him back to the United States as a potentially deadly infection
raged through his system." n115 Antonio recovered and leads a healthy life today in Phoenix. n116 The hospital, St. Joseph's in Phoenix, repatriates six to eight
patients per year. n117 The Vice-President of Scottsdale Healthcare in Arizona explained his view of the situation: Somebody falls out of a walnut tree. They
show up in our Trauma One center. We don't have any problem with treating or stabilizing them. It's the humane thing to do. That's not where the costs run up.
The costs run up after they're moved out of the trauma unit into a regular bed. Nobody, no nursing home, wants to take
them . . . . n118 The hospital that willingly admitted Antonio, El Centro Regional Medical Center in California, said "it never sends an immigrant over the
border. 'We don't export patients . . . I can understand the frustrations of other hospitals but the flip side is the human being element.'" n119 These
repatriation practices are largely unregulated by state or federal law. n120
The first rule of Project Mayhem is that you do not ask questions.
28
SCFI 2009
Immigration Health Aff
Project Mayhem
___ of ___
Inherency – States Failing
Of the few states that have care for immigrants, many are cutting it.
Anna Gorman
2008 L.A. Times
Forced to slash their budgets, some California counties
are eliminating nonemergency health services for illegal immigrants -- a
move that officials acknowledge could backfire by shifting the financial burden to emergency rooms. Sacramento County voted in
February to bar illegal immigrants from county clinics at an estimated savings of $2.4 million. Contra Costa County followed last month by cutting off undocumented adults, to save approximately $6 million. And Yolo
County is voting on a similar change next month, which would reduce costs by $1.2 million."This is a way for us to get through what I think is a horrible year for healthcare in California," said William Walker, director
illegal immigrants are living here but without federal or state
funding to provide essential medical services to them. Walker, who began his medical career treating undocumented farmworkers, said that
deciding to cut their services was difficult."This is the community of people we have all relied upon for decades, providing work
not only in construction but in service and child care," he said. "We all live and work here together."Trend could spread as the recession continues,
of Contra Costa Health Services. Walker said the national ambivalence on immigration policy means that
property tax revenue decreases and the number of newly uninsured patients increases, other county health departments in California and the nation may make similar changes, said Robert Pestronk, executive director of the National Assn. of County and City
Health Officials."Communities are having to make excruciating decisions about the services they fund," he said. But Pestronk said that shifting costs isn't the answer."This is a balloon that just expands," he said. "If you squeeze it in one place, it's just going to
expand somewhere else."John Schunhoff, Los Angeles County's interim health services department director, said there is no plan to eliminate health services to the county's illegal residents, despite significant projected deficits and concern about further cuts
Eliminating illegal immigrants from health services may enable counties to balance their budgets this year but
won't solve the problem in the long term, said David Hayes-Bautista, professor of medicine and director of UCLA's Center for the Study of Latino Health and Culture."We are mortgaging the future to scrape through the present,"
in state funding.
he said. And study after study shows that illegal immigrants are less likely than U.S.-born residents to go to the doctor or seek regular medical care, he said. Anti-illegal immigration activist Barbara Coe said she was thrilled that counties are beginning to
restrict services. Coe's group, California Coalition for Immigration Reform, sponsored Proposition 187, the initiative that tried to bar the state from providing public services to illegal immigrants before it died in federal court. Illegal immigrants "have absolutely
no right, No. 1, to be here and, No. 2, to take the tax dollars of law-abiding American taxpayers for anything," she said. But the policy changes have angered immigrant rights advocates, who argue that restrictions could also cause a chilling effect on legal
residents and U.S. citizens in mixed-status families."Even those people who qualify to get care won't," said Reshma Shamasunder, director of the California Immigrant Policy Center. Shamasunder also said that denying healthcare to one segment of the
population puts everyone else at risk as communicable diseases go untreated and emergency rooms become even more crowded. Jose Suarez, who has asthma, said he now plans to go to the hospital if he gets sick. Suarez, 25, was born in Mexico but has
been living in Contra Costa County for 10 years."It's unfair," he said. "We are real people. I understand they have to cut a few things here and there, but I believe they can do better."Marina Espinoza, also an illegal immigrant in Contra Costa County, said she
visits a county clinic a few times a month to monitor her diabetes and high blood pressure so that she doesn't end up in the hospital. Espinoza is considering returning to Mexico, where a relative has a lead on a job with health insurance."None of us choose to
get sick," said Espinoza, 39. "I can't afford the medications. How can I pay for that? It's that or rent."Before changing its policy on illegal immigrants, Sacramento County took several other steps to reduce healthcare costs, including closing three of its six
clinics. But that wasn't enough, said Keith Andrews, chief of primary health services in the Department of Health and Human Services. Andrews said he was left with a choice between firing staff or reducing the number of patients. The county is continuing to
treat everyone for communicable diseases. Andrews said about 4,000 people without legal residency or citizenship were receiving healthcare in the county. Although some are immigrants who have lived and worked in the area for years, he said, others are
foreign natives who came to the county to receive free medical treatment."This decision is going to impact all of our community," he said. "It's going to create other social problems because of the impact on emergency rooms."In Contra Costa County, which
will continue treating undocumented children and pregnant women, community groups mobilized against the proposal. They helped persuade county officials to allocate additional funds to the nonprofit community clinics to help treat the 5,500 undocumented
patients who will no longer be eligible for county services. Those patients will receive primary care at the clinics, but they won't have a place to go if they need to see a specialist, such as for cancer or heart problems."It's a major gap," said Soren Tjernell of
the Community Clinic Consortium, which represents clinics in Contra Costa and Solano counties. Yolo County's proposal, which goes before its Board of Supervisors on May 5, would affect about 1,200 undocumented patients. Joseph Iser, who heads the
county health department, said he wished that he had another source of revenue to continue services for illegal immigrants."Except by helping us balance the budget, it doesn't help us, it doesn't help our citizens, it doesn't help our undocumented," he said.
"But if we don't have the money, we just can't afford it."
More and more state legislatures are cutting non-emergency cares for immigrants
By Daniel B. Wood | Staff writer of The Christian Science Monitor The Christian Science Monitor
2009
Now, with revenues falling well short of predictions, services to undocumented immigrants are getting the ax in an effort to preserve other programs, from infrastructure to schools to the
environment. The cutbacks could potentially refire the debate over providing social services such as healthcare for illegal immigrants. In 2007, several state legislatures
introduced bills that sought to limit social service benefits including healthcare to illegal immigrants. An LA Times/Bloomberg survey in December 2007 found that one in three
Americans wanted to deny social services, including public schooling and emergency-room healthcare, to illegal immigrants. In California, two counties are
pulling back on
health services for illegal immigrants. Sacramento County closed two health clinics that serve the poor and ended services
with various mental health contractors. In early February, saving nearly $6 million in an effort to close a $55 million general fund shortfall.In Contra Costa
County, a proposed plan would screen out illegal immigrants - except for children and pregnant women - from nonemergency healthcare
services that are provided to low-income residents who cannot get insurance. The county is looking at cutting
services to an estimated 5,500 illegal immigrants they serve annually, to tally a savings of $6 million."The pressure is purely economic," says Dorothy
Sansoe, senior deputy county administrator for Contra Costa County. Her county has already cut $90 million from its general purpose budget and has to cut another $56 million by July 1."Here, many hospitals are
cutting services and staff just to survive," says Randy Ertll, who has served on the board of several Los Angeles County hospitals and is now Executive Director of the El Centro de Accion Social, or Center for Social
Action, a nonprofit agency that promotes cultural understanding in Pasadena.The issue is not just one of documented vs. undocumented immigrants, he says, but one of affordability in an economy where more and
more people are losing their jobs and often their insurance, too."Even many US citizens can't afford health insurance in the current recession
The first rule of Project Mayhem is that you do not ask questions.
29
SCFI 2009
Immigration Health Aff
Project Mayhem
___ of ___
Inherency – States Failing
Facing rejection of funds from the federal government, State Medicaid programs
struggle with immigrant patients waiting until crisis level to treat them
Janet M. Calvo 08; Professor, City University School of Law. Many thanks for the comments of Ruthann Robson and Andrea McArdle, the research
assistance of Johan Bysainnthe, and the typing assistance of Rosa Navarra. Loyola University Chicago School of Law, Beazley Institute for Health Law and
Policy Annals of Health Law; The Consequences of Restricted Health Care Access for Immigrants: Lessons from Medicaid and SCHIP; L/N
D. Conflicts Between State and Federal Authorities
The definition of emergency medical condition under Medicaid has been an area of contention not only in the courts, but also between state and federal
authorities. n112 Frequently, the controversy revolves around whether a person in need of medical care is eligible and can obtain the care. However, the source
of funding also contributes to this controversy. Hospitals and providers, confronted with what they view as an emergency, have
legal and ethical obligations to expeditiously provide and continue necessary medical care. n113 Further, they may
provide the care with an understanding that the person is Medicaid eligible, but then must confront whether
government officials will agree with their assessment of what constitutes appropriate treatment of an emergency
medical condition. State Medicaid programs decide whether the provider of health services will be reimbursed for the
health care provided to patients claiming Medicaid eligibility. n114 States, particularly those with significant immigrant
populations, face federal rejection of their determinations, subjecting them to loss of federal dollars for
reimbursement of Medicaid expenses. n115 New York is one such state that had to fight for federal reimbursement for medical services rendered
to Medicaid eligible patients. After a federal audit, the Federal Center for Medicaid Services challenged determinations made by the state of New York. n116
Because of the audit, New York will not receive millions of dollars in federal reimbursement for Medicaid expenses. n117 More specifically, one chief source of
conflict between state and federal governments concerns whether the provision of chemotherapy can be considered emergency care. n118 New York State
takes the position that what constitutes an emergency is a factual issue that should be determined by treating doctors who must submit written certifications
stating that the treatment provided is for an emergency medical condition. n119 Further, state officials assert that chemotherapy can cure and control cancer and
thus, functions as treatment for an emergency medical condition. n120 [*191] E. Further Adverse Consequences The conflicts and cases described above
demonstrate the negative consequences that result from the failure to define an emergency medical condition in the context of the realities of health care.
However, there are additional adverse and detrimental effects that result. For instance, the discourse regarding the term's meaning takes time away from actually
responding to medical conditions. Moreover,
it puts medical judgment and good medical practice at odds with the applicable
legal standard. Consequently, medical providers cannot meet their ethical obligations nor act in accord with the
standard required to avoid medical malpractice if the law compels them to engage in the "Russian roulette" approach
to treatment by consistently withdrawing treatment until a patient reaches a crisis level or discharging a patient
without an appropriate treatment plan. Hospitals and doctors are obligated to pursue certain courses of action. To illustrate, hospitals must have
adequate discharge plans for patients to meet legal and accreditation standards. n121 Physicians have a duty of continuous care and can be liable for patient
abandonment or lack of due diligence in caring for a patient. n122 The duty of continued care is not dependent on the patient's ability to pay for the care. n123
Further, the duty of continued care may be breached by premature discharge from a hospital or termination of treatment. n124 Once a physician undertakes
treatment, ordinary skill and care is necessary to determine when to discontinue treatment. n125 Thus, it is imperative that physicians maintain the ability to
determine the type of care needed by their patients. As illustrated above, the current healthcare system fails to provide adequate treatment for many patients.
This egregious condition of the system is further negatively impacted when noncitizens are added to the equation. For example, limiting health care for
noncitizens to emergencies leads to inappropriate and more costly care in addition to the unnecessary escalation of
diseases and conditions to dangerous levels. While emergency care is most often provided in hospitals, medical care
can be less costly when patients are treated at an earlier stage of an illness or condition in an outpatient setting. n126
In situations [*192] where emergency care is unavoidable, a patient is often admitted to the hospital for continuation of acute care. Acute care facilities are
designed to provide limited care and therefore seek to transfer patients to other, more appropriate treatment facilities or wards when there is a need for
continuation of health care. However, medical providers cannot release patients until they are placed in a setting appropriate to their health care needs. n127
Lack of access to alternative appropriate care leads to inappropriate and more costly continuation of acute care. This results in inefficient use of scarce medical
resources and subjects patients to unnecessary health risks in acute care facilities, such as infections. n128 This then results in additional illnesses, with their
attendant costs. n129
The first rule of Project Mayhem is that you do not ask questions.
30
SCFI 2009
Immigration Health Aff
Project Mayhem
___ of ___
Inherency – States Failing
Illegal Immigrants are high cost to states; but we have a moral obligation to keep them healthy
GEORGE SKELTON; February 2, 2009 Monday; Los Angeles Times; Capitol Journal; Immigration a factor in budget
math Metro Desk; Part B; Pg. 1; Sacramento L/N
Based on my e-mail, a lot of folks think the solution to California's state budget deficit is to round up all the illegal immigrants and
truck them down to Mexico. Wrong. Even if it were logistically possible and the deportees didn't just climb off the truck and hitch
another ride back up north, their absence from the state wouldn't come close to saving enough tax dollars to balance a budget that
has a $42-billion hole projected over the next 17 months. Painful cuts in education, healthcare and social service programs still
would be needed. Sharp tax increases would be required. That said, let's be honest: Illegal immigration does cost California
taxpayers a substantial wad, undeniably into the billions. But it hasn't been PC for officeholders to talk about this for years, ever
since Gov. Pete Wilson broke his pick waging an aggressive campaign for Proposition 187. That 1994 ballot initiative sought to bar
illegal immigrants from most public services, including education. Voters approved the measure overwhelmingly, but it was tossed
out by the courts. Wilson was demonized by Democrats within the Latino community. And many think the Republican Party never
has recovered among this rapidly growing slice of the electorate. So it's not a topic that comes easily to the tongues of politicians,
even Republicans. Besides, most of the policy issues are out of California's hands. The federal government has jurisdiction over the
border. Federal law decrees that every child is entitled to attend public school, regardless of immigration status. And
every person -- here illegally or not -- must be cared for in hospital emergency rooms. But the state does add a few
benefits that aren't required. And as Gov. Arnold Schwarzenegger and legislative leaders dig into the books trying to find billions in
savings, at least a brief look at what's being spent on illegal immigrants seems in order. First, nobody seems to know exactly.
Numbers vary widely, depending which side they come from in the ongoing angry debate over whether people who entered the
country illegally to work should be allowed to stay or loaded on the southbound truck. But here are some no-agenda numbers: There
were 2.8 million illegal immigrants living in California in 2006, the last year for which there are relatively good figures, according to
the nonpartisan Public Policy Institute of California. That represented about 8% of the state's population and roughly a quarter of the
nation's illegal immigrants. About 90% of California's illegal immigrants were from Latin America; 65% from Mexico. There are
roughly 19,000 illegal immigrants in state prisons, representing 11% of all inmates. That's costing $970 million during the current
fiscal year. The feds kick in a measly $111 million, leaving the state with an $859 million tab. Schools are the toughest to calculate.
Administrators don't ask kids about citizenship status. Anyway, many children of illegal immigrants were born in this country and
automatically became U.S. citizens. If you figure that the children of illegal immigrants attending K-12 schools approximates the
proportion of illegal immigrants in the population, the bill currently comes to roughly $4 billion. Most is state money; some local
property taxes. Illegal immigrants aren't entitled to welfare, called CalWORKs. But their citizen children are. Roughly 190,000 kids
are receiving welfare checks that pass through their parents. The cost: about $500 million, according to the nonpartisan Legislative
Analyst's Office. Schwarzenegger has proposed removing these children from the welfare rolls after five years. It's part of a broader
proposal to also boot off, after five years, the children of U.S. citizens who aren't meeting federal work requirements. There'd be a
combined savings of $522 million. The state is spending $775 million on Medi-Cal healthcare for illegal immigrants,
according to the legislative analyst. Of that, $642 million goes into direct benefits. Practically all the rest is paid to
counties to administer the program. The feds generally match the state dollar-for-dollar on mandatory programs. Socalled emergency services are the biggest state cost: $536 million. Prenatal care is $59 million. Not counted in the
overall total is the cost of baby delivery -- $108 million -- because the newborns aren't illegal immigrants. The state also
pays $47 million for programs that Washington does not require: Non-emergency care (breast and cervical cancer treatment), $25
million; long-term nursing home care, $19 million; abortions, $3 million. Schwarzenegger has proposed requiring illegal immigrants
to requalify every month for Medi-Cal benefits, except pregnancy-related emergencies. There also are other taxpayer costs -especially through local governments -- but those are the biggies for the state. Add them all up and the state spends well over $5
billion a year on illegal immigrants and their families. Of course, illegal immigrants do pay state taxes. But no way do they pay
enough to replenish what they're drawing in services. Their main revenue contribution would be the sales tax, but they can't afford to
be big consumers, and food and prescription drugs are exempt. My view is this: These
people are here illegally and shouldn't
be, regardless of whether they're just looking for a better life. Do it the legal way. And enforce the law against hiring
the undocumented. On the other hand, they are here. We can't have uneducated kids and unhealthy people living with
us. We have moral obligations and practical imperatives. The Obama administration and Congress need to finally
pass an immigration reform act that allows for an agriculture work program and a route to citizenship. Meanwhile, California
should be honest about the costs. Illegal immigrants are not the sole cause of the state's deficit. But they are a drain.
The first rule of Project Mayhem is that you do not ask questions.
31
SCFI 2009
Immigration Health Aff
Project Mayhem
___ of ___
Inherency – No Services
Immigrants do not use vast amounts of money through healthcare
Michael
Conlon 2009 Mike Conlon, partner-in-charge of Fulbright & Jaworski L.L.P.'s Houston office and Co-Head of our Corporations
Illegal Latino immigrants do not cause a drag on the U.S. health care system as some critics have contended and in fact get less care
than Latinos in the country legally, researchers said on Monday. Such immigrants tend not to have a regular doctor or other health-care
provider yet do not visit emergency rooms -- often a last resort in such cases -- with any more frequency than Latinos born in the United States, according to the
report from the University of California's School of Public Health. The finding from Alexander Ortega and colleagues at the school was based on a 2003
telephone survey of thousands of California residents, including 1,317 undocumented Mexicans, 2,851 citizens with Mexican immigrant parents, 271
undocumented Latinos from countries other than Mexico and 852 non-Mexican Latinos born in the United States. About 8.4 million of the 10.3 million illegal
aliens in the United States are Latino, of which 5.9 million are from Mexico, the report said. "One recurrent theme in the debate over immigration has been the
use of public services, including health care," Ortega's team wrote in the Archives of Internal Medicine. "Proponents of restrictive policies have argued that
immigrants overuse services, placing an unreasonable burden on the public. Despite a scarcity of well-designed research ... use of resources continues to be a
part of the public debate," they said. The researchers said illegal Mexican immigrants had 1.6 fewer visits to doctors over the course of a year than people born in
the country to Mexican immigrants. Other undocumented Latinos had 2.1 fewer physician visits than their U.S.-born counterparts, they said. "There are low
rates of use of health-care services by Mexican immigrants and similar trends among other Latinos do not support public concern about
immigrants' overuse of the health care system," the researchers wrote. "Undocumented individuals demonstrate less use of health care than U.S.-born citizens
and have more negative experiences with the health care that they have received," they said.
Uninsured illegal immigrants cannot afford preventive medical treatment, which
causes them to suffer from preventable diseases
Lebedinski 05(Wayne State University The Journal of Law in Society Fall, 2005 7 J.L. Soc'y 146 LENGTH: 15709 words EMTALA: TREATMENT OF
UNDOCUMENTED ALIENS AND THE FINANCIAL BURDEN IT PLACES ON HOSPITALS NAME: Svetlana Lebedinski)
An "undocumented alien" is a person of foreign origin who comes to the United States illegally, i.e. without authorization, or stays in the United States on an
expired visa. n75 Each year 1 to 1.5 million illegal aliens enter the United States. n76 The majority of the illegal population comes from
Central America, primarily Mexico. "Poverty, high unemployment, and overpopulation are the three main reasons that drive immigration, both legal and illegal,
because aliens can usually receive higher wages in the United States." n77 Where wages are higher for illegal aliens in comparison to
what they could earn at home, they are below the poverty level according to U.S. standards, and purchasing any type
of health insurance never enters the mind of an illegal immigrant. Paying out-of-pocket for preventative medical care
is unrealistic. Illegal immigrants have other, more important financial demands; the most important being providing financial support
to their family back home. Oftentimes, they live in extremely poor and unsanitary conditions in the U.S., in order to save and send money to their families.
Undocumented Aliens – Uninsured Some of the uninsured members of the population are illegal aliens with main concentrations in the states of New York,
Texas, Arizona and California. n78 Those states [*159] have long been voicing commentaries and opinions that undocumented aliens pose a real threat to the
healthcare systems. Major research has been done in those states and financial assistance programs have been used there as well. For example, Arizona
hospitals spend more than $ 91 million annually on medical care for undocumented aliens. n79 "In some instances, the provision of this care has forced Arizona
hospitals to 'reduce staffing, increase rates, and cut back services.' As a result, these costs are crippling the ability of Arizona hospitals to remain financially
viable and still provide quality emergency medical care to everyone in their community." n80 "Undocumented" alien is a term of art that can mean one of two
things. First, an individual entering the United States illegally and second, entering legally but subsequently violating the terms of his or her stay. n81 Some may
remain in the United States for a brief time and others may stay here indefinitely. n82 Two federal entitlement programs, Medicaid
and Medicare, are
available to the indigent, elderly, and disabled. n83 These two programs are not available to undocumented aliens. One other source of funding
may be available for an undocumented alien under the Hill-Burton Act. n84 To qualify under this Act and to become eligible for uncompensated non-emergency
care, an alien must reside in the United States for at least three months. n85 Under EMTALA, undocumented aliens are entitled to medical emergency care
regardless of how long they have been residing in the United States. "Despite the presumed presence of a large number of undocumented aliens in the United
States and the costs attributed to their utilization of health care services, little is actually known about their need for health care and their utilization of health care
services. Much of what we believe we know is unfortunately based on observation and inference, rather than systematic research." n86 A large portion of
undocumented aliens are migrant workers, mostly situated in California and the southern part of the country. n87 The uninsured,
and especially
aliens, are less likely to receive preventative, prenatal or other non-emergency medical care. n88 Thus, illegal aliens
are often in need of [*160] urgent care for illnesses that could have been effectively prevented. "The lack of health care benefits
and income to treat acute health conditions ultimately may lead to a chronic health condition and a subsequent, further decline in income." n89 Also, the lack of
legal status and a fear of deportation prevent illegal aliens from seeking or receiving non-emergency care. n90
The first rule of Project Mayhem is that you do not ask questions.
32
SCFI 2009
Immigration Health Aff
Project Mayhem
___ of ___
Inherency – No Services
President Obama’s healthcare reform bill prohibits illegal immigrants from receiving
healthcare.
Cover 09
House and Senate Health Reform Bills Prohibit Subsidies to Illegal AliensTuesday, June 23, 2009Matt Cover (CNSNews.com) –
Both the House and Senate versions of President Obama’s health care reform plans contain passages explicitly
excluding illegal immigrants from receiving federal money to purchase health insurance from either a private or
government-run health plan.
Coming on the eve of a White House summit on immigration, the provisions would mean that some of the 46 million uninsured people
living in the U.S. would be legally barred from benefiting from Obama’s government-led restructuring of the American
healthcare system.
Obama, who pledged on Friday to tackle immigration reform, will host senators and congressmen at the White House Thursday to discuss possibilities for a
reform bill.
The House bill, introduced simultaneously Friday in the House Education and Labor, Energy and Commerce, and Ways and Means committees,
specifically prohibits illegal aliens from receiving government subsidies to purchase health insurance through a
national insurance exchange.
“Nothing in this subtitle shall allow Federal payments for affordability credits on behalf of individuals who are not
lawfully present in the United States,” the draft bill reads.
This means that insurance may not ask the government for subsidies if they choose to offer coverage to an illegal
alien.
Under the system proposed by the House, private insurers offering plans in the exchange would receive federal subsidies if they allow people to buy insurance
they cannot afford, so long as those customers fall below a certain income level, no more than 400 percent of the federal poverty level.
The first rule of Project Mayhem is that you do not ask questions.
33
SCFI 2009
Immigration Health Aff
Project Mayhem
___ of ___
Inherency – Immigration Increasing
There are 11.9 million illegal immigrants currently living in the US.
THE WASHINGTON TIMES 08 October 9, 2008 Thursday
In addition, tightened enforcement measures have discouraged illegal immigrants from staying in the United States. Still, border enforcement, workplace
crackdowns, the
numbers.
threat of deportation and greater social awareness have not worked alone to push down illegal alien
The Pew Hispanic Center said that the unemployment rate among Hispanics had risen to 7.5 percent during the first quarter of 2008. There are
an
estimated 11.9 million illegal aliens living in America and 7 million of them are from Mexico, according to the Center; or 56
percent of non-citizen households are Hispanic. Moreover, the annual median income of all U.S. family households increased 1.3 percent while non citizen
households decreased by 7.3 percent from 2006-07.
Communities have also become aware of the fact that illegal immigrants do not simply provide cheap labor. The cost of them living here burdens local
communities - their schools, roads, hospitals, etc. So, even if businesses and households that employ illegal aliens pay them salaries commensurate for a
measurable standard of, say, housing, the bottomline is that local communities must bare the costs of everything else, as the president of Federation for
American Immigration Reform (FAIR) told The Washington Times editorial board. This is a notable fact during an election year. "Politicans should take amnesty
off the table completely if they want to find a solution and start talking about real solutions to America's immigration crisis," FAIR's Mr. Stein said.
Illegal immigrants make up more than 20% of the uninsured
Joe Carlson 2008 L O S A L A M O S N A T I O N A L L A B O R A T O R Y Operated by the University of California
As Congress considers different reform proposals, one sizable group of the uninsured appears destined to remain outside the reform conversation no matter
what plan becomes law. Illegal immigrants make up a large share of the people living in the U.S. without health insurance,
and a large share of the associated costs of treating the uninsured. Yet care for illegal immigrants is not likely to be a part
of a health reform package. The Pew Hispanic Center, a think tank funded by the nonpartisan Pew Charitable Trusts, reports that
illegal immigrants accounted for 17% of the 45.7 million people in the U.S. without health insurance in 2007. Those
immigrants' children, some of whom were born in the U.S., represent another 4% of the pool of uninsured residents. Although researchers at the RAND Corp. have
found that undocumented immigrants tend to use healthcare services at lower rates than the insured population, immigration critics like the Federation for American Immigration Reform say they tend to use costly
emergency care more often and have worse outcomes because of a lack of preventive and follow-up care. Yet dealing head-on with unauthorized immigrants' financial impact on the healthcare system appears
politically untenable. An aide to Senate Finance Committee Chairman Max Baucus (D-Mont.) reiterated the senator's stated position that ``healthcare reform is not the place for immigration reform.'' He added that
reform will minimize only ``a large part of the problem'' of uncompensated care. Those who provide healthcare to the uninsured are urging congressional leaders to begin talking in real terms about what illegal
immigrants cost and how to pay for their care. ``We will continue to lobby to make sure there is funding for coverage of undocumented immigrants. But I think we know that's a pretty heavy lift,'' Catholic Health
Association Senior Director of Public Policy Kathy Curran said at a legislative June 8 update during the group's annual assembly in New Orleans. When an uninsured illegal immigrant walks into an emergency room
in Texas needing care, no one typically asks to see a green card. But Texas Hospital Association policy analyst Ernie Schmid said the process of gathering information such as Social Security numbers can reveal
their status as an undocumented immigrant. And then? ``We go ahead and take care of them,'' Schmid said. Texas funds much of its immigrant population care with disproportionate-share hospital funds, which are
potentially on the chopping block in Washington. ``I'm a little upset that Congress has not recognized that there are a lot of people who don't fit into the traditional insurance model,'' Schmid said. ``We are going to
take care of them. So figure out a mechanism to pay for it. It's not that hard to do.''
The first rule of Project Mayhem is that you do not ask questions.
34
SCFI 2009
Immigration Health Aff
Project Mayhem
___ of ___
Inherency – Immigration Increasing
Immigrants account for a large sum of the uninsured
The American Resistance 2004
There are over 300,000 estimated anchor babies born to illegal alien mothers each year in the U.S. - babies who automatically
attain citizenship. Illegal alien mothers now add more to U.S. population each year than immigration from all sources in an average year before
1965. FAIR estimates "there are currently between 287,000 and 363,000 children born to illegal aliens each year. In 1994, California paid
for 74,987 deliveries to illegal alien mothers, at a total cost of $215.2 million (an average of $2,842 per delivery ). Illegal alien mothers accounted for 36 percent of all
Medi-Cal funded births in California that year." In a recent year in Colorado, the state's emergency Medicaid program paid an estimated $30 million in hospital and
physician delivery costs for about 6,000 illegal immigrant mothers - average of $5,000 per baby. Those 6,000 births to illegal aliens represent 40% of the births paid for by Medicaid in
Colorado. Those 6,000 babies immediately became U.S. citizens and qualified for full Medicaid services, with a cost yet to be tabulated. The federal Emergency Medical Treatment and Active Labor Act
(EMTALA) mandates that U.S. hospitals with emergency-room services must treat anyone who requires care, including illegal aliens. Medical service for Americans in affected communities is being severely
damaged as hospitals absorb more than $200 million in unreimbursed costs. Some emergency rooms have shut down because they cannot afford to stay open. Local tax-paying Americans are either denied medical
care or have to wait in long lines for service as the illegals flood the facilities. In California, the losses are calculated to be about $79 million, with $74 million in Texas, $31 million in Arizona, and $6 million in New
Mexico. These costs are staggering. The Cochise County, Arizona Health Department spends as much as 30 percent of its annual $9 million budget on illegal aliens. The Copper Queen Hospital in Bisbee, Arizona,
has spent $200,000 in uncompensated services out of a net operating budget of $300,000. The University Medical Center in Tucson may lose as much as $10 million and the Good Samaritan Regional Medical
Center, also in Tucson, has lost $1 million in the first quarter of fiscal 2002. The Gwinnett, Georgia, Hospital System expects has established a $34 million reserve to cover its anticipated outlay for illegal aliens in
2003. Los Angeles Times columnist Ronald Brownstein wrote in his December 30, 2003 column that the 'Health-Care Storm Brewing in California Threatens to Swamp U.S... the impending Medicaid disaster is not a
problem the states can handle alone; their budget shortfalls are too big.' "The General Accounting Office traveled to southern Arizona to study the impact of illegal immigrants on Arizona and other border state
hospitals. In 2002, three hospitals located in Cochise County funded more than $1 million in uncompensated health care costs... The Florida Hospital Association surveyed 28 hospitals and found that health care for
illegal aliens totaled at least $40 million in 2002."
Illegal immigrants account for a sizeable chunk of the uninsured
Jennifer Ludden Morning Edition, July 8, 2009 ·
As Congress wrangles with overhauling the health care system, there is one population not being discussed. No proposal for a national health plan
would cover the nation's estimated 11 million illegal immigrants. This would seem like a big problem, one that could seriously undermine
the cost-savings benefit of a program that aims to be universal, but analysts say the notion that illegal immigrants drain the health
system is overblown. Simply figuring out how many undocumented immigrants lack insurance is not easy. Foreign-born noncitizens are the
fastest growing segment of those without insurance — about 20 percent of the nation's estimated 46 million uninsured
— but surveys don't ask legal status. John Sheils of the Lewin Group, a nonpartisan health care consulting firm owned by UnitedHealth Group, has looked at
numerous studies to extrapolate a best guess."We've estimated about 6.1 million of the uninsured are actually undocumented," Sheils says. That's only
about half the total population of undocumented immigrants. Sheils says many illegal immigrants use false documents to work on
the books, with regular tax deductions and benefits."A lot of those people are getting employer health benefits as part of their compensation," Sheils says. A
spokesman with America's Health Insurance Plans says it's possible that individual insurance companies could check for legal status, but employer-provided
coverage is vetted at the workplace. If a fake ID can get you a job, it can also get your family health insurance. In fact, Sheils says, this is something lawmakers
might want to consider as they craft legislation aiming for near-universal coverage. "If you design a plan improperly, you actually would wind up taking away their
insurance, creating new uninsured people," he says. But what about those illegal immigrants who, today, do not have health insurance? Six million people —
others estimate 8 million — is still a sizeable chunk. So how much health care do they use each year? "The economics aren't as great as they've been
made out to be," says Paul Fronstin of the Employee Benefit Research Institute.
The first rule of Project Mayhem is that you do not ask questions.
35
SCFI 2009
Immigration Health Aff
Project Mayhem
___ of ___
Inherency – Immigration Increasing
Around 10 million immigrants are uninsured
Ed Merritt June 17,
2009
The administration uses the “46 million uninsured” as a reason to nationalize health care. But the
Census Bureau says about a fifth of
those aren’t U.S. citizens. In fact, a goodly number are illegal aliens.At a town hall meeting in Green Bay, Wis., last week, President Obama
spoke of the need to cover the “46 million people who don’t have health insurance.” At another point he simply referred to the “46 million uninsured.” At neither
point did he refer to them as “Americans.”That was wise, because not all them are, the Census Bureau says. According to “Income, Poverty, and Health
Insurance Coverage in the United States,” a Census Bureau report published last August,
of the 45.6 million persons in the U.S. that did
not have health insurance at some point in 2007, 9.7 million, or about 21%, were not U.S. citizens. The Census Bureau does not ask
if anyone is here legally or illegally, so we can’t tell how many are actually illegal aliens. We do know that throughout the Southwest and elsewhere, emergency
rooms have been overburdened by a continuous flood of illegal aliens. Also among the uninsured are 17 million Americans who live in households where the
annual income exceeds $50,000; 7 million of those without coverage have incomes of $75,000 a year or more. The notion that the uninsured are without health
care is bogus, as well. They consumed an estimated $116 billion worth of health care in 2008, according to the advocacy group Families USA. Many of the
uninsured are young and healthy (40% are between ages 18 and 34) and at this point in their lives, particularly in this economy, choose to put their dollars
elsewhere. Subtract noncitizens and those who can afford their own insurance but choose not to purchase it, and the number of uninsured falls dramatically.
“Many Americans are uninsured by choice,” wrote Dr. David Gratzer in his book “The Cure: How Capitalism Can Save American Health Care.”Gratzer cited a
study of the “non-poor uninsured” from the California HealthCare Foundation.“Why the lack of insurance (among people who own homes and computers)?”
Gratzer asks. “One clue is that 60% reported being in excellent health or very good health.”The uninsured are not always the same people, and many are without
coverage only for a relatively short time. Devon Herrick, senior fellow with the National Center for Policy Analysis, notes that “Being uninsured is a transitory
state, since most uninsured Americans are only without coverage for a short time.”
Exact numbers are unsure but illegal aliens are a large majority of the uninsured
Jeremy Lazarus, MD Board Member, American Medical Association Aug. 4,
2008
Host Kitty Pilgrim, said: “…there are
an estimated 47 million people in this country who don't have health insurance, and as we have reported here, for
20 million illegal aliens in the United States, and that means illegal aliens likely make up 40
percent of the uninsured in this country.” (Source: CNN Transcripts) Reputable, scientific surveys show that somewhere between 15 and 22
years, there are 12 million to
percent of the uninsured are illegal immigrants, which is far less than the 40 percent reported by CNN. The U.S. Census Bureau (CPS 2006) reported that there
were 10.2 million uninsured "foreign born" individuals who were "not citizens" (i.e., 21.7% of the total 47 million uninsured). It is unclear how many of these
individuals are legally in the U.S. on visas versus illegal immigrants, so that number could be substantially lower. In addition, the Center for Immigration Studies,
a non-partisan, independent think tank, uses socio-demographic characteristics in the CPS data to estimate the size of the illegal immigrant population. The
Center for Immigration Studies estimates that 15.4% of the 47 million uninsured (7.2 million) are illegal immigrants. Health care reform is vital for all uninsured
patients living in the U.S., particularly the hard-working Americans who don’t have access to the health care they need. In fact, 8 in 10 uninsured Americans are
in working families. We encourage CNN and Lou Dobbs to correct this inaccuracy in your report.
The first rule of Project Mayhem is that you do not ask questions.
36
SCFI 2009
Immigration Health Aff
Project Mayhem
___ of ___
Inherency – Immigrant Bias
Illegal Immigrants become targets of political scapegoating.
Short and Magana 02( Robert Short, Department of Psychology Arizona State University and Lisa Magana, Chicana/Chicano
Studies Department Arizona State University
SOCIAL CONSTRUCTION THEORY (Schneider & Ingram, 1993) refers
to how groups of individuals are characterized and
the culture at large. The characterizations are akin to social stereotypes (cf. Stephan, 1986) and may possess
either positive or negative attributes. Social constructions of groups are dynamic, fluctuating with the cultural Zeitgeist, or "spirit of the times." That
theory may explain why some interest groups obtain better resources and attention from their governments, whereas other
groups are scapegoats for social problems.Theoretically, Schneider and Ingram (1993) contended that, if groups are constructed
positively and have considerable political power, then they tend to receive better resources and attention from their
governments. For instance, politicians rarely portray senior citizens negatively, and research indicates that senior citizens
are powerful constituents, primarily because they have relatively high voter turnout as a group. Logically, then,
political candidates would rally around issues of preserving or improving social security, a senior-citizen resource.
Would the same rationale predict political response to initiatives intended to reduce or take away benefits from particular groups? For instance, how
might social construction theorists explain the tendency for politicians to rally around anti-immigrant initiatives?
According to social construction theory, immigrant populations who are not naturalized and cannot vote would likely
be the targets of political scapegoating because they have little to no political power.Senior citizens tend to be both positively
constructed and to possess strong political power among politicians. Nonnaturalized immigrants, in contrast, have weak political power
and are likely to be negatively constructed (i.e., politically scapegoated for social ills). On the basis of social construction theory (Schneider &
Ingram, 1993), politicians' negative construction of immigrants for political gain without fear of losing potential voters is reasonable. For instance, by
blaming nonnaturalized immigrants for community problems, elected officials can avoid accountability for poor
service delivery. Public officials are aware of the power of positively or negatively constructing groups and can
manipulate who is the winner or loser of resources. In other words, by constructing groups in a particular light, politicians can link their "logical
perceived by
connections" to their own agendas, such as being elected to office (Schneider & Ingram, 1993).Psychologically, the implications grow exponentially in complexity
when they involve racial groups that are related importantly to salient social phenomena. For instance, when racial categories become
intertwined with political initiatives (e.g., affirmative action, immigration) favoring or opposing the political initiatives
themselves can become opportunities for people to discriminate against particular populations without being socially
reprimanded and accused of bigotry (cf. Dovidio & Gaertner, 1996; Sears, 1988). One can hide one's true attitudes about racial groups by
championing political initiatives that appeal to universal abstract principles such as justice, egalitarianism, and equity.
Congress is Politically Biased Against Illegal Immigrants.
Franzia 09 (Manuel-Roig Franzia, Washington Post Foreign Service, LEXIS NEXIS,)
Immigration has emerged as a hot-button issue in the 2008 presidential contest, consistently ranking high on the list of voter
concerns and figuring prominently in debates. Immigration also tops a list of issues that voters in the Jan. 3 Iowa caucuses want candidates to address,
according to a CBS-New York Times poll released Tuesday. And 44 percent of caucus-goers want illegal immigrants to lose their jobs
and leave the country, the poll said. A poll by the Pew Research Center for the People and the Press released two weeks ago found that 65 percent
of Republican voters and 50 percent of Democratic voters ranked illegal immigration as a "very important" issue. Republican candidate Fred
Thompson has proposed taking federal grant money from so-called sanctuary cities in the United States that do not
report illegal immigrants to the federal government. Rep. Tom Tancredo (R-Colo.) has run television ads saying
migrants cross the border "to take our jobs."The potency of the immigration issue has been highlighted by the furor over Sen.Hillary Rodham
Clinton (D-N.Y.) speaking favorably about a plan to grant driver's licenses to illegal immigrants in New York state. Some analysts have said Clinton's recent drop
in the polls was caused in part by her comments about the license plan, which was dropped Wednesday by Democratic Gov. Eliot L. Spitzer of New York.
The first rule of Project Mayhem is that you do not ask questions.
37
SCFI 2009
Immigration Health Aff
Project Mayhem
___ of ___
Inherency – SCHIP
Obama intends to fund SCHIP with increased tobacco taxes, but the current decline in smoking will
leave the rest of America to foot the bill.
Hair 09
Completely separate from finding some magical source of funding for President-elect Barack Obama’s upcoming trillion-dollar spending bill that Democrats are
trying to disguise as a “stimulus” package, the massive SCHIP bill will clearly require considerable tax increases. Democrats
have left the program underfunded, and passage would require a substantial tax increase.
Rep. Dave Camp (R-Mich.), Republican ranking member on the House Ways & Means Committee, told me in an e-mail, “Shifting the focus away from poor
children is bad enough. Playing a shell game with the program’s funding and forcing every American to soon pay higher taxes just adds insult to injury.”
Republican staffers tell HUMAN EVENTS that the extent of the success of a serious effort by some Democrats to further enlarge the scope of the SCHIP
program -- thereby allowing them to gain a foothold in their attempt to quickly socialize medicine -- remains to be thoroughly assessed when the entire bill is
finally made available to all Republican members, hopefully before they’re asked to vote on it today. The
bill has been constructed by Democrats
behind closed doors with little or no time afforded Republicans to scrutinize the entire bill.
Democrats proposed a 61 percent tax on cigarettes in a disingenuously absurd proposal to cover the enormous cost
of the SCHIP program by increasing tobacco taxes. The main problem with this funding source is that smoking has
been on the decline for decades. According to an analysis by the Heritage Foundation, the Democrats would need to
recruit 22.4 million new smokers by 2017 to keep funding their Medicaid and SCHIP expansions. And as these
funding sources continue to decline, like any government program, SCHIP will continue to grow exponentially. In 2007,
SCHIP costs increased by 10 percent and in 2008 costs were up by18 percent.
When the decades-long trend away from smoking combined with the resulting decrease in revenue causes an enormous chasm between program spending and
the revenue stream, Democrats
will require the American taxpayer to fill that vast funding void. According to the Campaign for
Tobacco Free Kids, the working poor are hit hardest by tobacco taxes since 28.8 percent of adults below the poverty level smoke, compared to
only 20.3 percent of other adults. According to the Centers for Disease Control, other groups disproportionately likely to smoke include: adults with a GED
(46%), Native Americans (32%), adults without a high school diploma (27%), all blacks (23%), and young adults ages 18-24 (24%). In contrast, individuals with
undergraduate degrees (only 10% of whom smoke) or graduate degrees (7%) would be far less likely to be affected. Given such data, it is hard to imagine a
Smokers paying an additional 61 cents per
pack of cigarettes to finance a SCHIP expansion under the Democrat proposal would cost a working class family with
two adult smokers hundreds of dollars per year in additional federal tobacco taxes alone.
more regressive policy, disproportionately targeting such disadvantaged groups for higher taxes.
Obama isn’t doing enough now. SCHIP doesn’t meet the needs for immigrants. And if
we don’t solve for immigrant children now, they will spread diseases because they
are the most susceptible to them.
Obiajulu Nnamuchi. February 4, 2009 LL.B, LL.M, LL.M, Doctoral Candidate, Beazley Institute for Health Law & Policy, Loyola University
Chicago Law School Promises And Illusions Of The Reauthorization Of The State Children's Health Insurance Program. Internet Journal of
Law, Healthcare & Ethics; 2009, Vol. 5 Issue 2, p5-5, 1p
bill expanding the State Children's Health Insurance Program (SCHIP) by
President Barack Obama on February 4, 2009 seems to have infused new life to their long-awaited dream. The
SCHIP reauthorizing Act, twice vetoed by President George W. Bush, guarantees continued insurance coverage through 2013 to about 7
million poor children and allows additional 4 million to enroll in the program. Considering that there is an estimated 47
million uninsured in the United States, the addition might seem insubstantial, but freeing these children from the predicament associated with
For proponents of universal health care, the signing into law of the
lack of access to medical care is unquestionably a major achievement in the life of the new administration. Nonetheless, as we jubilate over the passage and signing of the bill, it would
children of legal
immigrants are ineligible to receive benefits until the expiration of five years from the date of their residence in this
country, meaning that for many of these children whose parents cannot afford private insurance, the only available
source of medical care is hospital emergency rooms. The Emergency Medical Treatment and Active Labor Act (EMTALA), passed in 1986, requires
be beneficial to caution ourselves as to what the expansion actually represents. The second concern relates to immigrant care. Under the previous law,
affected hospitals to provide appropriate care to anyone suffering from an emergency medical condition regardless of residency status or ability to pay. Long wait and overcrowding at
Experts believe that denial of
insurance to immigrant children, known to be more susceptible to illnesses and communicable diseases, constitutes
a public health blunder not only in terms of likely morbidities or mortalities in the general population but also in terms
of increased cost of treating the children. Numerous studies show that timely preventive and screening services is
more cost effective than emergency care. Moreover, with respect to children of illegal immigrants, one can easily argue that allowing them access to publicly
hospital emergency rooms throughout the nation is one of the more visible, but unintended, consequences of this "anti-dumping" statute.
funded health care is tantamount to rewarding illegality. But there is no similarly plausible argument regarding children of aliens who have been granted legal privileges to reside in this
country permanently.
The first rule of Project Mayhem is that you do not ask questions.
38
SCFI 2009
Immigration Health Aff
Project Mayhem
___ of ___
Harms – States
Hospitals are required to take care of illegal immigrants and receive no way to pay
this off thus indebting the state even more
Morgan Greenspon July 14 2009 Student, Loyola University Chicago School of Law, Class of 2009. Ms. Greenspon is a staff member of
Annals of Health Law.
In 1986, Congress enacted the Emergency Medical Treatment and Active Labor Act ("EMTALA") in an attempt to curb patient
dumping. n15 Patient dumping is the practice whereby a hospital transfers a patient to another hospital or facility, prior to stabilizing the patient, because of the patient's actual or
Congress intended EMTALA "to send a clear signal to the hospital community, public and private
alike, that all Americans, regardless of wealth or status, should know that a hospital will provide what services it can
when they are truly in physical distress." Although EMTALA requires only hospitals that receive Medicare funds to
provide emergency medical care to all persons who request it, n18 hospitals must accept federal and state sponsored health insurance [*312] programs to
maintain financial viability. n19 As a result, EMTALA has become a mandate on every hospital with an emergency department .
n20 Under EMTALA, hospitals have a duty to provide an examination to determine whether an emergency medical
condition exists whenever a person comes to an emergency department and requests medical treatment. n21 EMTALA
perceived inability to pay. n16
defines an emergency medical condition as "a medical condition manifesting itself by acute symptoms of sufficient severity (including severe pain) such that the absence of immediate
medical attention would reasonably be expected to result in placing the health of the individual ... in serious jeopardy, serious impairment to bodily functions, or serious dysfunction to
any bodily organ or part ... ." n22 If
a hospital determines an emergency medical condition exists, it must either provide medical
treatment to stabilize the patient, or in limited circumstances, transfer the individual to another facility. EMTALA's
requirement that hospitals treat any individual who presents with an emergency condition applies not only to
uninsured and indigent Americans, but also extends to undocumented immigrants. Although this ensures that
everyone in the United States will receive emergency medical assistance regardless of their financial situation,
ETMALA imposes additional challenges for hospitals already dealing with over-strained budgets.
The first rule of Project Mayhem is that you do not ask questions.
39
SCFI 2009
Immigration Health Aff
Project Mayhem
___ of ___
Harms – Hospital Costs
Because immigrants are afraid of deportation, they wait until an emergency situation
to go to the hospital. Thus costing the hospital more money and making this whole
situation worse.
Morgan Greenspon July 14 2009 Student, Loyola University Chicago School of Law, Class of 2009. Ms. Greenspon is a staff member of
Annals of Health Law.
Fear of deportation is one of the major factors that influences whether an undocumented immigrant will decide to
seek medical care. Thus, a common concern in the safety net community is that undocumented aliens will not seek medical attention until
their condition has deteriorated to the point that it becomes a medical emergency. As a result, hospitals are potentially left
uncompensated for the emergency care they are required to provide to indigent persons, which is much more
expensive than simple preventative care. EMTALA creates a financial anomaly in which hospitals can only seek
federal reimbursement for medical emergencies, and not reimbursement for less expensive preventative care. Perhaps
the best illustration of this may [*313] be the costs associated with pregnancy and childbirth. Under EMTALA, a hospital must treat a woman in labor, thereby allowing it to seek
reimbursement from Emergency Medicaid for providing this care. n27 However, EMTALA does not include any provisions for prenatal care or family planning. n28 Ironically, under
the current system, the federal government will reimburse a hospital for the much higher costs of emergency care,
but not for the low costs associated with preventive care; thus, preventing access to primary and preventative care
ultimately leads to higher health care costs. Providing early intervention and preventative care would not only make better use of the healthcare system's
scarce resources, but it is also medically preferable.
The Personal Responsibility and Work Opportunity Reconciliation Act prevents legal
and illegal immigrants from receiving Medicaid benefits and only allows for
immigrants to receive emergency treatment thus rising costs for hospitals.
Morgan Greenspon July 14 2009 Student, Loyola University Chicago School of Law, Class of 2009. Ms. Greenspon is a staff member of
Annals of Health Law.
The Personal Responsibility and Work Opportunity Reconciliation Act of 1996 prevents certain groups of legal
immigrants, and all undocumented immigrants, from receiving Medicaid benefits. n31 However, aliens who would
otherwise qualify for Medicaid, if not for their immigration status, remain eligible for Emergency Medicaid; these
undocumented aliens are entitled to receive emergency services that are necessary for the treatment of an
emergency medical condition. Thus, "the current legislation ... takes a back-end approach by providing illegal
immigrants health care access by providing emergency services." Under Emergency Medicaid, a hospital may be
compensated for providing care to undocumented aliens experiencing a medical emergency such as childbirth, labor,
or another condition that may threaten an individual's life. However, if the patient does not qualify for Emergency
Medicaid, then a hospital may go completely uncompensated. Additionally, if the federal government would help fund
preventative care, there is a good chance the overall amount of money spent on medical care for undocumented
aliens would decrease "because it is more expensive to provide emergency care than it is to take a front-end
approach by providing preventative care."
The first rule of Project Mayhem is that you do not ask questions.
40
SCFI 2009
Immigration Health Aff
Project Mayhem
___ of ___
Harms – Health
The Medicare Prescription drug, Improvement, and Modernization Act is not enough
to cover the increasing amount of immigrants. In addition the treatment the
immigrants receive is only for a very limited time, and they are often dismissed from
hospital with the existing medical condition.
Morgan Greenspon July 14 2009 Student, Loyola University Chicago School of Law, Class of 2009. Ms. Greenspon is a staff member of
Annals of Health Law.
Despite the altruistic intentions of EMTALA, hospitals are obligated to provide care to persons who cannot afford
medical treatment and who are not qualified to receive public benefits, thus leaving hospitals without compensation.
This has effectively transitioned emergency departments from a place of last resort to "the primary care provider of choice for the nation's uninsured." As a way to offset the
financial burden placed on hospitals participating in Medicare, Congress enacted section 1011 of the Medicare
Prescription Drug, Improvement, and Modernization Act of 2003 ("MMA") which sets aside $ 1 billion "in an effort to
help hospitals recoup some of their uncompensated expenses." Section 1011 reimburses hospitals for eligible
services rendered to undocumented immigrants. Coverage under Section 1011 begins simultaneously with EMTALA obligations. Thus, coverage under
Section 1011 commences when an individual presents at the hospital emergency department and requests an examination or treatment for a medical condition. Coverage
under Section 1011 continues until the individual is stabilized. In order to be considered stable, a patient's emergency
medical condition must be resolved; however, the underlying medical condition may still exist. Before the MMA, there
were no federal funds available to reimburse hospitals for emergency medical services, and hospitals were forced to
provide for undocumented, indigent patients. Under Section 1011, $ 250 million per fiscal years 2005 through 2008 is appropriated specifically to compensate
and reimburse hospitals for providing these services. n47 Two-thirds of the Section 1011 funds, or $ 167 million, is proportionally dispersed to the states based on their relative
percentages of the total number of undocumented aliens. n48 The remaining one-third, $ 83 million, is given to the six states with the largest number of undocumented alien
apprehensions for each fiscal year.
The first rule of Project Mayhem is that you do not ask questions.
41
SCFI 2009
Immigration Health Aff
Project Mayhem
___ of ___
Harms – Health
All hospitals must screen and treat patients in an emergency. If they do not treat a
patient (including undocumented immigrants) in an emergency situation, they receive
no Medicaid reimbursement for other patients.
Ortega 09 (Adrianne Ortega Boston University School of Law, 2009; M.P.H., Boston University School of Public Health, 2006; B.S., Northeastern
University, 2004. L/N)
The Emergency Medical Treatment and Active Labor Act ("EMTALA") mandates
that all hospitals screen and treat patients in an
emergency. n77 Hospitals that operate an emergency room must comply with EMTALA as a condition of federal
funding. n78 Hospitals that treat the uninsured in an emergency are eligible for reimbursement through Medicaid. n79 An obvious tension exists between
EMTALA and the Welfare Reform Act: hospitals receiving federal funds must treat all individuals in an emergency under EMTALA, and the Welfare Reform Act
prohibits the provision of services to immigrants. EMTALA, therefore, created an emergency exception to the Welfare Reform Act whereby hospitals must treat
undocumented immigrants in an emergency. n80 However, hospitals will not receive federal reimbursement once the patient no longer has an emergency
condition requiring care under EMTALA. n81
Hospitals and states struggle to draw the line between emergency and non-emergency care. EMTALA
defines an emergency medical
condition as a "medical condition manifesting itself by acute symptoms of sufficient severity [*194] (including severe pain)
such that the absence of immediate medical attention could reasonably be expected to result in - (i) placing the health
of the individual . . . in jeopardy, or (ii) serious impairment to bodily functions, or (iii) serious dysfunction of any bodily
organ . . . ." n82 EMTALA defines "stabilized" to mean that "no material deterioration of the condition is likely, within reasonable medical probability, to result
from or occur during the transfer of an individual from a facility, or, with respect to [pregnancy] . . . that the woman has delivered." n83 The statutory definition
leaves ample room for debate as to which diagnoses should be de defined as emergency conditions. For example, a
North Carolina court held that
an undocumented immigrant's acute lymphocytic leukemia did not constitute an "emergency medical condition." n84
The hospital, as a result, received no Medicaid reimbursement for chemotherapy provided to the undocumented
patients. n85 Also, the extent to which renal dialysis, an expensive chronic care procedure, constitutes an emergency medical condition varies from state to
state. n86 Dialysis requires lifelong treatment or kidney transplant, so if a state withholds dialysis, a patient will likely end up in the emergency room. n87 Some
states, like New York and California, define dialysis as emergency care because failure to treat the patient will result in an emergency. n88 Other states such as
Colorado, Texas, and New Mexico vary on their definition of dialysis because a patient may take days to deteriorate. n89 Part II of this note discusses the
practical implications of the financial burden that hospitals face when absorbing the costs of caring for non-citizen patients that straddle the line between
emergency and non-emergency care Studies differ regarding EMTALA and non-citizen usage of emergency rooms. Some have found that that because
undocumented immigrants are uninsured, poor, and lack private or employer-sponsored insurance, they are more likely to use emergency rooms as their
principal source of medical care. n90 Most studies, however, tend to show that immigrants are less likely to access ambulatory care services than other groups.
n91 Though the data appears [*195] contradictory, perhaps low-income immigrants are more likely to use emergency rooms when they need care because it is
the only place they can receive treatment, but are still less likely to access health care services than any other group.
.
Restrictions on Immigrant Access to Health Care Undermine Public Health Goals
Janet M. Calvo 08; Professor, City University School of Law. Many thanks for the comments of Ruthann Robson and Andrea McArdle, the research
assistance of Johan Bysainnthe, and the typing assistance of Rosa Navarra. Loyola University Chicago School of Law, Beazley Institute for Health Law and
Policy Annals of Health Law; The Consequences of Restricted Health Care Access for Immigrants: Lessons from Medicaid and SCHIP; L/N
The public health consequences of the restrictions on noncitizens' health care access raise public health concerns.
Contagious disease control is one of the primary concerns of the field of public health. n130 However, this objective is
undermined when restrictions on access limit immunization, prevent early detection and diagnosis, and impede the
control of contagion through appropriate isolation and quarantine. n131 Restrictions on health care access for
noncitizens also undermine the essential public health goals of diminishing infant mortality and morbidity, promoting
child health, and effectively managing chronic disease.
Federal law allows public health programs to immunize and treat immigrants for contagious diseases. n132 However, because the federal programs are limited in
scope, many individuals must rely instead on immunization through private and not-for-profit providers that rely on public and private health insurance. n133 If
noncitizens are precluded from [*193] that insurance, their access to care is limited. Additionally, symptoms of contagious disease often go undetected until the
individual is tested and diagnosed through a medical care provider.
The first rule of Project Mayhem is that you do not ask questions.
42
SCFI 2009
Immigration Health Aff
Project Mayhem
___ of ___
Harms – Health Narrative
An illegal immigrant dies of a fractured spine and terminal cancer because he was
denied treatment and, therefore, went undiagnosed for months.
Lo, 08 (Alex Lo, NEWS; Observer; Pg. 14, Thursday, August 28, 2008)
Some news stories are so disturbing that you cannot get them out of your head. The death of former
Hong Kong resident Jason Ng Hui-lui, while in the
died after months of agonising pain from a fractured
spine and terminal cancer. Both conditions went undiagnosed and untreated until a week before his death. Authorities
custody of US immigration officials, is one of them. Early this month, the computer engineer
accused him of "faking" his illness during his year-long detention as a suspected illegal immigrant; his traumatised family was rendered helpless by an
unresponsive and unaccountable bureaucracy. The 33-year-old Ng had been a New Yorker since he was 17 when he flew there from Hong Kong in 1992. He
had overstayed his tourist visa years ago. His wife is an American citizen; their two young children were born in America. He had a job in Manhattan and owned a
house nearby. In Canada, his application for residency or citizenship would have been a relaxed affair. But this is post-9/11 America. Life as he knew it came to
an abrupt end last summer when he went to what he believed was his final interview for a green card. Instead, US Immigration and Customs Enforcement agents
were waiting for him. A robust man at the time of his arrest, by
the time he died his family described him as looking like a man in his
80s with a broken back, his untreated cancer having spread to vital organs. His death isn't an isolated incident but part of a larger
and well-documented pattern of systemic abuse of suspected or confirmed illegal immigrants under a system that detained more than 300,000 people last year.
Dozens of deaths have been reported in the rapidly expanding network of state-operated and contracted detention facilities that critics have likened to a gulag;
allegations of human rights violations are regularly made by critics and families of abused inmates. Indeed, a convicted
criminal enjoys far more rights and protection, as well as legally mandated medical care in a US prison, than foreign inmates who
are routinely denied due process. Since the complete overhaul of the US security and intelligence services under the Department of Homeland
Security, enforcement agencies have been targeting immigrants with questionable residency status. There are violent raids by heavily armed federal agents on
perfectly harmless foreign workers, sweeping them into a detention system that neglects and abuses them. As one of Ng's lawyers, Joshua Bardavid, told me,
US immigration laws and their enforcement are convoluted and "out of control". The sole purpose of the detention system, as Homeland Security chief Michael
Chertoff admitted to The New York Times in response to Ng's death, "is to move people out very quickly and deport them back home ... We are not trying to
create a health care system for people." Commenting on some lawmakers' calls for reform, Mr Chertoff added: "Whether it's a state prison, federal prison, you're
going to get a certain number of deaths." Ng's death, in other words, is a statistic. The US has created two detention systems for foreigners and non-citizens
separate from normal jails - one for suspected terrorists and one for suspected illegal immigrants. In these systems, inmates have few or no rights and limited
access to an independent judiciary or adjudicating authority; many have little or no legal representation, and medical services are minimal or non-existent. Norms
in human rights guaranteed under international law and conventions are negated. In effect, once you are sucked into these systems, you are at the mercy of
faceless, unaccountable and brutal bureaucracies. I asked myself why Ng did not accept deportation - he would have died anyway but under far less awful
conditions. But then I understood. He thought he was already in his own country; he and his family had believed in America.
The first rule of Project Mayhem is that you do not ask questions.
43
SCFI 2009
Immigration Health Aff
Project Mayhem
___ of ___
Harms – Human Right
Undocumented immigrants are human beings and, therefore, must have access to
basic human rights, including health care, because it is their moral right. Health care
rights is inclusive of health care coverage. Coverage for undocumented immigrants
is justified because they pay taxes and contribute to their local communities.
McKeefery 07 (Michael J. McKeefery, 2007, University of Maryland School of Law (Baltimore, MD). B.A., Sociology, 2003, The College of William and
Mary (Williamsburg, VA))
For the purposes of this debate, "undocumented immigrants" or "illegal immigrants" are those individuals who are residing illegally in the United States. n17 A
person illegally resides in this country when that individual enters the country illegally, or when that individual enters the country in a legal manner but violates the
explicit terms of his or her immigration status. n18 As a whole, undocumented immigrants
insurance than native-born citizens for several reasons.
are much less likely to have health
n19
First, more than a quarter of the undocumented immigrants in the United States over
the age of sixteen are part-time employees, seasonal workers, or are unemployed altogether. n20 Normally, part-time and seasonal workers do not receive
employment-based health care coverage. n21 Second, undocumented immigrants are usually barred from government insurance
programs and often lack the financial resources to obtain private insurance. n22
For these reasons, the issue of whether undocumented immigrants should have access to health care coverage in the United States has become an area of
considerable debate. n23 Some participants in the debate argue that cost considerations justify excluding undocumented immigrants from coverage. n24 They
[*395] contend that tax-supported services, like federal health care plans, cannot sustain the increase in demand that would result if undocumented immigrants
were included in public health care programs. n25 They also argue that immigrants who reside illegally in the United States do not deserve to receive the benefits
of health care coverage, because undocumented immigrants do not usually pay taxes to support federal programs. n26 Another argument against granting
undocumented immigrants' access to health care services focuses on the fact that a denial of coverage would likely create a disincentive for individuals to enter
the United States illegally. n27 According to this point of view, such a disincentive is problematic because undocumented immigrants threaten national security,
the economy, the prevalence of the English language, American culture, and American jobs. n28
By contrast, other scholars have argued that undocumented immigrants must have access to basic human rights, such as
education, employment, and health care. n29 According to this point of view, undocumented immigrants are human beings and,
as such, it is their moral right to have access to services that are essential to sustaining life. n30 Proponents of this perspective
further assert that coverage is a moral necessity because some undocumented immigrants are children who have had no
choice but to follow their parents abroad. n31 These scholars also contend that health care coverage for undocumented
immigrants is justified because undocumented immigrants have been found to pay more in taxes than they collect in
benefits, n32 and because many undocumented immigrants reside in the United States for substantial periods of time
and contribute much to their local communities. n33
Based on the intensity of this debate, it is very important that the legislature clearly establish whether undocumented immigrants are covered by health care
services under federal health care initiatives. The following part discusses the various mechanisms in place to provide immigrants with access to health care
services in the United States, and explains why most of these mechanisms are not realistic means through which undocumented immigrants can receive health
care coverage.
Physicians have a moral responsibility to overcome biases and prejudices to do what
is best for their patients. Failure to do so is a failure of beneficence and
nonmaleficence.
Clark, Luke Surry, Krysta Contino: Health Care Access For Migrant Farmworkers: A Paradigm For Better Health. The Internet Journal of
Health. 2009. Volume 8 Number 2. Ebsco
Peter A.
It is clear, after reviewing these statistics and identifying the biases
and stereotyping that exist in the medical profession, that disparities
in U. S. health care expose minority patients, especially the undocumented migrant farm workers to unnecessary risks, including
possible injury and even death. Physicians have a moral responsibility to do what is good for their patients. Should a
physician be impeded in the exercise of his or her reason and free will because of prejudice or bias on the part of the medical establishment,
then that physician has an ethical responsibility to overcome that impediment and do what is demanded by the basic
precepts of medicine??"seek the patient's good. Hospitals also have a responsibility to their communities. If hypertension,
diabetes, obesity, TB and HIV/AIDS are major issues in the undocumented community of people that a particular hospital
serves, then it is the ethical responsibility of hospital administrators and health care professionals to formulate programs that
address this immediate need. Failure to recognize prejudice and bias is a failure not only of the test of beneficence; it
may also be a failure of the test of nonmaleficence.
The first rule of Project Mayhem is that you do not ask questions.
44
SCFI 2009
Immigration Health Aff
Project Mayhem
___ of ___
Harms – Human Rights
Healthcare for immigrants Key to human rights: EU proves
Published by Martinus Nijhoff European Journal of Health Law focuses Public International Law, on Human Rights, on Humanitarian
Law, and, on International Relations. 11: 245-272, 2004. http://www.medimmigrant.be/acces%20to%20health%20care%
20for%20illegal%20immigrants%20in%20the%20EU.pdf
In EU countries, health care coverage of the official population has expanded very rapidly since the 1960s, according to the principle of
universality. In the view of T. H. Marshall (1950), the endowment of this key social right was the furthest step in the consolidation of
democracy, following successive recognitions of civil and political rights. Critical, however, was the fact that all those rights were anchored to
citizenship, which failed to anticipate future phenomena such as IM and the associated problem of an increasing number of persons ‘without rights’.
More contemporarily, with the emergence of so-called post-materialism, a debate has been launched on the convenience of adding a
‘fourth phase’ to the Marshallian sequence, namely the detachment of rights from citizenship in favour of entitlements based on the
simple condition of human being. In effect, health care is regarded nowadays as a fundamental human right.8 All EU
Member States have recognised the right of everyone to the ‘highest attainable standard of physical and mental
health’ and to receive medical care in the event of sickness or pregnancy ‘the right of everyone to access to preventive health care and
the right to benefit from medical treatment’, the scope of this right (as defined in Article 52) could entail, as Peers warns, ‘certain restrictions
based on nationality or migration status’.11Even voices from official bodies such as the Council of Europe have risen to denounce this unclear situation,
acknowledging that IMs, ‘who are falling outside the scope of existing health and social services’, ‘represent a major
problem in the area of health-care provision’ that ‘requires closer examination’.12 In the face of that, the action of the European Commission has
been just to remind Member States that, in effect, ‘illegal immigrants are protected by universal human rights standards and should
enjoy some rights e.g. emergency healthcare rights and primary school education for their children’13 (italics not in the original).
Access to health care is essential as a human right for immigrants
Marcela X. Berdion SMU Law Review Association SMU Law Review J.D. Candidage 2008, SMU Dedman School of Law; B.A., Business & Political Law,
cum laude, Southwestern University. http://www.lexisnexis.com/us/lnacademic/results/docview/docview.do?start=25&sort=BOOLEAN&format
=GNBFI&risb=21_T6960714436
The idea that access to health care is an essential right for all people has likely existed in the hearts and minds of
medical professionals around the world for many years, but a right to health did not become codified as an
international human right until the 20th century, with the help of American leadership. President Franklin D. Roosevelt encouraged
the United States to embrace the global recognition of a right to health in his State of the Union address in 1944, while advancing his
idea of a second Bill of Rights, including "the right to adequate medical care and the opportunity to achieve and enjoy good
health." n1 Today, every country in the world is now party to at least one of the numerous international treaties and
legal documents addressing health-related rights, allowing health care to become a truly international ideal and
commitment. The United States, however, has not followed through with FDR's vision of providing a right to adequate
medical care and good health in this country. Although the federal government has made several attempts at shifting the status of health care in
the United States away from its past as a purely private market good towards that of at least a limited right with minimum levels of care, federal efforts
have failed to meet international standards by establishing health care as a human right for all people within its
borders. Instead, a patchwork of government attempts to address medical care needs have left health care in limbo as the product of a private-public system,
which partially subsidizes those whom the government deems worthy to receive the privilege of care in this country, but leaves millions of others who
do not qualify without essential access to health care. The current system in the United States therefore recognizes
health care only as a privilege for some, not as a human right for all.
The first rule of Project Mayhem is that you do not ask questions.
45
SCFI 2009
Immigration Health Aff
Project Mayhem
___ of ___
Harms – Human Rights
It is unethical to deny illegal immigrants basic health care when we allow them to
work in our country.
Neill, 02 ALEXANDER VIVERO, Doctor of Jurisprudence/Juris Doctor (J.D.)
spring 2002, The Scholar: St.Mary's Law Review on Minority Issues, The
Scholar: St.Mary's Law Review on Minority Issues4 SCHOLAR 405, HUMAN RIGHTS DON'T STOP AT THE BORDER: WHY TEXAS SHOULD PROVIDE
PREVENTATIVE HEALTH CARE FOR UNDOCUMENTED IMMIGRANTS, L/N
In 1986, Congress attempted to end this employment relationship by passing the Immigration Reform and Control Act (IRCA). n149 IRCA made it illegal for
employers in the United States to hire undocumented immigrants. n150 As an enforcement tool, IRCA contained a series of sanctions designed to dissuade
employers from hiring undocumented workers. n151 Congressional intentions aside, IRCA has done little to deter undocumented entry into the United States.
n152 One reason for IRCA's failure to eliminate the undocumented immigration problem is lack of enforcement. n153 During a five-year period between 1989
and 1994, statistics show the number of INS agents whose job is to inspect the seven million employers in the United States declined from 448 to 245. n154
During [*428] the same period, the revenue from the fines for employing undocumented immigrants fell from $ 18.5 million to $ 10.9 million. n155 The INS has
even recently stated that it has "turned a blind eye" to the workplace due to a lack of funding. n156 The lax enforcement of these employer sanctions alludes to
our willingness to allow undocumented immigrants to work in our country. n157 Additionally,
undocumented, uninsured immigrants often
perform inherently dangerous and physically demanding jobs. n158 This presents another moral inconsistency: how
can we deny these same undocumented immigrants with the basic need of health care when we allow them to work
in our country, often in jobs that create medical problems due to their physical nature? n159 Or to put that question in
another context, how can we take with one hand and refuse to give with the other?A prominent argument against providing
undocumented immigrants preventative health care is that such care is essentially a "reward" for undocumented entry into the United States. n160 However, this
argument [*429] fails to realize that employers in the United States, including Texas, actively promote violations of the law by employing undocumented
workers. n161 Opponents of the provision of preventative care also argue that it gives an incentive to enter the country illegally. n162 In a 1995 report to
Congress, the United States Commission on Immigration Reform stated that denial of public assistance benefits will leave undocumented immigrants with only
one solution, to retreat to their country of origin. n163 This argument ignores the overriding reality: undocumented immigrants come to the United States to work.
n164 Even if denied preventative care, undocumented immigrants will not simply shrug their shoulders and return home. Failure to provide this care will only
leave undocumented immigrants vulnerable to "irreversible pain, disability and even loss of life" with no ability to respond. n165 Once undocumented immigrants
enter the United States and Texas, we have a moral obligation to provide them with basic health care. As stated by United States Congressman, Sylvestre Reyes
D-El Paso, the former head of the El Paso district of the Border Patrol: "[Many immigrants] pick the food, they prepare the food and they
serve the food we eat, yet we have to debate whether to keep them healthy?" n166 The moral obligation to provide
preventative health care becomes more clear because undocumented immigrants are knowingly employed by Texas
business and provide goods and services that are used by Texans on a daily basis.
Immigrant children deemed deserving of healthcare benefits do not legally receive
them
Chang, 5 (Cindy, B.A. History (2003), Washington University in St. Louis; J.D. Candidate (2006), Washington University School of Law. 2005 Washington
University Washington University Law Quarterly. 83 Wash. U. L. Q. 1271)
The Plyler Court held that state statutes discriminating against undocumented immigrant children had to further a substantial goal of the state. n100
Unfortunately, even assuming
that barring undocumented immigrant children from health care benefits does not further a
substantial state interest, the equal protection holding in Plyler has limited, if any, legal impact on denying health care
benefits to undocumented immigrant children. Plyler noted that the federal government has plenary authority to determine
immigration policies, n101 and states may follow federal guidelines for treating undocumented immigrants. n102 Whereas no federal rule barred
undocumented immigrant children from public schools, n103 [*1286] PRWORA excludes undocumented immigrant children from state health care benefits.
n104 Thus, given the federal directive on the matter, it is unlikely that Plyler will provide constitutional grounds for overturning state
statutes limiting undocumented immigrant children's access to state health care benefits. Without strong equal protection
arguments against individual state statutes, the remaining constitutional question is whether PRWORA itself violates undocumented immigrant children's rights to
due process under the Fifth Amendment. n105 Because Diaz unequivocally held that immigrants' due process rights did not entitle them to all benefits associated
with citizenship, n106 it is unlikely that its precedence will result in ruling PRWORA in violation of immigrants' due process rights. Specific to undocumented
immigrants, the Court maintained in dictum, "The illegal entrant [cannot] advance even a colorable constitutional claim to a share in the bounty that a
conscientious sovereign makes available to its own citizens and some of its guests." n107 However, in light of the Court's subsequent Plyler decision, n108 it is
possible that the Court would make an exception for undocumented immigrant children. Nevertheless, given the Court's tolerance for discrimination against
lawfully admitted immigrants in Diaz, the Court is not likely to rule that PRWORA's discrimination against illegal immigrant children violates their due process
rights. Based on Plyler and Diaz, PRWORA and state statutes denying undocumented immigrant children health care benefits are
likely to survive Fifth and Fourteenth Amendment challenges. However, the Court's treatment of undocumented
immigrant children in Plyler transcends constitutional relevancy to form compelling policy arguments that support
providing undocumented immigrant children with government health care benefits. Regardless of its legal applicability to
PRWORA and related state statutes, Plyler recognizes the unique characteristics of undocumented immigrant children. The next section discusses these
characteristics and why undocumented immigrant children are deserving of government health care benefits.
The first rule of Project Mayhem is that you do not ask questions.
46
SCFI 2009
Immigration Health Aff
Project Mayhem
___ of ___
Harms – Morality
Americans have a moral obligation to resolve the immigrant issue and give the
immigrants a better life
Kevin Horgan, 2006 September 17, Sunday,GUEST COMMENTARY
OPINION;, Pg. F4 Contra Costa Times (California), MRISL, UMass grad) L/N
NO SUBSTANTIVE action on immigration reform will be taken by the U.S. Senate and Congress this year. The politics of the November elections will turn on
speculation rather than accountability, and both parties will avoid a fight that may alienate their constituents. You and I could never avoid such an overwhelming
responsibility.When a person is obligated to live up to a high standard, he or she often does so as if carrying a heavy burden. The weight is measured by whether
the duty is the product of actions he is responsible for, has tacitly supported, or has forced upon him. Americans have many obligations. Paying
taxes, stopping at red lights, tolerating purportedly harmless behavior, never using the n-word, and living by the Golden Rule, are all examples of responsibilities
and obligations, by degree.Then there are moral obligations. These beg a higher standard. Moral obligations can hurt, but
they cannot be denied. They connot sacrifice. Americans see a moral obligation to defend the weak, feed the hungry,
accept fatherhood and offer monetary assistance to those sincere but desperate for a chance at self-dignity in our land of plenty. Americans have a
moral obligation to resolve our immigration issue. It is thorny. It is not cut and dried. But resolve it we must.Our moral obligation to the
immigrant has become a heavy burden because we have fostered illegitimacy through political positioning and abrogated it by benign neglect.Our nation fought a
civil war 140 years ago on an idea: All men are created equal, and slavery had to end. We must call ourselves not to war, but to that greater standard, by
eschewing the trite excuses of economic forces and embrace
the immigrant with dignity, living wages and the responsibility that comes
with our way of life. Every time we save a few dollars using inexpensive, illegal labor, there is a tear shed, somewhere, for a higher ideal that condemns
slavish conditions.We know the causes of the illegal immigration mess we are in, but two are pillars of cultural apathy: a corrupt Mexican government, and a U.S.
neglect of adherence to its own laws.Short of the annexation of Mexico as our 51st state, its people need to hold the government accountable or migrate to make
a better life. Mexico is not governed by the rule of law, like the United States and most developed nations. Mexico is a malignancy of poverty.Our
nation is
guilty of a listless shrug by allowing our laws to be broken, without true consequence. Our immigration policies are a
sham because we have allowed them to be used as political trading cards. Where there is no consequence for illegal
acts, there is no integrity.Americans have an obligation to resolve the immigration puzzle, through compassionate laws, utilizing stern consequences for
failure to comply. Whether the alien, the employer, the border guard, the local cop or someone who needs a little yard work done, everyone has a responsibility
to obey the law. Americans are morally obligated to embrace those who come here legally in search of citizenship and a
better life.
It is morally wrong to deny noncitizen children health benefits
Deterding, 08 David J., Lawyer in St. Louis, Missouri, Associate, Saint Louis University School of Law Saint Louis University Law Journal Spring, 2008
52 St. Louis L.J. 951 L/N)
Finally, the
denial of health benefits to non-citizen children constructively punishes these children for the crimes of their
illegal alien parents and greatly reduces their chance to live healthy, productive lives. Recent studies have shown that low-income
illegal aliens are twice as likely to be uninsured as low-income citizens. n259 Thus, without government aid, most undocumented children have virtually no access
to medical care. n260 As a result, one in five children of undocumented parents is currently in poor or fair health and was not able to visit a doctor within the past
year. n261 The Lewis court noted that access to medical care during the first year of life can reduce the incidence of life-threatening illness by more than 40%. n262
However, the
lack of health care [*983] at an early age can have dramatic consequences including learning difficulties,
decreased future earnings, and even premature death. n263For all of these reasons, the denial of publicly funded health care benefits for noncitizen children, through the Welfare Reform Act and subsequent state regulation, fails to further a substantial state interest. The benefit to the regulating state is
minimal, while non-citizen children, taxpayers, and the nation's health are all put at a significant risk of lasting harm. Congress authorized this denial under the
guise of deterring illegal immigration by eliminating incentives and reducing the cost of publicly funded welfare benefits. However, it seems that denying health
benefits to unqualified alien children has failed to live up to congressional expectations. The authorization to deny health benefits to undocumented children has
had no significant effect on slowing illegal immigration, nor has the denial succeeded in reducing welfare expenditures. n264 As no substantial interest of the state
has been furthered, the
denial of publicly funded health benefits to undocumented children fails to satisfy heightened
scrutiny review and thus violates the equal protection rights of millions of innocent children.
The first rule of Project Mayhem is that you do not ask questions.
47
SCFI 2009
Immigration Health Aff
Project Mayhem
___ of ___
Harms – Morality
Distributive justice requires medical access for undocumented immigrants.
Clark, Surry and Contino, 2009 (By: Clark, Peter A an Associate Technical Fellow in the Intelligent Information Systems Group within Boeing's
Mathematics and Computing Technology Organization in Seattle, Washington. Surry, Luke Contino, Krysta, Internet Journal of Health, 15288315, 2009, Vol. 8,
Issue 2. “Health Care Access For Migrant Farmworkers: A Paradigm For Better Health.” EBSCO)
This principle recognizes that each person should be treated fairly and equitably, and be given his or her due. The
issue of medical disparities
among minorities and especially among the undocumented also focuses on distributive justice: the fair, equitable,
and appropriate distribution of medical resources in society. At a time when reforming healthcare in this country has become a high priority,
failure to initiate preventative measures that would save medical resources in the end violates the principle of
distributive justice. The justice principle can be applied to the problem under discussion in two ways. We Americans espouse the belief that
all men and women are created equal. Equality has also been a basic principle of the medical profession. If we truly believe in equality, we should
insist that all men and women must receive equal medical treatment and resources. Denying certain minorities medical treatment, when whites
receive them as a standard of care, is an unjust allocation of resources and violates a basic tenet of justice. Physicians and the
medical profession have an ethical obligation to use available resources fairly and to distribute them equitably.
Failure to do so is ethically irresponsible and morally objectionable. To compromise the basic ethical foundations
upon which medicine stands is destructive not just to minority patients but to society as a whole.
It’s a requirement that all persons (regardless of national origin) are entitled to
respect and protection.
Clark, Luke Surry, Krysta Contino: Health Care Access For Migrant Farmworkers: A Paradigm For Better Health. The Internet Journal of
2009. Volume 8 Number 2. Ebsco
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Health.
This principle incorporates two ethical convictions: first, that persons
should be treated as autonomous agents; and second, that persons
with diminished autonomy are entitled to protection. The principle of respect for persons thus divides into two separate
moral requirements: the requirement to acknowledge autonomy and the requirement to protect those with diminished
autonomy [ 36]. Respect for human persons refers to the right of a person to exercise self-determination and to be
treated with dignity and respect. all people deserve autonomy and to be treated with dignity and respect. failure to
provide any person with adequate health care, regardless of their race, creed, color, national origin, sexual
orientation, etc., violates this basic right of respect for persons. fear that undocumented individuals will be turned over to the ins if they
seek medical care violates personal freedom. it subjects all undocumented persons to the most terrible form of slavery, to be constantly afraid, not knowing their
condition or fate, and constantly fearing not living. this way of living does not promote human rights, it violates them.
Even though hospitals are morally obliged to address the medical needs of
minorities, they are failing to do so which results in suffering and death.
Clark, Luke Surry, Krysta Contino: Health Care Access For Migrant Farmworkers: A Paradigm For Better Health. The Internet Journal of
2009. Volume 8 Number 2. Ebsco
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Health.
The failure of the medical profession to be proactive in addressing the medical needs of this most vulnerable population is causing
needless suffering and even death. This form of prejudice clearly violates the ethical principle of respect for persons. Minority patients'
autonomy and the basic respect they deserve as human beings, is being violated because they are allowed to
endure pain, suffering, and even death when such hardships could be alleviated. All hospitals, and especially Catholic
hospitals, governed by the Ethical and Religious Directives for Catholic Health Care Services, have a moral and ethical obligation to address
the medical disparities that exist in the minority communities [ 40]. if catholic hospitals are committed to treating every person with dignity
and respect, then the barriers to health care must be lifted to ensure this commitment, and emphasis must be placed on
patient dignity and empowerment.
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Minorities including African Americans and undocumented immigrants feel they
cannot trust physicians, thus resulting in them living in pain and fear. Their sense of
fear is a violation of the basic principle of respect for persons.
Clark, Luke Surry, Krysta Contino: Health Care Access For Migrant Farmworkers: A Paradigm For Better Health. The Internet Journal of
2009. Volume 8 Number 2. Ebsco
Peter A.
Health.
Second, minorities in this country and especially the undocumented are the most vulnerable people. When immigrants, especially undocumented
immigrants, arrive at
a particular farm, they are often exhausted and fearful. They are seeking employment and have little financial support on
poor health, often because they have moved from town to town, farm to farm and have been
exposed not only to the elements but also to herbicides and pesticides. The average income is $7,500 per year and most have no health
care insurance or benefits. Communication is also an issue with the majority being uneducated and unable to read or speak
English. This vulnerability compounded with racial disparities give these individuals diminished autonomy. In 2002, an Institute of
which to fall back. In addition, some may be in
Medicine (IOM) report, which was requested by Congress, reviewed more than 100 studies that documented a wide range of disparities in the United States
health care system. This study found that racial and ethnic minorities in the United States receive lower health care than whites,
even when their insurance and income levels are the same [ 37]. the iom report made it clear that disparities between whites and
minorities exist in a number of disease areas [ 38]. these disparities are even greater among the undocumented population. giselle corbie-smith, md, and her
colleagues found that african americans were "more likely to believe that their physicians would not explain research fully or would treat them as part of an
experiment without their consent [ 38]." medical abuses have come to light through the oral tradition of minority groups and published reports. African
Americans believe that their physicians cannot be trusted, that physicians sometimes use them as guinea pigs in
experiments, and that they are sometimes not offered the same medical procedures that whites are offered, even
though they have the same clinical symptoms [ 39]. this fear and mistrust among the african american population in the united states is
also present among the hispanic peoples and is magnified with undocumented individuals. the result is that many undocumented and even
documented hispanic migrant farmworkers in the southern new jersey area are not seeking medical care until they are in the last stages of their disease. the
reason for this, according to those who work with this population and have gained their trust, is a mistrust of the medical establishment and a fear that if
they present to an emergency department and are found to be undocumented that they will be turned over to the immigration and
naturalization service (ins) for deportation. unfortunately, this has happened in a number of cases. even though most hospitals will not
contact ins in these situations, there is still a great fear among this population. because of this fear, these individuals enter the medical system only out of
desperation, when they can no longer stand the pain or have collapsed in a public setting. in most cases, the disease has progressed to the extent that treatment
is often futile or extremely expensive. this
sense of fear among the undocumented population violates the basic principles of
respect for persons. failure of the medical establishment to give this population adequate health care or to withhold treatment that is the
"standard of care" because the individual is undocumented or unable to afford said treatment is denying these individuals their basic rights of
dignity and respect. the medical profession is based on treating all people with dignity and respect. until we can show an improvement in the overall
quality of care and work to aggressively promote public health interventions on such diseases as hypertension, diabetes, obesity, tb, hiv/aids, etc. for minorities in
general and the undocumented specifically, we will never gain the trust of the minority communities and will never close the ever-widening gap in quality of care.
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Harms – Justice
Failure to initiate preventive health care violates justice.
Clark, Luke Surry, Krysta Contino: Health Care Access For Migrant Farmworkers: A Paradigm For Better Health. The Internet Journal of
2009. Volume 8 Number 2. Ebsco
Peter A.
Health.
Justice. This principle recognizes that each person should be treated fairly and equitably, and be given his or her due. The
issue of medical disparities among minorities and especially among the undocumented also focuses on distributive
justice: the fair, equitable, and appropriate distribution of medical resources in society. At a time when reforming healthcare in
this country has become a high priority, failure to initiate preventative measures that would save medical resources in the end
violates the principle of distributive justice. The justice principle can be applied to the problem under discussion in two ways.
Justice pertains to everyone and dictates that programs should be implemented for
preventive health care for minorities for the benefit of society.
Clark, Luke Surry, Krysta Contino: Health Care Access For Migrant Farmworkers: A Paradigm For Better Health. The Internet Journal of
2009. Volume 8 Number 2. Ebsco
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Health.
The principle of justice also pertains
to the fair and equitable allocation of resources. It has been documented that members of
minorities are less likely than whites to be given appropriate cardiac medicines or undergo coronary bypass surgery.
Minorities are less likely to receive kidney dialysis, kidney transplants, or the best diagnostic tests and treatments for
cancer. Minorities are also less apt to receive the most sophisticated treatments for HIV and diabetes. As of 2002, the total
cost of diabetes in the United States (direct and indirect) was $132 billion. Direct medical costs were $92 billion, indirect costs (related to disability, work loss,
premature death) was $40 billion. The average annual health care costs for a person with diabetes are $13,243, whereas the average annual health care costs
for a person without diabetes is $2,560 [ 44]. if african
americans and hispanics are twice as likely to die from diabetes than
whites, in many cases because of a lack of adequate medical treatment, then the principle of distribute justice would dictate
that programs should be implemented to screen, assess and treat hispanics and other minorities, especially the undocumented
migrant farm worker population, not only for their benefit but also to benefit society as a whole.
Everyone is created equally which means everyone should receive equal medical
treatment and resources.
Clark, Luke Surry, Krysta Contino: Health Care Access For Migrant Farmworkers: A Paradigm For Better Health. The Internet Journal of
Health. 2009. Volume 8 Number 2. Ebsco
Peter A.
We Americans espouse the belief that all men and women are created equal. Equality has also been a basic
principle of the medical profession. If we truly believe in equality, we should insist that all men and women must
receive equal medical treatment and resources. Denying certain minorities medical treatment, when whites receive them as a
standard of care, is an unjust allocation of resources and violates a basic tenet of justice. Physicians and the medical
profession have an ethical obligation to use available resources fairly and to distribute them equitably. Failure to do
so is ethically irresponsible and morally objectionable. To compromise the basic ethical foundations upon which medicine stands is
destructive not just to minority patients but to society as a whole.
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Soft Power
Human Rights is Key to U.S. Soft Power
Mark R. Shulman November 2008 Copyright (c) 2008 Fordham Law Review
Finally, labeling the situation a war implicates the use of armed forces - with ensuing risks and costs. As brave and capable as the professional armed forces are,
they are inherently incapable of addressing the full range of threats. Since the tragic war in Vietnam, western militaries have learned - or relearned - the art of
unconventional warfare. These skills have enabled soldiers to function effectively in forests, villages, and in cities. New technology has even enabled modern
armies to engage in combat in cyberspace. n93 But they are not capable of discriminating between financial transactions and communications of terrorists and
those of civilians. So using armed forces to interdict these interactions raises the [*577] costs of collateral damage to intolerably high levels. n94 And while they
can adapt to tackle nontraditional, psychological, propagandistic, urban, financial threats, doing so will significantly degrade their war-fighting capacity. Armed
forces are exceedingly expensive, and in such a sprawling, amorphous campaign, it is misguided or misleading to think that the United States can or should
address challenges with the machinery of war alone. Deploying military resources reifies the threat. Current policy renders support to the terrorists by honoring
their anarchic campaign as a war. The United States contributes significantly to their recruitment efforts when it unnecessarily exposes fine soldiers and marines
to their suicide bombers. The state-centeredness of a war paradigm likewise gives al Qaeda a higher profile and more opportunities to cultivate recruits and
develop partners. In lieu of pursuing a war, this essay proposes conducting a campaign to promote and protect the values articulated in the Four Freedoms. Just
as wise and successful leaders avoid unnecessary wars, they should avoid clashes of civilizations. German citizens who defected from the Nazi cause in the
early 1940s were deemed traitors to their country, nation, folk, neighbors, or family. The United States should avoid putting its potential friends in such a tight
position. More generally, it should strive purposefully to avoid triggering a clash between the pluralistic "West" and "Islam." n95 But by declaring "wars," a "clash
of civilizations" could become a self-fulfilling prophecy. Instead of falling into this trap, the United States should protect and promote values
that have received near universal acclaim and that are embodied in domestic and international law around the world.
The Four Freedoms have just these qualities. Individually, they derive from a U.S.-framed consensus of enlightenment values. And they were quickly adopted as
part and parcel of international law. Also, this campaign would enable the United States to focus on promoting basic human
rights that will rebuild the goodwill that has enabled it to inspire good and to wield so much soft power over the years.
A declaration of war has historically brought psychosocial advantages to those who seek it. Perhaps a campaign to promote and defend Four Freedoms will
prove insufficiently rousing. Perhaps the American people require the rhetoric of a war in order to muster sufficient resources to "win." Some parents will quite
reasonably balk at sending their sons and daughters to fight and die for worldwide freedoms. And indeed they should. For at least the near future, the United
States cannot easily extricate itself from the actual wars in Afghanistan and Iraq. As a result, some brave Americans will be injured or die in these faraway lands.
For better and for worse, these remain actual wars. Moreover, the pursuit of the Four Freedoms may even [*578] lead to another war. In 1941, the Four
Freedoms did not preclude or prevent war. However, they did provide a framework for making sensible foreign policy decisions, including whether a war is
necessary. They provide an informed and humane structure that allows nations to order priorities and allocate resources. Presumably - but not inevitably - with
this decision-making framework, fewer young people will die in wars of choice.
U.S. Soft Power is Reliant of Human Rights
Peter Margulies 2008 Copyright (c) 2008 Maryland Law Review
Commentators on American foreign policy contend that the United States' greatest strength lies in its "soft power" its ability to leverage cultural, social, and political vitality to persuade other countries without the use of force . n237 The
efficacy of soft power depends on perceptions that the United States acts fairly, n238 as measured by observance of
human rights and international humanitarian norms. American defection from international law norms discredits those
who promote such norms as an answer to extremists. It also gives a valuable rhetorical tool to despotic regimes that
wish to resist constructive change. n239 Popular indignation at this intransigence can result in a violent reaction that
puts extremists in power, as the case of Iran demonstrates. n240 In this fashion, the volatility [*50] bred by the decline
of American soft power damages American interests and legitimacy abroad. Issue entrepreneurship during times of crisis can also
impair the deliberation necessary for sound political judgment at home.
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Soft Power
The U.S. Providing Humanitarian Assistance Reflects Soft Power
Lisa a. Curtis Senior Research Fellow the Heritage Foundation Before the House Committee on Foreign Affairs Subcommittee on International
Organizations, Human Rights, and Oversight United States House of Representatives Delivered on April 26, 2007
While strategic communication is an important element in influencing foreign populations' opinions of America, it
is equally important to promote
deeper, more frequent cultural engagement, people-to-people exchanges, and targeted development assistance programs to
assert America's soft power. In a recent Washington Post op-ed, Homeland Security Secretary Michael Chertoff said it well: Moreover,
this war cannot be won by arms alone; "soft" power matters. In these ways, our current struggle resembles the Cold War. As with the Cold
War, we must respond globally. As with the Cold War, ideas matter as much as armaments. And as with the Cold War, this war requires our patience and
resolve. The U.S. Agency for International Development (USAID) has become more involved in public diplomacy after the 9/11 Commission reported
to
Congress that some of the largest recipients of U.S. foreign aid had very strong anti-American sentiment among their
populations. Establishing a State-USAID Policy Council and a Public Diplomacy Working Group has helped USAID to
establish closer ties with the Department of State to publicize America's humanitarian and development aid initiatives. The U.S.
response to the South Asia earthquake in the fall of 2005 and its positive impact on Pakistani attitudes toward the U.S. demonstrates that humanitarian
assistance can influence popular views of America. I visited Pakistan to attend the International Donors' Conference on November 19, 2005, as a staffer for the
Senate Foreign Relations Committee and saw first-hand the change in the Pakistani population's views of the U.S. because of our rapid and robust humanitarian
response to this monumental disaster. Even our harshest critics admitted that America had come through for Pakistan at its greatest hour of need. The U.S.
Chinook helicopters that rescued survivors and ferried food and shelter materials to the affected areas became a symbol of America's helping hand. The U.S.
response was well-coordinated among the State Department, Department of Defense (DOD), and USAID. DOD established mobile medical units in remote areas
of the Northwest Frontier Province and makeshift schools in the badly affected capital of Azad Kashmir, giving the Pakistanis a new perspective on the U.S.
military and demonstrating U.S. interest in the well-being of the Pakistani people. Polling shows that U.S. earthquake relief efforts doubled the percentage of
Pakistanis with favorable views of the U.S. from 23 percent to 46 percent from May 2005 to November 2005. This figure had dropped to 27 percent by 2006,
however. Similarly, the U.S. response to the tsunami disaster had a positive impact on public opinion of America in Indonesia. Favorable views of the U.S. went
from 15 percent to 38 percent. The
point is that providing humanitarian assistance is not only an act of goodwill, it can reflect
positively on the U.S. image in the region where people are benefiting from the aid. Engaging with civil society and
local religious leaders on issues such as human rights, political and economic reform, and religion in society also will
help build greater understanding and help defeat misperceptions of the U.S. Twelve years ago as a Political Officer serving at the
U.S. Embassy in Islamabad, I participated in a USIA-sponsored program to bring together female U.S.-based Islamic scholars and Pakistani female lawyers,
human rights workers, and NGO leaders to discuss the role of women in Islam. I felt then—and even more so now—that it was one of the more worthwhile
activities I was involved in as a diplomat. The U.S. has an important role to play in facilitating these kinds of open exchanges
and in supporting human rights, democracy, and economic development at the grassroots level. The State
Department should encourage officers' initiation and participation in such programs on a broad scale.
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The War on Terror Trades off with United States Actions on Human
Rights and its soft power
Harold Hongju Koh 2009 Copyright (c) 2009 Western New England Law Review Association, Inc. SPEECH: REPAIRING OUR HUMAN RIGHTS
Our commitments to principles of human rights and the rule of law were seen as a major source of our soft power.
[*12] But in the last few years, sadly, much of this has changed. I travel a lot. Maybe you do too. And if you have traveled abroad in the last
few years, you cannot help but notice the steady decline of our global human rights reputation. In the last seven years,
we have gone from being viewed as the major supporter of the international human rights system to its major target.
Our obsessive focus on the War on Terror has taken an extraordinary toll upon our global human rights policy. Seven
years of defining our human rights policy through the lens of the War on Terror has clouded our human rights
reputation, given cover to abuses committed by our allies in that War, and blunted our ability to criticize and deter gross
violators elsewhere in the world. After September 11, 2001, we were properly viewed with universal sympathy as
victims of a brutal attack. But we have responded with a series of unnecessary, self-inflicted wounds, which have
gravely diminished America's standing as the world's human rights leader. You know the list as well as I do: the horror of Abu Ghraib;
our disastrous policy on Guantanamo; our tolerance of torture and cruel treatment for detainees; our counterproductive decision to create military commissions;
warrantless government wiretapping; our attack on the United Nations and its human rights bodies, including the International Criminal Court; and the denial of
habeas corpus for suspected terrorist detainees that, thankfully, was struck down this past summer by a narrow majority of the United States Supreme Court.
Whatever you may think of these policies, there can be little doubt that the impact on our human rights reputation has been devastating. In a recent Pew Global
Attitudes survey, favorable opinions of the United States had fallen in most of our fifteen closest allies - including Spain, India, and Indonesia - even though those
polled largely shared our views as to the greatest dangers in the world. n1 And in these countries, amazingly, America's continuing presence in Iraq is cited as a
danger to world peace at least as often as the growing threat of Iran. n2 Today, a vast majority of our allies believe that our policies on Guantanamo are illegal.
And a recent foreign policy survey showed that many Americans believe that the [*13] ability of the United States to achieve its foreign policy goals has
decreased significantly over the last few years and that improving America's standing in the world should become a major goal of U.S. foreign policy. n3 When I
was Assistant Secretary for Human Rights in 1999, I told a United Nations body that the United States is "unalterably
committed to a world without torture." n4 That was not a casual statement; I had cleared that statement with every relevant agency
of the United States government. But, in just a few short years, we seem to have gone from what was a zero-tolerance policy
toward torture to what now seems to be a zero-accountability policy. Increasingly, that problem afflicts our popular culture. The
New Yorker magazine reports that before September 11th, there were only four torture scenes on television each year; after September 11th, the average rose to
at least one hundred torture scenes a year, with United States government officials regularly shown as justifiably committing crimes against humanity. n5 On the
popular television show 24, American officials are seen committing torture nearly every week. The question we should ask ourselves is: "is torture really making
us safer?" After all, 24 is widely exported by DVD to the Middle East. n6 If millions of television watchers in that region think that Americans routinely torture
detainees, why should we expect them to act differently toward their detainees, who may in time come to include our own citizens and soldiers? And what impact
does this have on our ability to help solve the acute problems around the world, especially in the Middle East? The Washington Post recently noted that the
United States is no longer a player "across the board" in the Middle East. n7 More countries [*14] in the region simply do not listen to us anymore, and openly
make moves that go against our stated policies and strategy. So this is our problem: how to repair our tarnished human rights reputation.
As a nation, and as families, we face many problems - the price of gas, housing, and food, just to name a few - but as a law dean and human rights lawyer, let
me ask you not to ignore what I think is the most serious problem facing Americans today. The reason is simple. Since World War II, our
country has
been the balance wheel of the global human rights system because our reputation for human rights principles and
commitment to law made us the engine that drove the global human rights system. In the post-Cold War world, from the fall of the
Berlin Wall to the fall of the Twin Towers, we tried to revive the human rights system - in the Balkans, in Sierra Leone, in East Timor, in The Hague. But since
September 11th, the post-post Cold War era has seen us too often siding with Pakistan in defending torture, siding with China in defending arbitrary detentions of
Uighur Muslims, and siding with Russia in defending human rights abuses against Chechens as part of the "War on Terror." When our human rights
system loses its balance, why should we be surprised when the world seems to go out of whack?
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The US has signed multiple agreement of Human Rights that they have failed to meet
this kills US international relations
Marcela X. Berdion SMU Law Review Association SMU Law Review J.D. Candidage 2008, SMU Dedman School of Law; B.A., Business & Political Law,
cum laude, Southwestern University. http://www.lexisnexis.com/us/lnacademic/results/docview/docview.do?start=25&sort=BOOLEAN&format
=GNBFI&risb=21_T6960714436
The right to health is codified in numerous international legal documents, the most important of which include the
Universal Declaration of Human Rights ("UDHR") n9 and the International Covenant on Economic, Social, and Cultural Rights ("ICESCR"). n10
The spirit of Roosevelt's second Bill of Rights became enshrined in the UDHR through Eleanor Roosevelt's leadership as the head of the U.N. Human
Rights Commission, and together with its implementing Covenants, the so-called International Bill of Rights seeks to protect the
international right to health. n11 Article 25 of the UDHR prescribes that, "everyone has the right to a standard of living
adequate for the health and well-being of himself and of his family, including food, clothing, housing, and medical
care and necessary social services." n12 The ICESCR, intended to expand upon the meaning of the rights given in the UDHR, provides the most
concrete assertion of the right to health and states in Article 12:
The United States led the formation of many of the aforementioned treaties and although it is a signatory to the ICESCR, the Convention on the Rights of the
Child, and the Convention on the Elimination of All Forms of Discrimination against Women, the Senate has never given its consent to ratify those treaties, which
are therefore not legally enforceable in the court system as international treaties under United States law. n21 However, the American signatures
on
these international documents are politically binding in the eyes of the international community and demonstrate the
country's support of the health provisions set forth in those agreements, as shown by President Carter's and President Clinton's
approval of the ICESCR. n22 Article 18 of the Vienna Convention on the [*1638] Law of Treaties prescribes that upon signing a treaty, a
nation is "obliged to refrain from acts which would defeat the object and purpose" of the treaty "until it shall have
made its intention clear not to become a party to the treaty." n23 It is likely that the intention not to become a party to the ICESCR is not
clear to the international community, given the actions of two presidents as late as 1993 asking for Senate consent of the treaty, such that the United States
is internationally committed to refrain from passing legislation that would impede the right to health under the ICESCR.
The right to public health, medical care, social security and social services. It also is considered responsible in the
eyes of the international community for fulfilling all of the provisions set forth in the treaties to which the United
States is a signatory, including the obligations to respect, protect, and fulfill the right to health under ICESCR by facilitating, providing, and promoting this
right in "adopting appropriate legislative, administrative, budgetary, judicial, promotional and other measures towards the full realization of the right to health." n27
The United States, however, has not met these international standards and commitments, and although it has signed
and legally bound itself to multiple documents hoping to ensure a universal right to health care, the country still views
health care largely as a privilege for some, not a human right for all.
The first rule of Project Mayhem is that you do not ask questions.
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Harms – Hegemony
United States is not meeting the requisite level of health care for all in the
international arena of human rights, this shows the US is violating international
agreement
Marcela X. Berdion SMU Law Review Association SMU Law Review J.D. Candidage 2008, SMU Dedman School of Law; B.A., Business & Political Law,
cum laude, Southwestern University. http://www.lexisnexis.com/us/lnacademic/results/docview/docview.do?start=25&sort=BOOLEAN&format
=GNBFI&risb=21_T6960714436
Despite its status as a leader in the field of medical advances and extraordinary care for those who can afford it, the United States
is not meeting the
requisite level of health care for all in the international arena of human rights, due to its policies which limit access to care and
compromise the quality of health care. As a signatory to the ICESCR in 1977, the United States stated its commitment in front of the international community to
uphold the values in the treaty. n52 Under the ICESCR, the United States is "obligated to respect the right to health by, inter alia,
refraining from denying or limiting equal access for all persons, including prisoners or detainees, minorities, asylum seekers and
illegal immigrants, to preventive, curative and palliative health services; [and] abstaining from enforcing discriminatory practices as a State policy." n53
Although the Supreme Court has recognized the rights of prisoners and detainees to health services, as the treaty provides, it has not extended equal access to
minorities, asylum seekers, and illegal immigrants to curative health [*1643] care, and federal legislation has completely denied the right of
illegal immigrants to preventative care. Since access to health care can be defined as "factors that influence the ease
with which medical care can be obtained," n54 whether an individual can physically access care does not fulfill a duty
to provide equal access to health care. Federal policies that perpetuate racial, cultural, and linguistic barriers to care thus also prevent equal
access to medical care. These barriers prevent all people in the United States from receiving the level of meaningful health
care internationally mandated as a necessary human right, especially for individuals who have to deal with both types of access issues,
such as many immigrants who lack physical access due to indigence and legal status and have significant racial, cultural, and linguistic hurdles to overcome. As
the number of immigrants in the United States steadily increases, more people will be marginalized by American
health care policies and deprived of their international human right to health. This trend particularly in Latino immigration must be
addressed since, "when ethnicity and insurance status are combined, rural uninsured Latinos are among the least likely individuals to receive healthcare," such
that the number of people without health care will continue to increase. n55 The issues immigrants face in obtaining medical care highlight
the consequences of a system that views health care as a privilege. n56 When faced with horrible examples of death
and disease due to the refusal of health care for lack of ability to pay, Congress could have used EMTALA as the
perfect avenue to provide a minimal level of health care for everyone in the United States and fulfill its international
commitments to provide a human right to health in the country. Senator Durenberger (a cosponsor of the Senate version of EMTALA), for
example, was moved to sponsor the bill because he believed, "the practice of rejecting indigent patients in life threatening situations for economic reasons alone
is unconscionable." The spirit of providing at least emergency care as a minimal part of the human right to health was certainly present during EMTALA's
passage, and is seen in Representative Bilirakis's statement that "no person should be denied emergency health care or hospital
admittance because of a lack of money or insurance." n70 However, if Congress did intend EMTALA to delineate and safeguard a right to a
minimal level of health, it did not succeed through the passage of that Act. The United States Is Not Meeting International Health
Standards The United States is also violating its obligations under the International Convention on the Elimination of
All Forms of Racial Discrimination by explicitly discriminating against immigrants' access to health care on the basis
of national origin in PROWRA, which is prohibited in the treaty and thus violates international law as recognized both inside and
outside the country. Discrimination in access to health care services also exists on a de-facto basis, as racial and ethnic minorities still receive poorer
health care services than Anglo-Americans, and racial minorities and immigrants compose the majority of those who are uninsured. The country must
begin honoring its international obligations by taking steps to end discrimination in the provision of health care and
honoring a human right to health.
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Harms – Economy
Illegal immigrants add to states' economies
USA TODAY April 23, 2008 Wed SECTION: NEWS; Pg. 10A LENGTH: 599 words wednesday FINAL EDITION Billy Hankins
Oklahoma Rep. Randy Terrill's claim that it's "indisputable" that illegal immigration imposes a "net financial drain" on states ignores some recent and important
research regarding the financial impact of illegal immigrants ("Oklahoma is doing its job," Opposing view, Illegal immigrants debate, April 16).
A 2006 study conducted by Texas' then comptroller, Carole Keeton Strayhorn, found that illegal immigrants represented a
$420 million net gain to the state in 2005.
Overall, Hispanic immigrants add to the economy. A study on North Carolina's Hispanic population, published by the Frank
Hawkins Kenan Institute of Private Enterprise at the University of North Carolina-Chapel Hill, found that in 2006, the Hispanic population imposed
a cost of $61 million on the state government but contributed more than $9 billion to the state economy.
Of course, this research does not prove that illegal immigrants impose no costs on state governments or on populations, but it does show that assertions such as
Terrill's are baseless scare tactics that only fuel anti-immigration sentiment.
Illegal Immigrants improve state economies
Carole Strayhorne December 2006 Undocumented Immigrants in Texas: A Financial Analysis of the Impact to the State Budget and Economy
the absence of the estimated 1.4 million undocumented immigrants in Texas in fiscal 2005
would have been a loss to our Gross State Product of $17.7 billion. Also, the Comptroller’s office estimates that state revenues
collected from undocumented immigrants exceed what the state spent on services, with the difference being $424.7
million
The Comptroller’s office estimates
Decline seen in number of Illegal Immigrants
New York Times Julia Preston Published: July 31, 2008
The number of illegal immigrants in the country has dropped by as much as 1.3 million in the past year, an 11 percent
decline since a historic peak last August, an immigration research group in Washington said in a report released Wednesday.The report, by
Steven A. Camarota and Karen Jensenius of the Center for Immigration Studies, found “strong indications” that stepped-up enforcement by immigration
authorities had played a major role in the decline. The report, which is based on monthly census surveys as recent as May, added to a growing body of studies
indicating that the population of illegal immigrants in the United States is dropping significantly. The study’s methods and conclusions were questioned by other
demographers and economists, who said the decline might be less than the center reported and was more likely the result of the weak economy, especially in
low-wage construction and manufacturing where illegal immigrants are generally employed.“The
decline can easily be explained by changes
in the economy,” said Steve Levy, senior economist at the Center for Continuing Study of the California Economy in Palo Alto. He said California had lost
134,000 construction jobs since the summer of 2006. The housing sector woes and weakening economy have been known for a
long time and can explain why unauthorized immigrants would stop coming and why some of those here would
leave,” Mr. Levy said.The Center for Immigration Studies is a policy advocacy group that favors reduced immigration and opposes legislation to give legal
status to illegal immigrants. The study supports the center’s contention that border enforcement and a crackdown on unauthorized workers and their employers
would lead many illegal immigrants to leave the United States without being deported. “The evidence presented here suggests that it has been possible to cut the
illegal population by inducing a large number of people to leave the country,” the study said. Federal immigration officials praised the results. “It reinforces what
we always thought, that comprehensive enforcement is a critical part of the reduction,” said Kelly A. Nantel, a spokeswoman for Immigration and Customs
Enforcement. The arguments provoked by the study reflected the difficulties of discussing options for stemming illegal immigration, when researchers cannot
agree on how many illegal immigrants there are and how they are affected by immigration enforcement. Mr. Camarota and Ms. Jensenius based their findings on
census figures for foreign-born Hispanics ages 18 to 40 with a high school degree or less. They estimated that three-quarters of those Hispanics were illegal
immigrants, and that they made up about two-thirds of the illegal immigrants in the United States. Using those estimates, they concluded that the illegal
immigrant population had dropped to 11.2 million, from a historic high of 12.5 million in August 2007. Jeffrey Passel, a
demographer at the Pew Hispanic Center in Washington who studies illegal immigration, said his research also showed a decline in
immigrants. But because of recent changes in the census’s data reporting, he said it was too soon to make precise calculations. Wayne Cornelius, director of
the Center for Comparative Immigration Studies at the University of California, San Diego, said Mr. Camarota and Ms. Jensenius had applied “highly arguable
assumptions” to their data. “They offer no direct evidence that fewer undocumented immigrants are attempting to come to the United States, or that fewer of them
are getting in, or that more of those already here are leaving the United States as a result of enforcement efforts,” said Mr. Cornelius, who has studied the impact
of border enforcement over the past 15 years.
The first rule of Project Mayhem is that you do not ask questions.
56
SCFI 2009
Immigration Health Aff
Project Mayhem
___ of ___
Harms – Economy
Noncitizens contribute more to the economy than they take away.
Marietta 06 [Melissa, Writer for the International Social Science Review, “Undocumented immigrants should receive social services,” International Social
Science Review, Spring-Summer, 2006, <http://findarticles.com/p/articles/mi_m0IMR/is_1-2_81/ai_n16599310/?tag=content;col1>
The National Research Council has found that "immigration benefits the U.S. economy overall, and has little negative
effect on the
income and job opportunities of most native-born Americans." (17) It asserts that "immigrants add as much as $ 10 billion
to the economy each year and they will pay more in taxes than they use in government services over their lifetimes."
(18) Jeffery Passel, the author of several studies on immigration, adds "that all immigrants arriving after 1970 pay a total of $70 billion in
taxes to all levels of government, thereby generating $25-$30 billion more than they use in public services."
Undocumented workers are integral to the U.S. agrarian economy and personal
dignity depends upon such recognition and access to healthcare.
Clark, Surry and Contino, 2009 (By: Clark, Peter A an Associate Technical Fellow in the Intelligent Information Systems Group within Boeing's
Mathematics and Computing Technology Organization in Seattle, Washington. Surry, Luke Contino, Krysta, Internet Journal of Health, 15288315, 2009, Vol. 8,
Issue 2. “Health Care Access For Migrant Farmworkers: A Paradigm For Better Health.” EBSCO)
Health care is a basic human right, which is documented in Article 25 of the United Nations Declaration on Human
Rights. Denying such services to any individual on the basis of their ethnic, legal, or financial status is morally wrong.
Migrant farmworkers are a vulnerable population in that many of the workers are undocumented and few, if any, have
health insurance, which severely limits their access to medical care. The farmworkers, who are an integral part of the
production and prosperity of the United States agricultural economy, are often denied basic health care, which
negates their personal dignity. Furthermore, providing health care to all is not an issue concerning only the patient that is ill; rather, it
encompasses a public health dimension, which involves the health of all members of the community.
The first rule of Project Mayhem is that you do not ask questions.
57
SCFI 2009
Immigration Health Aff
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___ of ___
Harms – Economy
Noncitizens are crucial to the agriculture industry, yet receive unfair treatment.
Clark, Surry and Contino, 2009 (By: Clark, Peter A an Associate Technical Fellow in the Intelligent Information Systems Group within Boeing's
Mathematics and Computing Technology Organization in Seattle, Washington. Surry, Luke Contino, Krysta, Internet Journal of Health, 15288315, 2009, Vol. 8,
Issue 2. “Health Care Access For Migrant Farmworkers: A Paradigm For Better Health.” EBSCO)
The American Farm Bureau estimates that without the help of illegal aliens, the agricultural sector of the economy
would lose between $5 and $9 billion in flowers, fruits, and vegetables and would cause more than 20% of the
production to move overseas [ 23]. The help provided by migrant farm workers is critical for the agriculture sector of the
united states economy; however, the constant exposure to dangerous living conditions, hazardous chemicals, and
long hours in the heat have proven to impose serious medical problems for many of those workers.
Even with insurance, noncitizens have lower medical expenditures than US-born
adults.
Ku 2009. (Leighton, PhD, MPH, Health Insurance Coverage and Medical Expenditures of Immigrants and Native-Born Citizens in the United States,
American Journal of Public Health, July, 2009,
I found that even when immigrants were
fully insured over the course of a year, their medical expenditures were
approximately one half to two thirds as much as those of US-born adults. Even after adjusting for health status,
race/ethnicity, gender, health insurance coverage, and other factors, I found that immigrants' medical costs averaged
about 14% to 20% less than those of US-born citizens.
Preventative care is more economically efficient than emergency treatment.
Park 04 Georgetown Immigration Law Journal Spring, 2004
NOTE: SUBSTANTIAL BARRIERS IN ILLEGAL IMMIGRANT ACCESS TO PUBLICLY-FUNDED HEALTH CARE: REASONS AND RECOMMENDATIONS FOR
CHANGE SEAM PARK (B.B.A., Emory University, 2001; J.D. Candidate, Florida State University College of Law, May 2005.)
Economic inefficiency is another problem with the current legislation. n83 The Welfare Reform Act denies illegal immigrants access to preventive care, but
provides that public health care facilities are required to treat emergency conditions for all people, regardless of their immigration status or their ability to pay. n84
The current legislation, therefore, takes a back-end approach to providing illegal immigrants health care access by
providing emergency services. However, this approach is critically flawed because it is more expensive to provide
emergency care than it is to take a front-end approach by providing preventive care. n85 Dissenters of taking a front-end
approach dispute that providing emergency care would be more costly than providing preventive care and claim that preventive care drains local resources that
would be better used serving the documented population. n86 However, these dissenters fail to realize that emergency
treatment can cost nearly
"four to ten times as much" as providing preventive care. n87 The cost discrepancy exists because it costs less for health
facilities to treat symptoms and conditions before they "degenerate into emergencies that necessitate more elaborate
procedures and care," n88 which could include much more expensive services such as intensive care and hospitalization. n89 Doctors and other health
care officials have expressed similar concerns. n90 One doctor commented, "It's been our view that from a good public health policy perspective, we would
provide preventive care so as to avoid the higher cost of emergency cost and hospitalization, which we would be
forced to provide." n91
The first rule of Project Mayhem is that you do not ask questions.
58
SCFI 2009
Immigration Health Aff
Project Mayhem
___ of ___
Harms – Economy
Improved Economy Causes Improves immigration
Patrice Hill,06 (“How immigrants make economy grow; Pool of workers fills gap left by declining U.S. birthrates”
THE WASHINGTON TIMES)
"allowing greater immigration in the U.S. would result in stronger long-run growth" that could
mitigate many of the pension-funding issues. In any case, as Congress considers how to reshape the immigration laws, he said lawmakers will
need to "develop sensible policies that encourage immigration" if they want to keep the economy growing. Periods of high immigration have been
associated with periods of high economic growth in the United States. Most recently, during the late 1990s, when immigration surged
Mr. Faucher said, adding that
to a peak of 1.5 million new entrants a year, economic growth picked up to more than 4 percent a year and the unemployment rate fell to below 4 percent, the
lowest level in a generation. By contrast, when immigration dropped dramatically after the September 11, 2001, terrorist attacks to about 1 million a year,
economic growth stagnated and the job market sank into a recession and sluggish recovery. The jobs recession finally receded in 2004 - about the time that
immigration picked up again to 1.2 million, according to the Pew Hispanic Center.
Immigrants help american businesses
Joe Florkowski(“General contractors to watch immigration reform in 2007;
Contractors favor a more streamlined process for immigrants to work legally in the U.S.”) 07
In late 2005, the members of the California Landscape Contractors Association could see the writing on the border wall.
Immigration reform was coming and the association, whose members often rely on laborers who may not be able
prove their ability to work in the United States, needed to step in and do something, said Larry Rohlfes, assistant executive director for the
Landscape Contractors Association.As the U.S. government grapples with the issue of illegal immigrants and undocumented workers, the construction industry -particularly in California--will watch its actions carefully. A
too tough enforcement policy could have serious repercussions to a
construction industry that is already facing severe labor shortages. And with the wave of construction expected to come from the passage of
bond measures in November to rebuild the state's infrastructure, California's general contractors are expected to keep busy in the foreseeable future.
Construction resulting from the passage of those bonds could begin within the next few months, said Tom Holsman, chief executive office of Associated General
Contractors of California."We know the workforce needs of the future require us to look beyond our borders," Holsman said.
"We're going to have to get workers from other places.""Undocumented
labor has become an integral part of the economy,
especially in the Southwest," Kyser said.The number of illegal immigrants in the U.S. has been estimated as many as 11
million, but that number is probably an underestimate, he said.Even relying on immigrant labor, California is
experiencing huge labor demand with the state's unemployment rate reaching a record low in October, Kyser said."If you talk to
[companies] the big complaint is there is not enough labor," Kyser said.Now that Democrats have gained control of the House and
Senate, no one is quite sure what will happen as far as legislation, but the feeling is something will get done. The AGC's Holsman said he was unsure of what will
happen while Rohlfes said he feels something will get done.“We think it's going to happen," Rohlfes said.With the Democrats in charge, Kyser, the economist
said he expects a more reasoned response to the issue. Some of the Republican responses to illegal immigration were too punitive, he said."If you send
these people away, things won't get done, or if they do get done, it will cost a lot more," Kyser said.
The first rule of Project Mayhem is that you do not ask questions.
59
SCFI 2009
Immigration Health Aff
Project Mayhem
___ of ___
Harms – Economy
Illegal Immigrants help our economy because they contribute billions of dollars to the country
MICHAEL MCMAHON 06 Bad News, Good News; Illegal immigrants are a burden for local government, but they also spur overall economic
growth. The Washington Post | December 20, 2006 | . This material is published under license from the Washington Post.
IN DEMANDING a reckoning of the costs local governments bear for the schooling, policing and other services provided to illegal immigrants, could Prince
William County's elected officials inspire a wave of such studies around the nation? It wouldn't be surprising. In suburban jurisdictions such as those around
Washington, local governments bear a financial burden as a result of the influx of undocumented immigrants -- particularly those with school-age children. That,
along with the social and political strains occasioned by day-labor centers, group houses and other issues associated with illegal immigrants, is a source of rising
resentment for local governments. Still, while sympathizing with local officials struggling to balance their budgets, keep in mind a larger truth: Illegal immigrants
are an overall net benefit to this country, to the tune of many billions of dollars. That point was made most recently in a study issued last week by the Texas state
comptroller, Carole Keeton Strayhorn. The
report, the first of its kind by a state's chief financial officer, concluded that Texas's
1.4 million illegal immigrants contributed $17.7 billion to the state's $900 billion economy in fiscal 2005 -- a boon to
businesses, employment, and state and federal government coffers. Ms. Strayhorn acknowledged that her report was a seat-of-the-
pants estimate. Predictably, it came under immediate attack from groups opposed to illegal immigration; they questioned some of its methodology and the
conclusion that the state budget took in more from illegal immigrants than it spent on them. But the critics managed to overlook the overarching point -- that illegal
immigrants generated an enormous amount of economic activity in Texas. The Prince William study was proposed, a few days before Texas released its report,
by W.S. Covington III, a Republican on the county Board of Supervisors. Mr. Covington acknowledges that illegal immigrants may contribute
greatly to the overall economy and represent a net gain for federal and state budgets. But he suspects that counties such as
Prince William are being bled by higher outlays for schools, health care, prisons and police. Prince William officials, who have been instructed to produce
estimates of what illegal immigrants cost the county, will do as they're told -- despite imperfect data on a range of topics, including the number of illegal
immigrants living in the county. But they will not address the benefits of illegal immigration, which are harder to measure. How many spinoff jobs do the
immigrants help create? How many new businesses? How much more education aid is the state able to provide localities as a result of the taxes paid and
economic growth generated by immigrants? Mr. Covington says that once he has a handle on the budgetary burden that illegal immigrants represent for the
county, he might send the bill to the federal government. From a local government perspective, it's an understandable gesture -- and a futile one. What it really
underlines is the federal failure to address and rationalize a system that has caused legal, social and political pain even as it has spurred economic growth.
Illegal Immigrants are needed for our economy to flourish because they provide a flexible work force
Apr. 30, 2009 (Sun Sentinel delivered by Newstex) -- Alan Greenspan
the former Fed chairman, set the tone today at a Senate hearing by asserting that illegal immigrants provide a flexible
workforce that fills labor needs. ``There is little doubt that unauthorized -- that is, illegal -- immigration has made a
significant contribution to the growth of our economy, Greenspan testified. He called for a temporary work program to provide legal
foreign laborers and the removal of quotas on highly skilled workers. Florida, an immigration crossroads, has always had a special interest in reform, though
much of the focus of the national debate is on the Southwest border. At his press conference Wednesday night, Obama Enhanced Coverage LinkingObama -
Illegal Immigrants Contribute to the economy and even pay taxes
New York Times Upfront September 1, 2008 Ewing, Walter
Undocumented immigrants contribute to our economy as workers, taxpayers, and consumers. They account for 5
percent of the total U.S. labor force, and at least a quarter of the workers in industries like construction, agriculture,
groundskeeping, meat processing, and textile production.All undocumented immigrants pay sales and property taxes,
and--contrary to popular belief--most pay federal and state income taxes as well, even though they're not eligible for Social
Security, Medicare, or the many other programs their tax dollars help fund. Undocumented immigrants also spend
billions of dollars each year, which supports our economy and helps create new jobs.A 2006 study by the Texas State
Comptroller estimated that the 1.4million undocumented immigrants in Texas alone added almost $18 billion to the state's economic output, and more than paid
for the $1.2 billion in state services they used by generating $1.6 billion in new state revenues.The contributions of undocumented immigrants
would be even greater if they were able to earn legal status. Workers who are not part of an underground economy
and don't live in fear of deportation are better able to acquire new job skills and move up the career ladder. That
translates into higher wages, more money paid in taxes, and more money to spend.Undocumented immigration is a symptom of an immigration system that is
broken. Lawmakers should revamp our immigration system so that it works with our economy, not against it.
The first rule of Project Mayhem is that you do not ask questions.
60
SCFI 2009
Immigration Health Aff
Project Mayhem
___ of ___
Hospitals Key to the Economy
Hospitals are key to the economy.
Josephine Gittler 84 (Professor of Law, University of Iowa College of Law and Co-Director, National Maternal and Child Health Resource Center.) 1984
Iowa UniversityIowa Law Review July, 1984 SYMPOSIUM: Hospital Cost Containment in Iowa: A Guide for State Public Policymakers
hospitals are an important component of the national and state economies by virtue of their position as major
employers and major purchasers of goods and services, private sector businesses and labor unions have become
concerned about dramatically rising hospital expenditures. This concern is related to the fact that employer-purchased health insurance is a
Although
standard fringe benefit that most employees receive. n76 From 1977 to 1982 the annual payments by companies for health insurance benefits nationwide rose
from $ 33 billion to $ 78 billion. During this period it is estimated that the companies' average payment for health benefits per employee rose from $ 1250 to $
2000 a year and that employee health benefit costs as a percentage of the average company payroll rose from 9% to about 11%. n77 In Iowa, as elsewhere,
employee health benefit costs have risen substantially.
The first rule of Project Mayhem is that you do not ask questions.
61
SCFI 2009
Immigration Health Aff
Project Mayhem
___ of ___
Harms – Disease
Disease rates are much higher among illegal immigrants
Sarah J. Rasalam is a Member, 2007-2008, The Elder Law Journal; J.D. 2008, University of Illinois; Graduate Certificate in Gerontology 2005, The
University of Georgia; B.A. & B.S. 2004, The University of Georgia.
09
Although the disease rate among immigrants is higher, the INA subjects all legal immigrants to health screening to
ensure that they do not bring diseases into the United States. Much of the high disease rate can be attributed to
illegal immigrants who are not subject to health screening. Because the amendment to allow unskilled workers to enter the United States
would promote legal immigration, potential immigrants who have diseases would be prevented from entering the United States.
Illegal Immigrants are refused non-emergency medical treatment such as long term
disease care
Adrienne Ortega 2009 + J.D., Boston University School of Law, 2009; M.P.H., Boston University School of Public Health, 2006; B.S., Northeastern
University, 2004. Thank you to the AJLM Editorial Board and Kevin Outterson for their assistance with this note, and to my family for their support. Copyright (c)
2009 American Society of Law, Medicine & Ethics, Inc., and Boston UniversityAmerican Journal of Law & Medicine 2009 35 Am. J. L. and Med. 185 Lexis Nexis
Emergency Medical Treatment and Active Labor Act ("EMTALA") mandates that all hospitals screen and treat patients in
an emergency. n77 Hospitals that operate an emergency room must comply with EMTALA as a condition of federal funding. n78 Hospitals that treat the
uninsured in an emergency are eligible for reimbursement through Medicaid. n79 An obvious tension exists between EMTALA and the
Welfare Reform Act: hospitals receiving federal funds must treat all individuals in an emergency under EMTALA, and
the Welfare Reform Act prohibits the provision of services to immigrants. EMTALA, therefore, created an emergency
exception to the Welfare Reform Act whereby hospitals must treat undocumented immigrants in an emergency. n80
However, hospitals will not receive federal reimbursement once the patient no longer has an emergency condition
requiring care under EMTALA. n81 Hospitals and states struggle to draw the line between emergency and non-emergency care. EMTALA defines an emergency
medical condition as a "medical condition manifesting itself by acute symptoms of sufficient severity [*194] (including severe pain) such that the absence of
immediate medical attention could reasonably be expected to result in - (i) placing the health of the individual . . . in jeopardy, or (ii) serious impairment to bodily
functions, or (iii) serious dysfunction of any bodily organ . . . ." n82 EMTALA defines "stabilized" to mean that "no material deterioration of the condition is likely,
within reasonable medical probability, to result from or occur during the transfer of an individual from a facility, or, with respect to [pregnancy] . . . that the woman
For
example, a North Carolina court held that an undocumented immigrant's acute lymphocytic leukemia did not
constitute an "emergency medical condition." n84 The hospital, as a result, received no Medicaid reimbursement for
chemotherapy provided to the undocumented patients. n85 Also, the extent to which renal dialysis, an expensive chronic care procedure,
has delivered." n83 The statutory definition leaves ample room for debate as to which diagnoses should be de defined as emergency conditions.
constitutes an emergency medical condition varies from state to state. n86 Dialysis requires lifelong treatment or kidney transplant, so if a state withholds
dialysis, a patient will likely end up in the emergency room. n87 Some states, like New York and California, define dialysis as emergency care because failure to
treat the patient will result in an emergency. n88 Other states such as Colorado, Texas, and New Mexico vary on their definition of dialysis because a patient may
take days to deteriorate. n89 Part II of this note discusses the practical implications of the financial burden that hospitals face when absorbing the costs of caring
for non-citizen patients that straddle the line between emergency and non-emergency care. Studies differ regarding EMTALA and non-citizen usage of
emergency rooms. Some have found that that because undocumented immigrants are uninsured, poor, and lack private or employer-sponsored insurance, they
are more likely to use emergency rooms as their principal source of medical care. n90 Most studies, however, tend to show that immigrants are less likely to
access ambulatory care services than other groups. n91 Though the data appears [*195] contradictory, perhaps low-income
immigrants are more
likely to use emergency rooms when they need care because it is the only place they can receive treatment, but are
still less likely to access health care services than any other group.
The first rule of Project Mayhem is that you do not ask questions.
62
SCFI 2009
Immigration Health Aff
Project Mayhem
___ of ___
Harms – Disease
Illegal Immigrants may avoid medical treatment of diseases for fear of being deported
Adrienne Ortega 2009+ J.D., Boston University School of Law, 2009; M.P.H., Boston University School of Public Health, 2006; B.S., Northeastern
University, 2004. Thank you to the AJLM Editorial Board and Kevin Outterson for their assistance with this note, and to my family for their support. American
Society of Law, Medicine & Ethics, Inc., and Boston UniversityAmerican Journal of Law & Medicine 2009 35 Am. J. L. and Med. 185 Lexis Nexis
The high cost of treating non-citizens after emergencies leads hospitals
to go to great lengths to get rid of expensive, undocumented
patients. n108 A recent New York Times article, Immigrants Facing Deportation by U.S. Hospitals, details the process by which United States hospitals are
"repatriating the sick." n109 Tactics include flying or driving undocumented patients back to their country of origin. n110 Once a hospital repatriates a patient, the
patient "is out of sight . . . out of mind" and the hospital fails to follow-up with the patient. n111 Startling statistics revealed in the article include: Some 96
immigrants a year repatriated by St. Joseph's Hospital in Phoenix; 6 to 8 patients a year flown to their homelands from Broward General Medical Center in Fort
Lauderdale, Fla.; 10 returned to Honduras from Chicago hospitals since early 2007; some 87 medical cases involving Mexican immigrants -- and 265 involving
people injured crossing the border -- handled by the Mexican consulate in San Diego last year, most but not all of which ended in repatriation. n112 [*197]
Some label this type of international patient dumping a "death sentence," because most home countries lack the
facilities to treat the patients' often complex diagnoses. n113 For example, a Phoenix hospital repatriated an uninsured farmworker, Antonio
Torres, to Mexico when he was comatose and connected to a ventilator. n114 "For days, Torres languished in a busy emergency room . . . but his parents . . .
found a hospital in California willing to treat him, loaded him in a donated ambulance, and drove him back to the United States as a potentially deadly infection
raged through his system." n115 Antonio recovered and leads a healthy life today in Phoenix. n116 The hospital, St. Joseph's in Phoenix, repatriates six to eight
patients per year. n117 The Vice-President of Scottsdale Healthcare in Arizona explained his view of the situation: Somebody falls out of a walnut tree. They
show up in our Trauma One center. We don't have any problem with treating or stabilizing them. It's the humane thing to do. That's not where the costs run up.
The costs run up after they're moved out of the trauma unit into a regular bed. Nobody, no nursing home, wants to take them . . . . n118 The hospital that willingly
admitted Antonio, El Centro Regional Medical Center in California, said "it never sends an immigrant over the border. 'We don't export patients . . . I can
understand the frustrations of other hospitals but the flip side is the human being element.'" n119 These repatriation practices are largely
unregulated by state or federal law. n120 The Fourth District Court of Appeal in Florida is the only court to rule on such a case. n121 In Montejo v.
Martin Memorial Hospital, the court found that a hospital that flew a patient back to his homeland of Honduras violated federal hospital discharge regulations
because it failed to provide evidence of an appropriate rehabilitation facility in Honduras. n122 The court held that a hospital that accepts federal funds cannot
repatriate patients to their home country without proof they are entering a facility that meets their needs. n123 This ruling leads to interesting questions regarding
whether the home countries of undocumented patients have "appropriate facilities" for transfer. n124 If they do not, the court's holding suggests that hospitals
cannot repatriate non-citizens under current federal hospital discharge regulations. n125 Should a hospital receive evidence that the patient is admitted into an
appropriate facility in the home country, the holding of the Fourth Circuit [*198] suggests that repatriation practices are
otherwise legal and do not require consent of the patient. n126
Universal Healthcare stops the spread of preventable disease
Paul Krugman 2008 Paul Krugman joined The New York Times in 1999 as a columnist on the Op-Ed Page and continues as professor of Economics
and International Affairs at Princeton University.
Not long ago, a young Ohio woman named Trina Bachtel, who was having health problems while pregnant, tried to get help at a local clinic. Unfortunately, she
had previously sought care at the same clinic while uninsured and had a large unpaid balance. The clinic wouldn’t see her again unless she paid $100 per visit —
which she didn’t have. Eventually, she sought care at a hospital 30 miles away. By then, however, it was too late. Both she and the baby died. You may think
that this was an extreme case, but stories like this are common in America. Back in 2006, The Wall Street Journal told another such story: that of a
young woman named Monique White, who failed to get regular care for lupus because she lacked insurance. Then,
one night, “as skin lesions spread over her body and her stomach swelled, she couldn’t sleep.” The Journal’s report goes on: “Mama,
please help me! Please take me to the E.R.,” she howled, according to her mother, Gail Deal. “O.K., let’s go,” Mrs. Deal recalls saying. “No, I can’t,” the daughter
replied. “I don’t have insurance.” She was rushed to the hospital the next day after suffering a seizure — and the hospital
spared no expense on her treatment. But it all came too late; she was dead a few months later. How can such
things happen? “I mean, people have access to health care in America,” President Bush once declared. “After all,
you just go to an emergency room.” Not quite. First of all, visits to the emergency room are no substitute for regular
care, which can identify and treat health problems before they get acute. And more than 40 percent of uninsured
adults have no regular source of care. Second, uninsured Americans often postpone medical care, even when they
know they need it, because of expense. Finally, while it’s true that hospitals will treat anyone who arrives in an emergency room with an acute
problem — and it’s wonderful that they will — it’s also true that hospitals bill patients for emergency-room treatment. And fear of those bills often
causes uninsured Americans to hesitate before seeking medical help, even in emergencies, as the Monique White
story illustrates. The end result is that the uninsured receive a lot less care than the insured. And sometimes this
lack of care kills them. According to a recent estimate by the Urban Institute, the lack of health insurance leads to
27,000 preventable deaths in America each year. But are they really preventable? Yes. Stories like those of Trina
Bachtel and Monique White are common in America, but don’t happen in any other rich country — because every
other advanced nation has some form of universal health insurance. We should, too. All of which makes the media circus of a
few days ago truly shameful.
The first rule of Project Mayhem is that you do not ask questions.
63
SCFI 2009
Immigration Health Aff
Project Mayhem
___ of ___
Harms – Disease
Illegal immigrants may carry HIV because they are afraid getting tested will lead to
them being discovered and deported: Universal Healthcare would solve.
Demetrius Lambrinos 06 recieved his JD/MBA with an emphasis on law and economics from the University of Iowa in 2006. He is currently practicing at
the law firm of Zelle, Hofmann, Voelbel, Mason & Gette LLP in San Francisco where he primarily handles issues related to class action antitrust cases. He would
like to thank Erin Herbold and everyone at JGRJ for helping make publication of this Note possible.Copyright (c) 2006 The Journal of Gender, Race & Justice
The Journal of Gender, Race & Justice Fall, 2006 10 J. Gender Race & Just. 119
Given the risk of false-positives and false-negatives and the fact that many individuals who enter the United States are never tested, the
HIV ban instills a false sense of security. n122 The tests also encourage public officials to make hard-line status determinations on the basis of fallible test results
and perpetuate the belief that HIV comes from outside the United States. n123 This dangerous belief ignores the reality that foreign-born
individuals
living in the United States are more likely to contract HIV after they arrive than they are to bring it with them and
emboldens the already problematic, narrow-minded, xenophobic attitudes toward immigrants. n124 2. The Threat of
Deportation or Repatriation Under §1182 Drives Many HIV-Positive Aliens Underground, thus Heightening this Risk
of Exposure. Under the current HIV immigration ban, infected aliens are more likely to refuse treatment and
counseling out of a fear of being detected. n125 This, in effect, turns HIV-positive aliens who have not been officially
tested into "time bombs of public health." n126 Another effect is that aliens who are not yet infected will avoid any
and all testing and counseling for fear of discrimination or deportation, thus increasing the risk that they could
become infected in the future. n127 Both groups are also more likely to seek illegal modes of entry rather than risk a
mandatory HIV test during the asylum/refugee application phase. n128 The now undocumented aliens find lawful
employment difficult to obtain and often resort to drug dealing and prostitution, occupations which "virtually guarantee
the spread of the virus." n129 Thus, once HIV-positive aliens are driven underground there is a "predictable increase
in high risk behavior, increasing the spread of the disease in the short term and swelling the cost of treating those infected in the long term."
Extreme Drug Resistant TB presents a deadly threat to HIV positive immigrants and
the people who associate with them; Could lead to pandemic.
NaturalNews 06 The NaturalNews Network is a non-profit collection of public education websites covering topics that empower individuals to make
positive changes in their health, environmental sensitivity, consumer choices and informed skepticism.
The head of the World Health Organization's tuberculosis resistance team, Dr. Paul Nunn, announced yesterday that
new strains of the disease that are immune to modern drug treatments are cropping up across the globe. It was only by
coincidence that Harvard sent scientists to determine the extent of drug resistance in diseases in South Africa, and discovered the new TB strain referred to as
extreme drug-resistant TB, or XDR-TB. If the study had been in some other parts of Africa, the strain might not have been identified because there are no
research facilities to make diagnoses or monitor numbers. Nunn noted that the situation was dire, and said that of
the 9 million known cases of TB
worldwide, as many as 2 percent could be XDR-TB. "This is raising the specter of something that we have been
worried might happen for a decade - the possibility of virtually untreatable TB," Nunn said. It is particularly worrisome,
Nunn added, that the disease is very transmittable, especially in small spaces such as airplane cabins. According to
Nunn, 100 percent of XDR-TB patients who could be tested were HIV positive, and the spread of this strain in Africa
could shatter any hope of containing the AIDS pandemic currently afflicting parts of the continent. A cluster of TB cases occurred in
KwaZulu-Natal in South Africa, and 221 of the 544 patients studied had TB strains that were resistant to the two common drugs, rifampicin and isoniazid. Fiftythree of the patients had XDR-TB, and 52 of them died from the condition, which casts a pall over the use of antiretroviral (ARV) drug
treatments to keep the millions of HIV patients alive until a cure can be found. "There is no point in investing hugely in ARV programs if patients are going to die
Cases of XDR-TB have been discovered in the U.K., Eastern
Europe and even the United States, where the best drug treatments in the world are available. In March, the U.S.
Centers for Disease Control reported 64 cases of XDR-TB, 21 of which were fatal. Experts say that despite the
significant number of known XDR-TB cases found worldwide, an even greater number may be going unrecognized.
Part of the problem is that all TB drugs are old -- as it was thought conquered more than 50 years ago -- and drug
companies do not invest in TB drugs because it is regarded as a disease of Third World countries. As the AIDS crisis has
a few weeks later from extreme drug-resistant tuberculosis," Nunn said.
brought more attention to the inadequacy of general medical treatment in Africa, public-private partnerships have been put together in order to find and develop
new drugs, but they have yet to produce results. tomorrow in an emergency two-day meeting of WHO officials and international TB experts in Johannesburg,
South Africa.
The first rule of Project Mayhem is that you do not ask questions.
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Restrictions on Health Care for Illegal Immigrants creates outbreakes of contagious
diseases.
Janet M. Calvo, Summer 2008 Professor, City University School of Law. Many thanks for the comments of Ruthann Robson and Andrea McArdle,
the research assistance of Johan Bysainnthe, and the typing assistance of Rosa Navarra.
Medicaid and Child Health Insurance through SCHIP are federal programs designed to fill the gaps in health care
access for low-income individuals. However, qualification for these programs is severely restricted based on
citizenship status. This article explains how these restrictions pervert the concept and provision of emergency care. It further discusses how they
undermine public health objectives that protect the public at large, limit access to eligible citizens, and also impede the effective and economic functioning of the
healthcare system. The restrictions on health care access for noncitizens undermine public health policies relating to the
control of contagious diseases like tuberculosis ("TB"), severe acute respiratory syndrome ("SARS"), and pandemic
influenza, all of which require access to medical care for early detection and response. Additionally, the Medicaid and
SCHIP restrictions impede the reduction of infant mortality and morbidity, the promotion of child health, and the
control of chronic disease. As illustrated above, the current healthcare system fails to provide adequate treatment for many patients. This egregious
condition of the system is further negatively impacted when noncitizens are added to the equation. For example limiting health care for noncitizens
to emergencies leads to inappropriate and more costly care in addition to the unnecessary escalation of diseases
and conditions to dangerous levels. While emergency care is most often provided in hospitals, medical care can be
less costly when patients are treated at an earlier stage of an illness or condition in an outpatient setting. TB is a
serious, worldwide contagious disease.
TB is a dangerous disease that requires immediate action Illegal Immigrants cant get
Janet M. Calvo, Summer 2008 Professor, City University School of Law. Many thanks for the comments of Ruthann Robson and Andrea McArdle,
the research assistance of Johan Bysainnthe, and the typing assistance of Rosa Navarra.
TB has the potential to do great harm as it is spreads from person to person through the air. Once an individual is
infected, the disease usually affects the lungs but also can affect other parts of the body. It is a serious condition that
can lead to death, but can be controlled with proper diagnosis and treatment. Persons who become infected can
have a latent or an active condition. Access to health care for prevention, screening, early diagnoses, and treatment
are necessary to prevent the increase of drug-resistant TB and the associated costs. Providing health care access to
noncitizens is therefore important in meeting the public health goal of controlling and hopefully eliminating this
disease. While treatment programs are targeted to help treat and curtail the spread of TB, general health care access
is essential.
Nearly 50 million Americans remain uninsured posing serious TB risks.
Rashford, 2007 (Marleise Rashford, RN, BSN, is Family Nurse Practitioner Graduate Student, Florida Atlantic University, Boca Raton, Florida. Nursing
Forum Volume 42, No. 1, January-March, 2007 “A Universal Healthcare System: Is it Right for the United States?” EBSCO)
The number of uninsured Americans remains grave and continues to grow. According to the U.S. Census Bureau (2004), between
2000 and 2003, the
number of Americans without health insurance rose by 1.4 million to 45 million. To get a perspective of what this actually means, let
us take a look at the numbers. The population of the United States based on the 2000 census was 281,421,906 and that means that approximately one sixth
of the population is uninsured and lacks adequate health care. Also, we cannot neglect the thousands, possibly millions, of
undocumented individuals that reside in this country; they get sick and seek medical care at the many EDs in their
communities. If so many individuals are not receiving basic health care, this could lead to major public health crises in
the near future as noted in a study that showed an increased incidence of tuberculosis in certain communities (White & Atmar, 2002).
The first rule of Project Mayhem is that you do not ask questions.
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Early detection and diagnosis prevents the spread of various diseases.
Janet Calvo, 2008 (Professor, City University School of Law. “The Consequences of Restricted Health Care Access for Immigrants: Lessons from
Medicaid and SCHIP.” 17 Ann. Health L. 175//ZE)
Another important element of communicable disease control is the early detection and treatment of contagious
diseases, such as SARS, TB, influenza, hepatitis, and venereal disease. For such diseases, access to primary care is
essential to contain the risk of contagion for the larger community. These diseases may be asymptomatic and can only be detected through
primary care screenings, particularly sexually transmitted diseases. n145 Moreover, contagious diseases may have common symptoms that
require careful medical screening to assess. n146 Influenza is an example. Influenza, or the "flu", is transmitted by respiratory secretions, direct
contact, and contact with infected surfaces and objects. n147 Its symptoms and severity vary; they can be non-specific and include fever, chills, cough, and
headache. n148 The challenge to those in public health is that the "flu" may be minor or it may be caused by a new
respiratory pathogen that can [*195] lead to an epidemic if not detected and controlled. n149 With proper primary care,
these diseases can be treated during their early stages, thereby reducing, containing, and eliminating their risks.
Giving healthcare access to noncitizens is key to controlling tuberculosis.
Janet Calvo, 2008 (Professor, City University School of Law. “The Consequences of Restricted Health Care Access for Immigrants: Lessons from
Medicaid and SCHIP.” 17 Ann. Health L. 175//ZE)
TB is a serious, worldwide contagious disease. n150 TB has the potential to do great harm as it is spread from person to person through the air. n151 Once an
individual is infected, the disease usually affects the lungs but also can affect other parts of the body. n152 It is a serious condition that can lead to death, but can
be controlled with proper diagnosis and treatment. n153 Persons who become infected can have a latent or an active condition. n154 Control of TB
necessitates screening. Screening is especially important for at-risk groups, which include foreign-born persons.
Treatment of latent TB is recommended to decrease the risk of the development of active TB. n155 However, active TB can also be treated. n156 A fully
administered drug treatment results in cure rates of 95%, but because treatment is specific and sometimes lengthy, it must be supervised and facilitated by a
healthcare worker. n157 While
TB has been on the decline in the United States, it continues to increase in foreign-born
persons. n158 In the United States in 2006, the number of TB cases among foreign-born persons increased. The TB rate in foreign-born
persons in the United States in 2006 was 9.5 times greater than that of native-born [*196] persons. n159 These numbers
illustrate that it is crucial for noncitizens to have access to screening. Elimination of TB is an important public health goal. n160 In the 1960's and 1970's,
declining TB rates in the United States led to a dismantling of prevention and treatment programs. n161 The consequence was increased TB infection rates with
drug-resistant strains emerging. n162 It was estimated that the monetary costs of losing control of TB exceeded one billion
dollars in New York City alone. n163
Of particular current concern is the control of multidrug-resistant and extensively drug-resistant TB, n164 which
are significantly more difficult to treat. Others can become infected by breathing in the air containing these TB germs. n165 Multidrug-resistant
TB
disproportionately affects foreign born persons. They accounted for 81.5% of these cases in 2005. n166 From 2000-2006,
73% of the extensively drug-resistant TB cases occurred in foreign-born persons. n167 Control of multidrug-resistant TB first requires appropriate testing and
screening. The treatment of the disease requires appropriate medication and monitoring to assure that the therapy is completed. n168 Access to health
care for prevention, screening, early diagnoses, and treatment are necessary to prevent the increase of drugresistant TB and the associated costs. Drug-resistant TB also occurs in patients with active TB who are initially treated with medication, but do not
get their full course of treatment. n169 When drug-resistant TB develops, the treatment required is much more extensive and expensive. Treatment for multidrugresistant TB requires a minimum of eighteen to twenty- [*197] four months; in-patient costs for someone with extensively drug-resistant TB can be $ 600,000.
Providing health care access to noncitizens is therefore important in meeting the public health goal of controlling
and hopefully eliminating this disease. While treatment programs are targeted to help treat and curtail the spread of TB, general health care access
n170
is essential. As with many diseases, TB presents with common symptoms such as a cough and fatigue at the early stages when it is easiest to treat and
contagion can be best controlled. n171
The first rule of Project Mayhem is that you do not ask questions.
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Rise of TB is because of current policies towards immigrants, government must act
Kimberly A. Johns* and Christos Varkoutas** (Kimberly A. Johns and Christos Varkoutas, Journal of Contemporary Health Law &
Policy, “The Tuberculosis Crisis: The Deadly Consequence of Immigration Policies and Welfare Reform,” Fall 19 98, 15 J. Contemp. Health L. & Pol'y 101, JMP)
The escalating problem is both attributable to, and compounded by, not only the rise in drug- resistant strains of the disease, but also by recent
U.S. policies and reforms regarding immigrants. Immigrants are particularly vulnerable to TB and currently have one
of the highest rates of infection. The current legal framework regarding this class of persons has exacerbated the
country's TB problem by presenting significant opportunities for the quick and rampant spread of the disease. The
policies of the U.S. government towards immigrants may, in fact, be contributing to the rise of drug-resistant TB.
Persons infected with TB, especially drug-resistant strains, continue to enter the U.S. Furthermore, TB-infected immigrants
avoid proper treatment rather than face the harsh effects of recent legislative reforms. The end result is the
continuing spread of TB as well as increasing incidence of drug-resistant strains of the disease.Despite the grim picture, the
U.S. government has not recognized the impact of its policies and regulations on the spread of TB. Incidence of TB
continues to increase without significant government action to proactively prevent a full-blown epidemic. Current TB
treatment methods will remain ineffective given the debilitating constraints of immigration and welfare policies. Government indifference towards
the disease, coupled with these policies and reforms, may ultimately lead to an epidemic rise in TB among the country's overall population. If the government
recognizes the deleterious effects of its policies and takes action to avoid the disaster before it happens, solutions for curbing TB are close at hand.
Immigrants are bringing in TB and are predisposed to it
Kimberly A. Johns* and Christos Varkoutas** (Kimberly A. Johns and Christos Varkoutas, Journal of Contemporary Health Law &
Policy, “The Tuberculosis Crisis: The Deadly Consequence of Immigration Policies and Welfare Reform,” Fall 19 98, 15 J. Contemp. Health L. & Pol'y 101, JMP)
In general, a significant number
of TB cases are "imported" into the U.S. by immigrants, either documented or
undocumented. Immigrants are predisposed to suffer respiratory and other infectious diseases like TB, due to the
concentration of undocumented immigrants among the migrant farm worker population, their substandard living
conditions, and malnourishment. Additionally, immigrants suffer from drug-resistant strains of TB at a significantly high
rate, dramatically increasing their vulnerability to the diseases. The increased rate at which immigrants in the U.S. suffer from the disease, despite recent
declines of TB incidence among the general population, demonstrates the vulnerability of immigrants. Thus, any formulation to combat
TB must adequately address this adversely affected group. Specifically, the U.S. government must consider the effects of current
immigration policies and the new welfare reform act on the incidence of TB in the immigrant population.
Illegal immigrants are not tested for diseases
Kimberly A. Johns* and Christos Varkoutas** (Kimberly A. Johns and Christos Varkoutas, Journal of Contemporary Health Law &
Policy, “The Tuberculosis Crisis: The Deadly Consequence of Immigration Policies and Welfare Reform,” Fall 19 98, 15 J. Contemp. Health L. & Pol'y 101, JMP)
Currently, before consular offices issue visas to immigrants, applicants are required to submit to a physical examination. Therefore, anyone
seeking
permanent entry into the U.S. is subject to an examination to determine whether that person is infected with a
contagious disease such as TB. However, one seeking a nonimmigrant visa need not submit to a physical examination unless the consular official
believes it is necessary. Furthermore, there is no requirement for foreigners entering the U.S. who do not need a visa, or U.S. citizens returning to the country
Obviously, undocumented immigrants who enter
the country covertly are also not subject to TB testing. Therefore, many persons entering the country are never tested
for TB prior to their arrival in the U.S.
after traveling abroad, to submit to any physical examinations before entering the country.
The first rule of Project Mayhem is that you do not ask questions.
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Harms – TB
Immigration reform act fails to prevent TB
Kimberly A. Johns* and Christos Varkoutas** (Kimberly A. Johns and Christos Varkoutas, Journal of Contemporary Health Law &
Policy, “The Tuberculosis Crisis: The Deadly Consequence of Immigration Policies and Welfare Reform,” Fall 1998, 15 J. Contemp. Health L. & Pol'y 101, JMP)
The new immigration reform act focuses tremendous resources on stemming the tide of covert undocumented
immigration. This narrowly tailored plan, however, will not prevent people infected with TB from entering the country.
Despite enhanced efforts provided in the act, undocumented immigration continues. In fact, because the provisions of the
immigration reform act make deportation easier, the incentive for undocumented immigrants to conceal themselves
from government authorities increases. As a result, such immigrants are unlikely to be tested for any deadly disease.
Additionally, as noted above, some foreigners and Americans traveling abroad can easily enter the country without being subject to TB
testing. Therefore, if the government's aim is to halt TB from crossing the nation's borders, policies must be more encompassing.
TB patients will not get help from welfare reform act
Kimberly A. Johns* and Christos Varkoutas** (Kimberly A. Johns and Christos Varkoutas, Journal of Contemporary Health Law &
Policy, “The Tuberculosis Crisis: The Deadly Consequence of Immigration Policies and Welfare Reform,” Fall 1998, 15 J. Contemp. Health L. & Pol'y 101, JMP)
The new welfare reform act does not provide coverage for undocumented immigrants who need non-emergency
medical care. Although strictly limiting access to medical benefits, this reform makes an exception for treatment of communicable
diseases. By drastically limiting medical coverage of documented immigrants to emergency situations, the welfare reform also acts as a bar for immigrants
legally present in the country to receive medical treatment. Because of the vague nature of early TB symptoms, the disease does not
always appear to be an emergency, or readily identifiable as a communicable disease. Therefore, without benefits to
cover the cost of treatment, many immigrants with TB forego medical assistance. Thus, by the time TB-infected
persons reach the high threshold for covered emergency care, there is not much that can be done for them, and they
have likely already infected many others.
Immigrants won’t get help because of fear of deportation
Kimberly A. Johns* and Christos Varkoutas** (Kimberly A. Johns and Christos Varkoutas, Journal of Contemporary Health Law &
Policy, “The Tuberculosis Crisis: The Deadly Consequence of Immigration Policies and Welfare Reform,” Fall 1998, 15 J. Contemp. Health L. & Pol'y 101, JMP)
The new legislation
also requires the reporting of known undocumented immigrants who seek medical assistance.
General health laws also require the reporting of the name, address, and contacts of TB-infected patients. Therefore, undocumented immigrants have
the added risk of deportation just by attempting to receive medical assistance to treat their disease, even if their
condition has progressed to an emergency. Documented immigrants are also reluctant to seek care for fear that they
will be deported because they are "undesirable" or that undocumented friends or family will be detected and deported
through contact tracing by health officials. Thus, the fear of deportation forces many immigrants to avoid treatment, even when such treatment is
available under the narrow exceptions of the reform legislation. Sadly, immigrants often allow their own condition to degenerate to an
extreme stage of the disease while at the same time infecting more people.
The first rule of Project Mayhem is that you do not ask questions.
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Harms – TB
Drug resistant strains of TB are becoming more common, with wider potential for
outbreak
Kimberly A. Johns* and Christos Varkoutas** (Kimberly A. Johns and Christos Varkoutas, Journal of Contemporary Health Law &
Policy, “The Tuberculosis Crisis: The Deadly Consequence of Immigration Policies and Welfare Reform,” Fall 19 98, 15 J. Contemp. Health L. & Pol'y 101, JMP)
The advent of drug therapy radically altered the treatment and control of TB. Streptomycin, discovered by Selman Abraham in
the 1940s, was the first drug used in treating TB. Discovery of this drug dramatically improved the ability to treat TB sufferers.
Later, however, the medical community realized that streptomycin had not cured TB, but had only limited the disease's
negative effects. TB deaths following the discovery of streptomycin provided evidence of TB strains that were resistant to this miracle drug. To combat
the setback, scientists made great gains in treating the disease through the discovery of new drugs, and the combination of
such new drugs. The improvement and growth of drug therapy treatment had progressed to the point where the cure rate for TB was nearly 100 percent.
Unfortunately, this reliance on modern medicine has fueled the current resurgence of TB. The overuse and misuse of
medications has led to the creation of TB strains that are resistant to drug treatment. A person may develop drug-resistant TB in
one of two ways. First, transmitted or primary drug resistance develops from infections with TB organisms that are already resistant to at least one drug. Second,
acquired or secondary drug resistance develops as a result of ineffective treatment of TB. Conventional drug therapy treatments often prove useless in
combating these cases. Due to the inability of current drug regimens to effectively treat drug-resistant TB, the cure rate in
such cases is approximately forty to sixty. Furthermore, drug-resistant TB remains infectious for a longer period of time
than does typical TB. Therefore, the potential for infection is greatly increased. Consequently, the possible widespread outbreak of
drug-resistant TB would be extremely dangerous.
Immigrants are forced into self-medication which helps creation of drug-resistant TB
Kimberly A. Johns* and Christos Varkoutas** (Kimberly A. Johns and Christos Varkoutas, Journal of Contemporary Health Law &
Policy, “The Tuberculosis Crisis: The Deadly Consequence of Immigration Policies and Welfare Reform,” Fall 19 98, 15 J. Contemp. Health L. & Pol'y 101, JMP)
Fear forces immigrants, if they seek any treatment at all, into an underground system of drugs. In this case,
"underground drugs" are not illicit, dependency-inducing drugs, but instead are antibiotics, obtained without a prescription, which are
then used in the treatment of TB. Unfortunately, the treatment of TB is extremely lengthy and patient's compliance with
this regimen, especially when not under direct supervision, is extremely poor. Therefore, immigrants who attempt to selfmedicate often fail to comply with the difficult regimen. A dangerous cycle is thus created: an infected person fails to effectively
self-medicate, continues to spread the disease, and contributes to the creation of drug-resistant TB, which is even
more difficult to treat in newly-infected persons.
The first rule of Project Mayhem is that you do not ask questions.
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Harms – Racism
Injustice done against noncitizens is inextricably tied with oppression of racial
minorities.
Johnson 03 (Kevin, Associate Dean and Professor of Law at UC Davis, The “Huddled Masses” Myth,
http://www.temple.edu/tempress/chapters_1400/1597_ch1.pdf)
Much has been written about how notions of race are social constructions that serve to help justify racial subordination. Beliefs in
racial inferiority rationalize racial hierarchy. Historically, the negative treatment of different U.S. “racial” groups, such as the Irish and southern and eastern
Europeans, that are today considered to be a white is a powerful demonstration of race as a social rather than a biological construction. Immigrant status,
even more clearly than race, is
also a social construction. It is not immutable, and it is not fixed by biology. The law creates “aliens” as
outsiders who are allocated few political and legal rights. Moreover, the legal construction of “aliens” not only affects the general
public’s view of noncitizens but also contributes to their harsh treatment. Given the modern sensibilities about civil rights, the unsympathetic
treatment of noncitizens can be more easily rationalized than can attacks on minority citizens. As this justification goes, we support fair treatment of citizens of
Mexican ancestry but simply want to halt the immigration of “aliens,” especially “illegal aliens,” who cause social, economic, and political problems. We are not
“Racist,” even though the enforcement measures that we endorse fall disproportionately on people of color; we simply want to promote an immigration policy that
serves all U.S. citizens. The rationalization is unpersuasive. In the modern United States, race and immigrant status neatly, albeit loosely,
coincide. The immigrants who are adversely affected by a restrictionist measure are, more likely than not, racial minorities. The vast majority of
today’s immigrants to the United States—as many as 80 to 90 percent each year—are people of color. This impact is a
predictable, if not an intentional, consequence of many restrictionist measures in modern times. In certain circumstances, restrictionist laws and
policies may, in fact, amount to an attack on people of color, with immigration status used as a proxy for race. The use of
proxies to discriminate obscures the true inequality of the law and allows for the plausible denial of a discriminatory
intent while ensuring discriminatory results. In their analysis of the history of immigration laws, the chapters that follow conclude that, taken as a
whole, the laws reflect the dominant sentiment about subordinated groups in the United States. As John Higham’s classic study of nativism in the United States
has documented, this nation has historically exhibited a great intolerance for immigrants who deviate from the perceived
Anglo-Saxon norm. The harsh treatment that has undeniably been meted out to disfavored groups of U.S. citizens, does not compare to the nation’s
harsh treatment of “aliens”—by definition outsiders to the community—who share the same characteristics as the disfavored groups of citizens. This
phenomenon is evident in recent immigration milestones: the reduction of public benefits to immigrants as part of welfare
reform combined with punitive immigration reform legislation in 1996; the militarization of the U.S. border with Mexico in the 1990s that
resulted in hundreds of deaths of Mexican citizens; the unconscionable treatment of Haitians (poor, black, and culturally different) fleeing political and economic
turmoil; the crackdown on “criminal aliens,” which resulted in record levels of deportations of Mexican citizens; and the targeting of Arabs and Muslims by means
of special reporting requirements, arrests, interrogations, and detention after the September 11, 2001, attacks. These lessons hold true for most subordinate
peoples in the United States. The history of racial exclusions in the immigration laws is perhaps one of the most well-known examples. Beginning in the 1800s,
the race and class of Chinese immigrants prompted their exclusion under the U.S. immigration laws. Racial fears toward southern and eastern Europeans
culminated in the Immigration Act of 1924 and the national origins quota system. Although the Immigration Act of 1965 eliminated the most glaring grounds for
racial exclusion, the immigration laws in operation today continue to have distinctly racial impacts. The poor, considered likely to become “public charges,” have
also been subjected to exclusion and deportation under the immigration laws. One of the oldest features of the federal immigration laws, the public charge
provisions, adversely affects the largest number of potential immigrants. Today, the public charge exclusion bars thousands of immigrants from developing
nations that are populated by people of color from coming to the United States each year. Political undesirables, such as anarchists, communists, and (in current
parlance) “terrorists,” have been marked for adverse treatment as well. In the aftermath of the Red Scare following World War I and the Years dominated by
Senator Joseph McCarthy’s search for communists in our midst, the federal government’s vigorous application of the ideological provisions of the immigration
laws resulted in extreme impacts on immigrants who had lived peacefully in this country for many years. The exclusionary aspects of the U.S. immigration laws
remain intact in the modern era. The nation has become somewhat more tolerant of political dissent since the 1950s grip of McCarthyism. But even before the
September 11 attacks, the U.S. government deported immigrants for their political views (sometimes after hearings in which the alleged “terrorist” was denied the
opportunity to review the government’s evidence and for tenuous links to Arab and Muslim “terrorists.” Legal constraints soften the treatment of poor citizens in
our cities. But few constraints limit governmental power to bar the poor—the archetypal “huddled masses”—from immigrating to the
United States, severely limit the eligibility of poor immigrants to public benefits, and deport those immigrants who
utilize such benefits and services, all features of modern immigration laws. Although perhaps narrowed by the U.S. Supreme Court
during Chief Justice William Rehnquist’s leadership, constitutional protections exist for citizen criminals; in contrast, the political process has subjected the deeply
unpopular “criminal aliens” to increasingly harsh measures. Until 1990, homosexuals could be banned from entering the United States as “psychopathic
personalities.” At the time of the removal of that bar from immigration laws, there was a growing recognition in this country that lesbians and gay men had rights
against discrimination. The chapters that follow explore the differential treatment of non-citizens and of citizens who share characteristics with non-citizens. In an
era marked by intense anti-immigrant sentiment in the United States, and perhaps the world, it is especially important to understand the dynamic relationship
between immigration and the civil rights of minorities.
The first rule of Project Mayhem is that you do not ask questions.
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Pursuing equality for noncitizens is key to preventing xenophobia and government
injustice based on ethnicity against citizens.
Johnson 03 (Kevin, Associate Dean and Professor of Law at UC Davis, The “Huddled Masses” Myth,
http://www.temple.edu/tempress/chapters_1400/1597_ch1.pdf)
This book’s examination of the
relationship between the treatment of noncitizen minorities and domestic minorities offers
insights into how dominant society views subordinated groups, including people of color, political dissidents, the poor, criminals, women,
and homosexuals. The harsh treatment of “alien” minorities under the immigration laws is a reflection of U.S. society’s potential treatment of domestic minorities,
even U.S. citizens, in the absence of legal and other constraints. The
history of exclusion and deportation of noncitizens under the U.S.
immigration laws give us a view of the soul of America, and what we learn is disturbing. Without boundaries demarcated by law, the nation
could well act out its true desires with respect to disfavored minority groups. Could that time ever come? The possibility may not be as far-fetched as some might
believe. As
part of the war on terrorism that followed September 11, 2001, the federal government aggressively acted
against Arab and Muslim noncitizens, arresting, interrogating, and detaining hundreds with no evidence of individual
wrongdoing and later carried out some of the same actions against U.S. citizens. Consider the case of a U.S. citizen,
born Jose Padilla, who converted to Islam and changed his name to Abdullah Al-Muhajir. Arrested and detained in the United States for
alleged involvement in the early stages of an Al Qaeda terrorist plan to construct and detonate a “dirty bomb” in this country, he has been
labeled an “enemy combatant” by the U.S. government had was denied access to an attorney. The federal government, moreover, has
announced that it plans to hold al-Muhajir in a military jail indefinitely without charging him with a crime. In this precedentsetting case, the U.S. government has, by means of presidential fiat, denied a U.S. citizen protections guaranteed by the Bill of Rights. This example reveals
what is at stake for citizens and noncitizens as the war on terrorism continues. It suggests that the U.S. government’s treatment of noncitizens is inextricably
linked to its treatment of citizens. Denial
of rights to noncitizens lays the groundwork for denial of rights to citizens. Clearly, those
who are truly committed to racial justice in the United States cannot ignore the treatment of immigrants.
The first rule of Project Mayhem is that you do not ask questions.
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Solvency
Giving healthcare to noncitizens saves money in the long run.
Marietta 06 [Melissa, Writer for the International Social Science Review, “Undocumented immigrants should receive social services,” International Social
Science Review, Spring-Summer, 2006, http://findarticles.com/p/articles/mi_m0IMR/is_1-2_81/ai_n16599310/?tag=content;col1
Many immigrants do not receive needed healthcare because they fear deportation. Denying healthcare
to any segment of the population
can lead to more extreme ailments that become more expensive to treat. Dr. Hogai Nassery, a physician who practices in Chamblee,
GA, states:
it's less expensive to provide prenatal care for an undocumented woman than to provide medical care for her
premature infant and it's more economical to regulate a man's high blood pressure than to take care of him after a
massive stroke. A cut in access to primary health care will simply lead to more uninsured patients in our already
overburdened emergency rooms.
Estimates of the cost of giving healthcare to noncitizens are exaggerated.
Marietta 06 [Melissa, Writer for the International Social Science Review, “Undocumented immigrants should receive social services,” International Social
Science Review, Spring-Summer, 2006, http://findarticles.com/p/articles/mi_m0IMR/is_1-2_81/ai_n16599310/?tag=content;col1
Reality dictates that millions of undocumented immigrants plan to remain in the United States. Denying them healthcare services will lead to increased instances
of infectious, yet treatable diseases. The state legislatures of Georgia and Oklahoma nonetheless are trying to bar
undocumented immigrants from receiving any medical care, including emergency room services. (6) This overlooks the fact that
most undocumented immigrants in the U.S. are younger workers. Since younger people tend to use less healthcare
than the elderly, healthcare cost estimates for undocumented aliens tend to be exaggerated. (7)
Giving healthcare to noncitizens makes the system much more efficient.
Pagan, 7 – Professor of Economics and Director of the Institute for Population Health Policy in the Department of Economics and Finance at the University
of Texas-Pan American (Jose A. Pagan, Immigration Reform and Health, December 2007, http://www.reforminstitute.org/uploads/publications/JoseAPagan.pdf, )
Comprehensive immigration reform is necessary if we want to improve the way in which immigrants access health care resources. Mainstreaming
immigrants into the U.S. health care system will improve the functioning of our health care system by allowing
immigrants to access the services they really need more effectively. Improving access to health care for immigrants has the
added benefit of increasing the quality of care that we all receive, particularly if we reside in communities with
relatively large uninsured immigrant populations. Uninsurance forces many immigrants to reduce the quantity and
quality of health care demanded, which in turn reduces health care quality and availability for everyone else residing
in communities where immigrants concentrate. It is important to point out that the overall burden immigrants place in our health care system is
rather small. About half of documented immigrants are uninsured and the proportion of undocumented immigrants who are uninsured is certainly much higher.
Immigrants’ lack of health insurance implies not only lower rates of overall health care utilization, but also a less efficient use of the health care system.
The first rule of Project Mayhem is that you do not ask questions.
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Healthcare for noncitizens circumvents emergency care, the only healthcare
currently available for them, which lacks a universally accepted definition.
Janet Calvo, 2008 (Professor, City University School of Law. “The Consequences of Restricted Health Care Access for Immigrants: Lessons from
Medicaid and SCHIP.” 17 Ann. Health L. 175//ZE)
All otherwise eligible aliens are entitled to Medicaid coverage for "such care and services [as] are necessary for the treatment of an emergency medical
condition of the alien." n54 An "emergency medical condition" is a [*184] medical condition (including emergency labor and delivery) that
manifests itself by acute symptoms of sufficient severity (including severe pain) such that the absence of immediate medical
attention could reasonably be expected to place the patient's health in serious jeopardy; inflict serious impairment to
bodily functions; or cause serious dysfunction of any bodily organ or part. n55 As will be discussed more fully below, what meets
this definition has been hotly contested in the courts and between states and the federal government. III. Restrictions on
Alien Eligibility for Health Care Distort the Provision of Appropriate and Effective Care for Emergency Medical Conditions Under Medicaid, those who
do not fit into an eligible immigration status or who cannot prove their citizenship status are limited to treatment for an
emergency medical condition. There has been confusion and controversy about what constitutes treatment for an emergency medical condition.
Moreover, the limitation of noncitizen access to care for emergency medical conditions has undermined the ability of medical professionals to prevent
emergencies and to treat medical conditions in a manner consistent with their obligations to save lives and prevent damage to health. Individuals in need of care
and providers have argued for the definition of an emergency medical condition that reflects the reality of how conditions and illnesses are treated in the
healthcare system. State and federal courts have divergently interpreted the statutory definition of treatment for an
emergency medical condition. n56 Moreover, some view the outcome of court interpretations as inconsistent even when the courts apparently apply
the same legal standard. n57 Courts' varying interpretations of what constitutes treatment for an emergency medical
condition have created negative consequences not only for the individuals in need of care, but also for the providers
of emergency services.
Vaccinations are particularly important to prevent epidemics in immigrant
populations.
Janet Calvo, 2008 (Professor, City University School of Law. “The Consequences of Restricted Health Care Access for Immigrants: Lessons from
Medicaid and SCHIP.” 17 Ann. Health L. 175//ZE)
The need of the United States to maintain high immunization rates creates a public health concern. n134 The infectious
agents of vaccine or toxoid-preventable diseases have not yet been eradicated. Thus, any decline in immunization
rates can be expected to increase the risk of new outbreaks of these diseases, resulting in an increase in
unnecessary disability and deaths. Health care access, particularly for children, is important in keeping immunization rates high because children
are particularly vulnerable to diseases such as measles, mumps, and diphtheria. n135 Further, they frequently interact with other children in playgrounds and
schools. While providing programs which focus exclusively on immunization may be helpful to some, a well child program provided through routine health care
access is most important to assuring that children receive recommended vaccinations over time, thereby protecting not only their health but the public's health as
well. n136 Immunization for children depends on the ability of their parents or other caretakers to obtain health care, but the restrictions on health care access
lead to confusion and fear in immigrant communities, discouraging parents from obtaining needed health care for their children. n137 Although immunization for
children is of the utmost importance, the
immigrant population as a whole is in dire need of immunization. Immunization of adults is also
a high priority because many immigrants come from countries in which they were not immunized. n138 Adults need access to health
care to be assessed for and provided with necessary immunizations. Further, immunization for women in childbearing years is critical;
not only for their health, but also for the health of the children they bear. n139 If the system is structured to address the
immunization needs of immigrants thereby protecting those individuals from contagious diseases, then the risk to the
general population of becoming infected is minimized.
The first rule of Project Mayhem is that you do not ask questions.
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In the status quo immigrants are already being treated in hospitals, regardless of
their status. Parkland hospital proves.
Morgan Greenspon July 14 2009 Student, Loyola University Chicago School of Law, Class of 2009. Ms. Greenspon is a staff member of
Annals of Health Law.
Safety net hospitals, such as Parkland, provide access to health care for those who lack health insurance and would
not otherwise be able to afford medical care. Safety net providers are defined as "institutions and professionals that
by mandate or mission deliver a large amount of care to uninsured or other vulnerable populations." The safety net is
comprised of 310 hospitals that take on substantial responsibility in aiding and serving the uninsured, Medicaid
enrollees, and other susceptible populations that face a variety of barriers to accessing health care. The providers
that comprise the safety net are an essential component in our current healthcare system, giving care to groups of
people who would otherwise be excluded from receiving public benefits. Safety net providers are not only important to uninsured citizens, but
they also play a crucial role in providing health care to undocumented immigrants. n5 While all hospitals that participate in certain federally-funded programs have specific
hospitals like Parkland have decided to go above and beyond what is federally
required. Despite the fear that the provision of public benefits to undocumented aliens will create further incentive for migration, n6 Dr. Cutrer believes that
all patients should have health care access because healthcare professionals take an oath to provide care to those in
need.
responsibilities regarding what medical services they must provide,
In the status quo, the Texas law proves that immigrants are being treated and cared
for in hospitals. Hospitals are being compensated and the process is working.
Morgan Greenspon July 14 2009
of Annals of Health Law.
Student, Loyola University Chicago School of Law, Class of 2009. Ms. Greenspon is a staff member
Under state law, Texas counties must exercise one of three options to provide health care to their indigent residents hospital districts,
public hospitals, and county indigent health care programs. n8 Regardless of which option a county chooses , there is a "statutory obligation to cover a set of
basic healthcare services including primary and preventative services designed to meet the needs of the community ."
Hospital districts, such as Parkland, are created in accordance with Section 281.002 of the Texas [*311] Health and Safety Code, and are required to furnish
medical aid and hospital care to indigent and needy persons residing in the district. Additionally, the Texas
Constitution stipulates the creation of hospital districts, "providing that any district so created shall assume full
responsibility for providing medical and hospital care for its needy inhabitants." Under Texas law, hospital districts
must treat patients without charge if the patient is unable to pay for medical treatment. In order to finance these
uncompensated services, hospital districts are given the power to tax the residents of their counties. Thus, Texans residing in a
county with a hospital district pay taxes that directly fund medical services for the uninsured and indigent. Although Section 281.002 of the Texas Health and Safety Code does not explicitly require hospitals to
provide uncompensated care to undocumented immigrants, hospital districts must also operate in accordance with federal law. n14
The first rule of Project Mayhem is that you do not ask questions.
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Solvency – Feds Key
Even the states argue that the federal government is necessary in noncitizen
healthcare because of conflicting laws.
Janet Calvo, 2008 (Professor, City University School of Law. “The Consequences of Restricted Health Care Access for Immigrants: Lessons from
Medicaid and SCHIP.” 17 Ann. Health L. 175//ZE)
The economic benefits of immigration generally flow to the federal government, but the costs of new and increased populations are often absorbed by states and
localities as they are primarily responsible for their residents' health and welfare. Federal
law and practice inhibit states' ability to obtain
federal financial contributions for immigrant health care through Medicaid and SCHIP. n246 The controversies about the
definition of emergency care described above illustrate this idea; promised federal funds for state Medicaid programs have been
revoked because the federal authorities disagreed with the states on the definition of an emergency medical
condition. n247 State and federal governments have clashed over health care access for noncitizens. On a policy level, states and localities
can argue that health care for noncitizens is ultimately a federal responsibility because the federal government can
decide which noncitizens can enter and stay in the country. Within the current Medicaid system, states contend that the federal
government should pay a share of healthcare costs for noncitizens and should not impede state and local public health [*207] objectives by forcing state and
localities to solely bear the expense of providing for noncitizens. n248 Examples from New York, Texas, and Colorado illustrate some of the conflicts between
federal standards and state and local requirements. In New York, for example, an interpretation of federal legislative restrictions on noncitizen eligibility for
Medicaid by the Second Circuit resulted in the dissolution of a long-standing injunction in that state, which had protected access to pre-natal health care and
required federal funding regardless of the immigration status of pregnant women. n249 At about the same time, the New York Court of Appeals interpreted the
state and federal constitutions to require state medical assistance for several categories of noncitizens. n250 The State of New York therefore had an obligation
to provide medical care without receiving federal contributions. In a Texas community, doctors included all residents in a preventive
medical program designed to improve public health and limit emergency room costs. n251 The State Attorney General
asserted that this program violated federal law because it did not restrict the access of undocumented aliens. n252
Legal scholars, however, asserted that the federal law violated the Tenth Amendment. n253 The doctors argued that restrictions would undermine the public
health and fiscal objectives of the program. n254 The State of Colorado responded to the pressure of state budget restrictions for Medicaid by excluding all
immigrants from the Medicaid program, even those allowed to be included by federal law. n255 However, in 2005, the Colorado legislature passed a bill that
restored Medicaid eligibility for several categories of immigrants. n256 Lifting the restrictions based on noncitizen status in the current
Medicaid/SCHIP system would relieve states and localities of some burdens and would enable them to obtain federal
financial contribution for [*208] the health services they provide. In the broader context of health care reform, inclusion
of noncitizens is necessary to avoid similar federal-state conflicts.
States will just cut funding and illegal immigrants face a lack of medical services in the status quo.
Gorman, 2009 (Anna Gorman- Research analyst and marketing administrator. MAIN NEWS; Metro Desk; Part A; Pg. 3. Los Angeles Times April 27,.
“Some counties have halted non-emergency care of undocumented patients. Critics say ERs will pay the price.”
Forced to slash their budgets, some
California counties are eliminating nonemergency health services for illegal immigrants -a move that officials acknowledge could backfire by shifting the financial burden to emergency rooms. Sacramento County
voted in February to bar illegal immigrants from county clinics at an estimated savings of $2.4 million. Contra Costa County followed last month by cutting off
undocumented adults, to save approximately $6 million. And Yolo County is voting on a similar change next month, which would reduce costs by $1.2 million.
"This is a way for us to get through what I think is a horrible year for healthcare in California," said William Walker, director of Contra Costa Health Services.
Walker said the national ambivalence on immigration policy means that illegal
immigrants are living here but without federal or state
funding to provide essential medical services to them. Walker, who began his medical career treating undocumented farmworkers, said that
deciding to cut their services was difficult.
The first rule of Project Mayhem is that you do not ask questions.
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Solvency – Feds Key
Empirically speaking the federal government is key to developing social change because the states
are poorly staffed and structured.
Clarke, 81 (GARY J. CLARKE, MA, JD AJPH January 1981, Vol. 71, Supplement. American Journal of Public Health. “The Role of The States in the
Delivery of Health Services” EBSCO)
the federal government into
analysts and advocates of social change have continually identified state governments as
obstacles to achieving federal goals. As one intergovernmental expert has noted " . . . certain indictments of the states . . . had been made again
and again since the Depression. The most common charges were that state elected and appointed officials were corrupt, incompetent,
and racist; that state constitutions were long, complex, and antiquated; that Governors were weak, underpaid, and overworked; and
that legislatures were unrepresentative, backward and cumbersome."' In fact, as long ago as 1933, one specialist in public
The federal view of the states has long been rife with suspicion, distrust, and even outright hostility. With the entrance of
social programs in the 1930s,
administration went so far as to write the following. "The American State is finished. I do not predict that the States will go, but affirm that they have gone."^
Renewed social activism by the federal government in the 1960s brought forth a renewed spate of charges against the states—charges that were heard well into
the 1970s and formed the basis of much federal health policy in that decade. In 1974, for instance, after reviewing the lessons of The Great Society and 1960s,
two noted public policy analysts offered the following assessment: " . . . the sorry fact is that most state and local governments— with some
notable exceptions—are poorly structured and poorly staffed to carry out new and innovative tasks. They have a hard time
even meeting their routine commitments."' Again, in 1976, a noted health economist gave the following testimony to the Health and Environment Subcommittee
of the House Interstate and Foreign Commerce Committee. ". . . it is questionable, however, whether state governors should be given control of these programs
designed for the most part to assist disadvantaged groups such as migrant workers, blacks, and other minorities who have traditionally been neglected by state
and local governments."* And more recently, one eminent analyst of state health activities wrote: "When
measured by expenditures, state and
local health departments do not figure large on the health care scene. . . . In recent years, budgets for official public
health agencies have been restrained more than other sectors of the health economy."' Such statements are not surprising and
are, in fact, rather commonplace. Federal health expenditures now greatly exceed state and local health spending, and state
governments are widely perceived as administratively inept and unresponsive to the needs of the poor. Many of the
more widely known national health insurance proposals, for example, have called for a substantial dimunition or
complete elimination of states' programs to provide health care for the poor, administer benefits, and regulate health
insurance.
The USFG is the most effective because it works in a unified force.
Clarke, 81 (GARY J. CLARKE, MA, JD AJPH January 1981, Vol. 71, Supplement. American Journal of Public Health. “The Role of The States in the
Delivery of Health Services” EBSCO)
James Madison, in the Federalist Papers, first described the inherent theoretical advantages of a national government.* He argued that the larger
the number of jurisdictions in the republic, the less likely that the interest of any single jurisdiction would prevail. E. E.
Schattschneider updated this theory in The Semi-sovereign People.^ He argued that the greater the scope of conflict over a decision, the
more likely that the eventual decision would meet accepted public interest criteria. This latter argument—that states
are not as capable of making decisions in the public interest as the federal government— is probably most telling. Low
state Medicaid benefits, inadequate licensing procedures for health facilities, poor supervision of insurance carriers, barbarous mental hospitals, antiquated
regulation of health professionals, parochial health manpower education programs and more, are all alleged to be the failings of state government in the health
arena. To paraphrase former North Carolina Governor Terry Sanford's introduction to his book. Storm Over the States, these half-dozen charges were true about
all of the states some of the time, and some of the states all of the time.
The first rule of Project Mayhem is that you do not ask questions.
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Solvency – Feds Key
Federal action is key because state policies vary, are unfair, and fail to keep up with
reality.
Lindsey Catlett 07 Reporter at University of Virginia Law School Communications Intern at Leadership Conference on Civil Rights August 15, 2007 States
Respond to Federal Immigration Reform Inaction < http://www.civilrights.org/immigration/reform/states-respond-1.html>
Several states have enacted new laws that prohibit non-citizens from receiving public benefits like healthcare and
social services. South Carolina's lawmakers passed a resolution requesting that the governor of South Carolina declare by
executive order that no undocumented immigrant "is eligible to receive any services or assistance provided by the
department of social services or any other state agency to the extent allowed by law."
In contrast, California is extending all housing, income, and educational support programs to migrant workers in the
state. Washington passed a law that makes a $14 million subsidy available for facilities that house low income
migrant, seasonal, or temporary farm workers.
Over half of U.S. state legislatures have approved laws to prevent undocumented immigrants from receiving driver's licenses. Louisiana now requires that all
driver's license applicants be checked in the Basic Pilot Program and the federal Homeland Security terrorism watch list.
Civil rights groups are alarmed by these contrasting policies in various states and the lack of federal immigration
policy consensus, but still recognize the importance of the states filling the void in the immigration debate.
"Many of us agree that some state laws are an important first step on the road to that goal of comprehensive immigration reform, because the states are acting
when the federal government is not. However, many
of the new state policies are unfair and burdensome, and fail to keep up with
economic realities," said Henderson.
"America's immigration system clearly needs sweeping changes by the federal government and it needs them soon.
This is a moral issue and I believe it goes directly to our most basic understanding of civil and human rights," said
Henderson.
The first rule of Project Mayhem is that you do not ask questions.
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A2: States
States can’t solve because immigrants will still be afraid of deportation.
Park 04 Georgetown Immigration Law Journal Spring, 2004
NOTE: SUBSTANTIAL BARRIERS IN ILLEGAL IMMIGRANT ACCESS TO PUBLICLY-FUNDED HEALTH CARE: REASONS AND RECOMMENDATIONS FOR
CHANGE SEAM PARK (B.B.A., Emory University, 2001; J.D. Candidate, Florida State University College of Law, May 2005.)
Under the Welfare Reform Act, states have been granted the option of passing affirmative legislation to provide state-funded health care for illegal immigrants.
n14 Some states have decided to take advantage of this option, while others have not. The
combined effect of Section 434 of the Welfare
Reform Act and Section 632 of the Immigration Reform Law, however, nullifies the potential effectiveness of this provision
because even if states decide to make state-funded preventive health care available, illegal immigrants must remain
fearful of having their immigration status reported to the INS. n15 Therefore, federal legislation leaves an often impoverished and
uninsured portion of the population without reasonable access to any health care, whether it is state-funded preventative care, federally-funded emergency
services, or treatment for communicable disease.
Without changing the Welfare Reform Act and the Immigration Reform Law, states
will still have to pay for the healthcare themselves and will not be required to keep
immigration status from the INS.
Park 04 Georgetown Immigration Law Journal Spring, 2004
NOTE: SUBSTANTIAL BARRIERS IN ILLEGAL IMMIGRANT ACCESS TO PUBLICLY-FUNDED HEALTH CARE: REASONS AND RECOMMENDATIONS FOR
CHANGE SEAM PARK (B.B.A., Emory University, 2001; J.D. Candidate, Florida State University College of Law, May 2005.)
The Welfare Reform Act prohibits states from providing illegal immigrants with any "state or local benefit," n55 which
includes any "health . . . benefit, or any other similar benefit for which payments or assistance are provided to an
individual, household, or family eligibility unit by an agency of a State or local government or by appropriate funds of
a State of local government." n56 However, the Welfare Reform Act gives states the ability to pass affirmative legislation
providing illegal immigrants with state-funded preventive health care at their discretion. n57 States that desire to take
advantage of this authority are faced with two problems. First, the Welfare Reform Act has made it difficult and
confusing for states to provide illegal immigrants [*577] with state-funded preventive care, assuming they desire to exercise this
option. The second problem is a subtle, familiar problem caused by Section 434 of the Welfare Reform Act and Section 642 of the
Immigration Reform Law. n58 The problem is that illegal immigrants must remain fearful of having their having their
undocumented status revealed to the INS, regardless of whether the federal or state government is providing the
health care.
States can’t prohibit the disclosure of immigration status to the INS.
Park 04 Georgetown Immigration Law Journal Spring, 2004
NOTE: SUBSTANTIAL BARRIERS IN ILLEGAL IMMIGRANT ACCESS TO PUBLICLY-FUNDED HEALTH CARE: REASONS AND RECOMMENDATIONS FOR
CHANGE SEAM PARK (B.B.A., Emory University, 2001; J.D. Candidate, Florida State University College of Law, May 2005.)
The second problem arises if a state successfully passes affirmative legislation providing illegal immigrants with state-funded preventive care. The problem is
caused by Section
434 of the Welfare Reform Act and Section 642 of the Immigration Reform Law because these statutes ban
any state or governmental entity from instructing their state health officials to prohibit the disclosure of the
undocumented status of these illegal immigrants. Therefore, illegal immigrants must remain deterred from accessing
preventive care that the state legislature has purposely made available because they are not provided with security against having state health care officials
revealing their immigration status to the INS. Essentially, the federal government is giving with one hand, but taking with the other as
the Welfare Reform Act allows states to pass legislation to provide illegal immigrants with preventive health care, but Section 434 of the Welfare Reform Act and
Section 642 of the Immigration Reform Law nullify the effectiveness of this provision. These statutes prevent states from instructing their state health officials not
to disclose immigration information to the INS.
The first rule of Project Mayhem is that you do not ask questions.
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Project Mayhem
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A2: States
Immigrant Discrimination can only be solved on a federal level, states cannot be
effective.
Bosniak, 94 (Linda S., Assistant Professor of Law, Rutgers-Camden. 1994 Virginia Journal of International Law Association. Virginia Journal of
International Law. Fall, 1994. Lexis.)
In response to Professor Spiro's proposal, I will make three points. First, no matter what we conclude about where the site of government authority to regulate
immigration should properly lie, we need to ask if that authority should be rightfully understood to encompass the sorts of social and economic exclusions of
aliens mandated by California's Proposition 187 and contemplated elsewhere. Second, the current legal import of the preemption doctrine goes beyond the
allocation of authority question and must be regarded, at least functionally, as a crucial part of structure of protections available to aliens against state power.
Finally, notwithstanding Professor Spiro's suggestion that
international human rights norms can provide a substitute for the
protections afforded to aliens under the federal Constitution, existing international norms provide no effective
constraints on state discrimination against aliens, especially where measures like Proposition 187 are concerned.
The first rule of Project Mayhem is that you do not ask questions.
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A2 Immigrants wouldn’t use
The main barrier to utilization of health care is financial; thus, the plan that removes that would
ensure the noncitizens use the care.
Leclere, Jensen and Biddlecom, 94 (Felicia B. Leclere, Leif Jensen and Ann E. Biddlecom Journal of Health and Social Behavior Vol. 35,
No. 4 (Dec., 1994), pp. 370-384)
A Canadian study proves empirics- immigrants utilized health care services equally when given the
opportunity.
Wen, Goel, Williams, 96 (Wen SW, Goel V, Williams JI. “Utilization of health care services by immigrants and other ethnic/cultural groups in
Ontario.” Institute for Clinical Evaluative Sciences in Ontario, University of Toronto, Canada. May, 1996. http://groups.google.com/group/scfi-varsitypolicy/browse_thread/thread/27b9abc7607bf13d/0c09f66e2afeee94?hl=en#0c09f66e2afeee94 )
OBJECTIVES: This study assesses the accessibility of health care services by immigrants and other ethnic/cultural groups in Ontario, using the 1990 Ontario
Health Survey. METHODS: The population sample of 38,519 adults aged 16-64 is weighted to represent the entire non-institutionalized population of the
province. Outcome measures were whether the study participants visited a general practitioner's office, a specialist's office, or a hospital's emergency
while the percentages of participants who ever visited a
general practitioner's office during the past 12 months were slightly higher in immigrants and other ethnic/cultural
groups, the rates of visits to the specialist's office were quite similar, and the rates of hospital emergency
department's visits were often lower (except for aboriginals), than for Canadians. These differences in the utilization of
health services across different immigrant and ethnic/cultural groups remained unchanged after controlling for health
status (as measured by self-reported health problems) and age differences. However, because the sample sizes in some immigrant and ethnic/cultural groups
department during the past 12 months. RESULTS: The results showed that
were small, many of the differences were not statistically significant. CONCLUSIONS: We conclude that while immigrants and other ethnic/cultural groups in
Ontario usually had equal access to regular services (e.g., visits to general practitioner's office), they often had lower utilization of hospital emergency
departments. However, general purpose surveys have limited utility in assessing reasons of health care utilization amongst different ethnic/cultural groups.
The first rule of Project Mayhem is that you do not ask questions.
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A2: Magnet DA
Immigrants don’t come to the country to steal healthcare.
Brietta Clark, Prof of Law, Loyola Law School. 2008 (“The Immigrant Health Care Narrative and What it Tells Us About the U.S. Health Care System.”
17 Ann. Health L. 229//ZE)
To counter the picture of the immigrant lured here by the prospect of getting public benefits, critics
of health policy exclusions offer a competing
statistics
about the number of immigrant families on public assistance as painting a misleading and very narrow picture of
immigrants' use of public resources. For example, a demographer at the University of Southern California who has studied immigrants' use of public services
found no evidence of large scale use of public benefits by unauthorized immigrants. 142 In fact, statistics show that immigrants tend to
underutilize public benefits and generally have a net positive effect on the economy. 143 Considering the link between
immigration and health care specifically reveals an even weaker case for deterrence justifications. A direct connection between health care
access and decisions to immigrate usually is not and cannot be made for two reasons. The first is inherent in the healthcare market:
health care tends to be given a much lower priority than [*255] employment, which is necessary for food and shelter,
especially by people suffering from severe economic circumstances. 144 The second reason is that the type of health care
complained about often is unanticipated emergency health care. 145 Even the "anchor baby" claim used by the Texas legislators to fight
healthcare coverage for children of illegal immigrants is undermined by the Texas Hospital Association's own policy director who admits that
"most illegal immigrants who go to major hospitals in Texas can show that they have been living here for years." 146 Pro-access
arguments that public health benefits are not a motivating factor for immigrants are also supported by the data on immigrants' use of health services. Studies
show that immigrants, especially unauthorized immigrants, underutilize healthcare benefits. 147 Even legal immigrants and children of
narrative of immigrants as self-reliant and less likely than citizens to seek public benefits, even those to which they may be entitled. They criticize
immigrants entitled to care tend to underutilize the healthcare system as a result of immigration-related benefit restrictions and enforcement policies. 148
Moreover, some data
suggests that immigrants are much more likely to pay for their health care than citizens in many
cases, undermining the view of immigrants as welfare abusers. 149 For example, although there are many reasons why immigrants may
have trouble getting insurance and may need to rely on public benefits or assistance initially, [*256] data suggests that this reliance tends to be
temporary and that "within a decade, new immigrants in California moved up quickly to steadier jobs with more benefits, and the rates of uninsured
immigrants dropped sharply." 150 All of this underlying-motivation data is consistent with a trend that many scholars and immigrants' rights groups have found to
result from increased restrictions and stepped-up immigration enforcement., despite Illegal immigration continues and has even grown
despite the recent laws that make it increasingly difficult for unauthorized immigrants to live in the United States. 151
Illegal immigrants are still crossing the border, and they literally live as outlaws in hiding because these restrictionist policies have made life much harder for
them. Many flock to urban areas where they can more easily "disappear" or blend in to society, while those in less urban areas try to avoid contact with others as
much as possible. 152 These laws may deter immigrants from seeking certain kinds of benefits and keep them segregated in society, but they do not deter
immigration decisions and they cannot deter immigrants' need for care for injury or illness that is beyond their control.
The first rule of Project Mayhem is that you do not ask questions.
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A2: Magnet DA
Illegal immigrants will not bombard the system.
Brietta Clark, Prof of Law, Loyola Law School. 2008 (“The Immigrant Health Care Narrative and What it Tells Us About the U.S. Health Care System.”
17 Ann. Health L. 229//ZE)
To counter the picture of the immigrant lured here by the prospect of getting public benefits, critics of health policy exclusions offer a competing narrative of
immigrants as self-reliant and less likely than citizens to seek public benefits, even those to which they may be entitled. They criticize statistics about the number
of immigrant families on public assistance as painting a misleading and very narrow picture of immigrants' use of public resources. For example, a demographer
at the University of Southern California who has studied immigrants' use of public services found no evidence of large scale use of public benefits by
unauthorized immigrants. 142 In fact, statistics show that immigrants
tend to underutilize public benefits and generally have a net
positive effect on the economy. 143 Considering the link between immigration and health care specifically reveals an even weaker case for
deterrence justifications. A direct connection between health care access and decisions to immigrate usually is not and
cannot be made for two reasons. The first is inherent in the healthcare market: health care tends to be given a much lower
priority than [*255] employment, which is necessary for food and shelter, especially by people suffering from severe economic circumstances. 144
The second reason is that the type of health care complained about often is unanticipated emergency health care. 145 Even
the "anchor baby" claim used by the Texas legislators to fight healthcare coverage for children of illegal immigrants is undermined by the Texas Hospital
Association's own policy director who admits that "most illegal immigrants who go to major hospitals in Texas can show that they have been living here for years."
146 Pro-access arguments that public health benefits are not a motivating factor for immigrants are also supported by the data on immigrants' use of health
services. Studies show that immigrants, especially unauthorized immigrants, underutilize healthcare benefits. 147 Even legal immigrants
and children of immigrants entitled to care tend to underutilize the healthcare system as a result of immigration-related benefit restrictions and enforcement
policies. 148 Moreover, some data suggests that immigrants are much more likely to pay for their health care than citizens in many cases, undermining the view
of immigrants as welfare abusers. 149 For example, although there are many reasons why immigrants may have trouble getting insurance and may need to rely
on public benefits or assistance initially, [*256] data suggests that this reliance tends to be temporary and that "within a decade, new immigrants in California
moved up quickly to steadier jobs with more benefits, and the rates of uninsured immigrants dropped sharply." 150 All of this underlying-motivation data is
consistent with a trend that many scholars and immigrants' rights groups have found to result from increased restrictions and stepped-up immigration
enforcement. Illegal immigration continues and has even grown, despite the recent laws that make it increasingly difficult for unauthorized immigrants to live in
the United States. 151 Illegal immigrants are still crossing the border, and they literally live as outlaws in hiding because these restrictionist policies have made
life much harder for them. Many flock to urban areas where they can more easily "disappear" or blend in to society, while those in less urban areas try to avoid
contact with others as much as possible. 152 These laws may deter immigrants from seeking certain kinds of benefits and keep them segregated in society, but
they do not deter immigration decisions and they cannot deter immigrants' need for care for injury or illness that is beyond their control.
The first rule of Project Mayhem is that you do not ask questions.
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****NEGATIVE****
The first rule of Project Mayhem is that you do not ask questions.
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Inherency Take-Outs
Immigrants do not overburden America’s health care system, in contrast to other
studies.
RYAN KNUTSON Spring, 2008 Articles Editor, BOSTON COLLEGE THIRD WORLD LAW JOURNAL (2007-2008).
MMA calls into question the efficacy of PRWOA given that Congress explicitly intended to reduce the financial burden
that immigrants place on the public benefit system. Studies revealing that immigrants utilize health care services less
than their citizen counterpart’s further question whether restricting access to comprehensive health care actually
reduces the alleged burden immigrants place on the American economy and people. Rather, these studies suggest
that immigrants do not overburden America's health care system. In light of the current economic reality, PRWOA's restriction on immigrant access to health care cannot be seen
as effective public policy.
The first rule of Project Mayhem is that you do not ask questions.
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Economy Take-Outs
Cutting Illegal immigrants save money
Anna Gorman
2008 L.A. Times
Forced to slash their budgets, some California counties are eliminating nonemergency health services for illegal immigrants -- a move that officials acknowledge could backfire by
shifting the financial burden to emergency rooms. Sacramento County voted in
February to bar illegal immigrants from county clinics at an
estimated savings of $2.4 million. Contra Costa County followed last month by cutting off undocumented adults, to save
approximately $6 million. And Yolo County is voting on a similar change next month, which would reduce costs by $1.2 million."This is a
way for us to get through what I think is a horrible year for healthcare in California," said William Walker, director of Contra Costa Health Services.
Walker said the national ambivalence on immigration policy means that illegal immigrants are living here but without federal or state funding to provide essential medical services to
them. Walker, who began his medical career treating undocumented farmworkers, said that deciding to cut their services was difficult."This is the community of people we have all relied
upon for decades, providing work not only in construction but in service and child care," he said. "We all live and work here together."Trend could spread as the recession continues,
property tax revenue decreases and the number of newly uninsured patients increases, other county health departments in California and the nation may make similar changes, said
Robert Pestronk, executive director of the National Assn. of County and City Health Officials."Communities are having to make excruciating decisions about the services they fund," he
said. But Pestronk said that shifting costs isn't the answer."This is a balloon that just expands," he said. "If you squeeze it in one place, it's just going to expand somewhere else."John
Schunhoff, Los Angeles County's interim health services department director, said there is no plan to eliminate health services to the county's illegal residents, despite significant
projected deficits and concern about further cuts in state funding. Eliminating illegal immigrants from health services may enable counties to balance their budgets this year but won't
solve the problem in the long term, said David Hayes-Bautista, professor of medicine and director of UCLA's Center for the Study of Latino Health and Culture."We are mortgaging the
future to scrape through the present," he said. And study after study shows that illegal immigrants are less likely than U.S.-born residents to go to the doctor or seek regular medical
care, he said. Anti-illegal immigration activist Barbara Coe said she was thrilled that counties are beginning to restrict services. Coe's group, California Coalition for Immigration Reform,
sponsored Proposition 187, the initiative that tried to bar the state from providing public services to illegal immigrants before it died in federal court. Illegal
immigrants
"have absolutely no right, No. 1, to be here and, No. 2, to take the tax dollars of law-abiding American taxpayers for
anything," she said. But the policy changes have angered immigrant rights advocates, who argue that restrictions could also cause a chilling effect on legal residents and U.S.
citizens in mixed-status families."Even those people who qualify to get care won't," said Reshma Shamasunder, director of the California Immigrant Policy Center. Shamasunder also
said that denying healthcare to one segment of the population puts everyone else at risk as communicable diseases go untreated and emergency rooms become even more crowded.
Jose Suarez, who has asthma, said he now plans to go to the hospital if he gets sick. Suarez, 25, was born in Mexico but has been living in Contra Costa County for 10 years."It's
unfair," he said. "We are real people. I understand they have to cut a few things here and there, but I believe they can do better."Marina Espinoza, also an illegal immigrant in Contra
Costa County, said she visits a county clinic a few times a month to monitor her diabetes and high blood pressure so that she doesn't end up in the hospital. Espinoza is considering
returning to Mexico, where a relative has a lead on a job with health insurance."None of us choose to get sick," said Espinoza, 39. "I can't afford the medications. How can I pay for
that? It's that or rent."Before changing its policy on illegal immigrants, Sacramento County took several other steps to reduce healthcare costs, including closing three of its six clinics.
But that wasn't enough, said Keith Andrews, chief of primary health services in the Department of Health and Human Services. Andrews said he was left with a choice between firing
staff or reducing the number of patients. The county is continuing to treat everyone for communicable diseases. Andrews said about 4,000 people without legal residency or citizenship
were receiving healthcare in the county. Although some are immigrants who have lived and worked in the area for years, he said, others are foreign natives who came to the county to
receive free medical treatment."This decision is going to impact all of our community," he said. "It's going to create other social problems because of the impact on emergency rooms."In
Contra Costa County, which will continue treating undocumented children and pregnant women, community groups mobilized against the proposal. They helped persuade county
officials to allocate additional funds to the nonprofit community clinics to help treat the 5,500 undocumented patients who will no longer be eligible for county services. Those patients
will receive primary care at the clinics, but they won't have a place to go if they need to see a specialist, such as for cancer or heart problems."It's a major gap," said Soren Tjernell of
the Community Clinic Consortium, which represents clinics in Contra Costa and Solano counties. Yolo County's proposal, which goes before its Board of Supervisors on May 5, would
affect about 1,200 undocumented patients. Joseph Iser, who heads the county health department, said he wished that he had another source of revenue to continue services for illegal
immigrants."Except by helping us balance the budget, it doesn't help us, it doesn't help our citizens, it doesn't help our undocumented," he said. "But if we
money, we just can't afford it."
don't have the
Illegal immigrants are taking jobs from legal American citizens
Tim Ryan U.S. Congressman 2008
Among today’s major issues, illegal immigration is at the top of the list. Immigrants have been coming in to America
illegally for years. They come with no documentation or green cards and live lives that are just as good, if not better
than most Americans. Today, there are 12 million illegal aliens living within the United States’ borders and something
needs to be done about it. Illegal aliens have been coming in to America for quiet some time, but over the last 10 years the issue has become a great
concern of the American people. Ineffective borders and inadequate border patrol are allowing illegals to come in to the country daily. The immigrants are getting
very good at eluding the border patrol. America has the technology to catch the aliens trying to come in to America illegally and they need to use it.
Immigration needs to be stopped because illegals take honest working Americans’ tax dollars. Billions of tax dollars a
year are spent on illegal aliens. It just is not fair to the hard working families of America. They wake up every morning
and go to jobs that they probably do not even like, just to have extra tax dollars taken out of their checks so the
government can pay for all the illegal aliens coming in to America. Both of my parents work hard and it is not right that immigrants live lives
just as good as they do and do not even work. Not only are illegals taking money, they are also taking jobs. Over the last 10 years, the
employment rate of legal citizens has dropped 35%. The employment rate of illegals has risen 42%. It is not fair to
American citizens who work hard and abide by the laws. Many jobs are offered to illegals because they will work in the harsh conditions for
less pay. This is outrageous and is tearing America apart. It is estimated that by the year 2020, if illegal immigration is not slowed drastically,
73% of all jobs will be occupied by illegal immigrants. Something needs to be done about this and fast. be occupied by.
The first rule of Project Mayhem is that you do not ask questions.
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Economy Take-Outs
Illegal immigration is harming our economy by lowering our wages
New York Times Upfront Krikorian, Mark September 1, 2008
In purely economic terms, illegal
immigration is harmful because it floods our 21st-century economy with 19th-century-style
low-skilled workers. Almost 60 percent of adult illegal immigrants lack a high school education. That's more than nine times
the rate among native-born Americans. This has three consequences. First, it means big costs for taxpayers. Workers with little
education don't earn much money, so they pay little in taxes and use a lot of government services. For example, half of
Mexican immigrant families use at least one welfare program. It's not a question of laziness; it's just that the average high school
dropout cannot support a family in a modern society like ours without government assistance, no matter how many
jobs she has. The second problem is that it reduces the wages of low-skilled Americans. As we flood the market for entry level jobseekers,
they lose the ability to demand higher salaries. Research shows that illegal immigration has cut the earnings of poor Americans by 7
percent, and even forced some out of the job market. Finally, by keeping wages lower, illegal immigration takes away much of the incentive to
invest in labor-saving technologies that make workers more productive, thus slowing the innovation that's needed for continued economic vitality and
competitiveness. What worked for our country 100 years ago is no longer helpful. Cutting illegal immigration levels
to ensure broad-based economic prosperity in the future.
is vital
Immigrants take more than they earn
Donald Lambro(“Immigration costs far outweigh labors; Heritage, Cato split on contributions”, THE WASHINGTON TIMES) 07
Low-skilled legal immigrants and illegal aliens in the U.S. are receiving much more in federal social welfare benefits
than they pay in taxes at a net cost of $89 billion a year to American taxpayers, according to a Heritage Foundation study. A cost-benefit
analysis by the conservative think tank of the immigration reform bill being debated in the Senate - which it said would grant what many
consider amnesty to illegal aliens and increase the flow of low-skilled workers into the U.S. - warned that if the legislation becomes
law, which would result in "the largest expansion of the welfare state in 30 years." "Such proposals would increase
poverty in the U.S. in the short and long term and dramatically increase the burden on U.S. taxpayers," said Robert E. Rector, senior
research fellow for welfare at Heritage and the co-author of the study with Christine Kim .Mr. Rector's findings and conclusions were sharply
disputed by another conservative think tank, the Cato Institute, which said that some of his cost estimates were "grossly exaggerated"
and that low-skilled workers, especially Hispanics with a strong work ethic, contributed to the U.S. economy's overall
growth and prosperity. Daniel Griswold, director of Cato's Center for Trade Policy Studies, acknowledged that lower-skilled workers on
average "consume more in government services than they pay in taxes." But he pointed to several studies that showed their work in
many low-skill industries, from agriculture to construction, also helped expand state economies."The right policy response to the fiscal concerns about
immigration is not to artificially suppress labor migration but to control and reallocate government spending," Mr. Griswold said in a recent paper. Mr. Rector
amassed a significant amount of data drawn from the U.S. census surveys that he said showed how a wave of poorly educated, low-
income immigrants and illegals were imposing increasing costs on the country through 60 means-tested aid
programs, from welfare to food stamps for immigrant families with children born in this country."Each year, roughly 1.5 million
legal and illegal immigrants enter and take up residence in the U.S. This immigrant flow is disproportionately poorly educated because illegal immigration
primarily attracts low-skill workers and the legal immigration system favors kinship ties over skill levels," he said. According to Heritage, the nation has
4.5
million low-skilled immigrant households containing 15.9 million people, or about 5 percent of the population. About 60
percent of these households were headed by legal immigrants and 40 percent by illegal’s, the study said. Contrary to a belief among many
Americans that low-skilled, low-paid immigrants do not pay any taxes, Mr. Rector said, "These families are rarely idle; they consistently work and pay
taxes." But the taxes they pay seldom cover the costs of the substantial benefits they receive, he said. In fiscal 2004, "the
average low-skill immigrant household received $30,160 in direct benefits, means-test benefits, education and population-based
services from all levels of government," he said. In return, however, these households on average paid only $10,573 in taxes that
year. Mr. Rector said the solution is to "reduce the costs of low-skill immigration to the taxpayers" by enforcing laws
against employing illegal aliens, making a guest-worker program "truly temporary and not a gateway to welfare entitlements," ending
birthright citizenship for children of illegal aliens and ruling out any amnesty in the immigration reform bill. Several
government and free-market think tank studies assembled by Mr. Griswold at the Cato Institute paint a different picture of the impact of low-skilled immigrants in
the U.S. economy.
"Several state-level studies have found that the increased economic activity created by lower-skilled, mostly Hispanic
immigrants far exceeds the costs to state and local governments," Mr. Griswold wrote.
The first rule of Project Mayhem is that you do not ask questions.
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Economy Take-Outs
Immigrants have cost billions of dollars in California and other places
Robert Longley December, 2004 26 years of experience in municipal government in Texas and California cities. He has also served as About's Guide to
U.S. Government since October 1997.
In hosting America's largest population of illegal immigrants, California bears a huge cost to provide basic human services for this fast growing, low-income
segment of its population. A new study from the Federation for American Immigration Reform (FAIR) examines the costs of education, health care and
incarceration of illegal aliens, and concludes that the costs to Californians is $10.5 billion per year. Among the key finding of the report are
that the state's already struggling K-12 education system spends approximately $7.7 billion a year to school the children of illegal aliens who now constitute 15
percent of the student body. Another
$1.4 billion of the taxpayers' money goes toward providing health care to illegal aliens
and their families, the same amount that is spent incarcerating illegal aliens criminals. "California's addiction to 'cheap' illegal alien
labor is bankrupting the state and posing enormous burdens on the state's shrinking middle class tax base," stated Dan Stein, President of FAIR. "Most
Californians, who have seen their taxes increase while public services deteriorate, already know the impact that mass illegal immigration is having on their
communities, but even they may be shocked when they learn just how much of a drain illegal immigration has become." The Costs of Illegal Immigration to
Californians focuses on three specific program areas because those were the costs examined by researchers from the Urban Institute in 1994. Looking at the
costs of education, health care and incarceration for illegal aliens in 1994, the Urban Institute estimated that California was subsidizing
illegal immigrants to the tune of about $1.1 billion. The enormous rise in the costs of illegal immigrants over the
intervening ten years is due to the rapid growth in illegal residents. It is reasonable to expect those costs to continue to soar if action is
not taken to turn the tide. "Nineteen ninety-four was the same year that California voters rebelled and overwhelmingly passed Proposition 187, which sought to
limit liability for mass illegal immigration. Since then, state and local governments have blatantly ignored the wishes of the voters and continued to shell out
publicly financed benefits on illegal aliens," said Stein. "Predictably, the costs of illegal immigration have grown geometrically, while the state has spiraled into a
fiscal crisis that has brought it near bankruptcy. "Nothing could more starkly illustrate the very high costs of ‘cheap labor' than California's current situation,"
continued Stein. "A small number of powerful interests in the state reap the benefits, while the average native-born family in California gets handed a nearly
$1,200 a year bill." The Federation for American Immigration Reform is a nonprofit, public-interest, membership organization advocating immigration policy
reforms that would tighten border security and prevent illegal immigration, while reducing legal immigration levels from about 1.1 million persons per year to
300,000 per year.
illegal immigrants. Something needs to be done about this and fast. be occupied by illegal immigrants. Something needs to be done about
this and fast.
The first rule of Project Mayhem is that you do not ask questions.
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Solvency Take-Outs
Even though a disproportionate number of immigrants live in poverty, they are much
less likely to use non-emergency medical services
Knutson 08 (Boston College Third World Law Journal Spring, 2008 28 B.C. Third World L.J. 40 NOTE: DEPRIVATION OF CARE: ARE FEDERAL LAWS
RESTRICTING THE PROVISION OF MEDICAL CARE TO IMMIGRANTS WORKING AS PLANNED?NAME: RYAN KNUTSON*)
To understand the manner in which immigrants affect local communities, one must be aware that immigrants' lifestyles differ remarkably from their native-born
U.S. citizen counterparts. n48 On the whole, immigrants' educational and economic progress is significantly lower in comparison to native-born citizens. n49
Immigrants are more likely than the native born to live in poverty, with 17.1% of immigrants in poverty compared to 12% of native-born citizens. n50 Despite
accounting for only 12.1% of the total population, immigrants and their U.S. born children account for nearly one in
four of those living in poverty in America. n51 As can be imagined, immigrants' incomes are approximately twenty-five percent lower than natives.
n52 Correspondingly, immigrants are also less likely to have health insurance. n53 One third of all immigrants lack health insurance
compared to only thirteen percent of native-born citizens. n54 [*409] Undocumented immigrants fare even worse with an estimated
sixty-five percent lacking health insurance. n55 Given the stark educational and economic hurdles, it is not surprising that immigrants use public
benefit programs more often than native citizens. n56 However, despite their greater need for public benefits, recent studies have
shown that low-income immigrants are actually less likely to have access to regular health care. n57
In fact, immigrants use relatively fewer health services in comparison to their native-born citizen counterparts. n58 A recent
study by the Rand Corporation revealed that being an immigrant correlated to a "substantial and significant reduction in access" to health care compared to
native citizens. n59 Lack of health insurance, language barriers, and fear of deportation are all cited as contributing factors
that inhibit immigrants from seeking medical care. n60 Researchers for the Rand study found that being a non-citizen adult or child resulted in
dramatic reductions in a person's actual number of doctor and emergency room visits compared to both native-born and naturalized citizens. n61 When [*410]
immigrants did seek medical treatment, community clinics and hospital outpatient departments accounted for the
most frequent sources of care. n62
In 2000, a subsequent study completed by Rand revealed that due to reduced medical care access, immigrants accounted for only a small fraction of total health
care expenditures in the United States. n63 The 2000 study found that despite comprising
approximately 13% of the total population,
immigrants accounted for only 8.5% of total medical expenditures. n64 Moreover, immigrants accounted for an even
smaller percentage of total public spending on health care. n65 The native-born accounted for 93.3% of the total public spending on health
care compared with 6.6% for the foreign-born. n66 Focusing on undocumented immigrants revealed that only 1.5% of total national health care expenditures
went to the undocumented. n67 Public supported health care for immigrants totaled only $ 1.1 billion, or 1.3% of the total $ 88.5 billion in publicly funded care.
n68 Studies evidencing immigrants' lower use and overall expenditures of medical care suggest that policy makers
have been incorrect in charging that immigrants place an unduly high burden on taxpayers via their use of the
medical system. n69
The first rule of Project Mayhem is that you do not ask questions.
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Solvency Take-Outs
Alternative Causality – Racial barriers and ethnic hierarchies as well as fear of
deportation make a full extension of health care to migrants or even minorities
impossible.
Betancourt et al, 03(Joseph R. Betancourt: MD from the Institute for Health Policy, Massachusetts General Hospital and MPH from bDepartment of
Medicine, Harvard Medical School; Alexander R. Green: MD from Beth Israel Deaconess Medical Center; J. Emilio Carrillo: MD,
MPH from Department of Medicine, Weill Medical College of Cornell University, eNew York–Presbyterian Healthcare Network and New
York Presbyterian Hospital Community Health Plan and Department of Public Health, Weill Medical College of Cornell University; Owusu
Ananeh-Firempong II aInstitute for Health Policy, Massachusetts General Hospital “Defining Cultural Competence: A Practical Framework for Addressing
Racial/Ethnic Disparities in Health and Health Care,” Public Health Reports 2003 Association of Schools of Public Health. Jstor) JC
The first rule of Project Mayhem is that you do not ask questions.
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Solvency Take-Outs
Alternative Causality: Lack of racial diversity in health care institutions inhibit care of
immigrants and minorities.
Betancourt et al, 03(Joseph R. Betancourt: MD from the Institute for Health Policy, Massachusetts General Hospital and MPH from bDepartment of
Medicine, Harvard Medical School; Alexander R. Green: MD from Beth Israel Deaconess Medical Center; J. Emilio Carrillo: MD,
MPH from Department of Medicine, Weill Medical College of Cornell University, eNew York–Presbyterian Healthcare Network and New York Presbyterian
Hospital Community Health Plan and Department of Public Health, Weill Medical College of Cornell University; Owusu Ananeh-Firempong II aInstitute for Health
Policy, Massachusetts General Hospital “Defining Cultural Competence: A Practical Framework for Addressing Racial/Ethnic Disparities in Health and Health
Care,” Public Health Reports 2003 Association of Schools of Public Health. Jstor) JC
Large bureaucracies and minority specialist care inefficiencies inhibit solvency.
Betancourt et al, 03(Joseph R. Betancourt: MD from the Institute for Health Policy, Massachusetts General Hospital and MPH from bDepartment of
Medicine, Harvard Medical School; Alexander R. Green: MD from Beth Israel Deaconess Medical Center; J. Emilio Carrillo: MD,
MPH from Department of Medicine, Weill Medical College of Cornell University, eNew York–Presbyterian Healthcare Network and New
York Presbyterian Hospital Community Health Plan and Department of Public Health, Weill Medical College of Cornell University; Owusu
Ananeh-Firempong II aInstitute for Health Policy, Massachusetts General Hospital “Defining Cultural Competence: A Practical Framework for Addressing
Racial/Ethnic Disparities in Health and Health Care,” Public Health Reports 2003 Association of Schools of Public Health. Jstor) JC
The first rule of Project Mayhem is that you do not ask questions.
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Solvency Take-Outs
Lack of qualified interpreters make minority health care services ineffective and
counterproductive.
Betancourt et al, 03(Joseph R. Betancourt: MD from the Institute for Health Policy, Massachusetts General Hospital and MPH from bDepartment of
Medicine, Harvard Medical School; Alexander R. Green: MD from Beth Israel Deaconess Medical Center; J. Emilio Carrillo: MD,
MPH from Department of Medicine, Weill Medical College of Cornell University, eNew York–Presbyterian Healthcare Network and New
York Presbyterian Hospital Community Health Plan and Department of Public Health, Weill Medical College of Cornell University; Owusu
Ananeh-Firempong II aInstitute for Health Policy, Massachusetts General Hospital “Defining Cultural Competence: A Practical Framework for Addressing
Racial/Ethnic Disparities in Health and Health Care,” Public Health Reports 2003 Association of Schools of Public Health. Jstor) JC
The first rule of Project Mayhem is that you do not ask questions.
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Solvency Take-Outs
Stereotyping and cultural differences mean migrants won’t be helped and will ignore
services or be treated counterproductively.
Betancourt et al, 03(Joseph R. Betancourt: MD from the Institute for Health Policy, Massachusetts General Hospital and MPH from bDepartment of
Medicine, Harvard Medical School; Alexander R. Green: MD from Beth Israel Deaconess Medical Center; J. Emilio Carrillo: MD,
MPH from Department of Medicine, Weill Medical College of Cornell University, eNew York–Presbyterian Healthcare Network and New
York Presbyterian Hospital Community Health Plan and Department of Public Health, Weill Medical College of Cornell University; Owusu
Ananeh-Firempong II aInstitute for Health Policy, Massachusetts General Hospital “Defining Cultural Competence: A Practical Framework for Addressing
Racial/Ethnic Disparities in Health and Health Care,” Public Health Reports 2003 Association of Schools of Public Health. Jstor) JC
The first rule of Project Mayhem is that you do not ask questions.
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States CP Solvency
States can and should pass affirmative legislation on healthcare for immigrants.
Park 04 Georgetown Immigration Law Journal Spring, 2004
NOTE: SUBSTANTIAL BARRIERS IN ILLEGAL IMMIGRANT ACCESS TO PUBLICLY-FUNDED HEALTH CARE: REASONS AND RECOMMENDATIONS FOR
CHANGE SEAM PARK (B.B.A., Emory University, 2001; J.D. Candidate, Florida State University College of Law, May 2005.)
The final recommendation suggests that state legislatures should pass affirmative legislation providing illegal immigrants with
state-funded health care access outside of the limited scope of available federal care. Although this is the final step in the
recommendation process, all states currently have the ability to pass this type of legislation. n156 Therefore, this step is not conditioned
on the fulfillment of the first two steps of the recommendation process. However, if state and local governments are not issued the authority to pass limited
cooperation ordinances, and subsequently do not pass them, illegal immigrants must remain fearful from accessing any form of health care.
For the sake of argument, assuming state and local governments are given the authority, and indeed pass limited cooperation ordinances, states should [*591]
pass affirmative legislation providing illegal immigrants with state-funded health care. State
legislatures, of course, have the ability to provide
as much or as little care as they please outside of what the federal government has chosen to provide. n157 Much of a
state's decisions on the amount of care to provide will undoubtedly depend on its fiscal policy. n158 If economic ability to provide illegal immigrants with
preventive health care is, indeed, the state's primary concern, states should consider the detrimental long-term economic effects if a state does not, at least,
provide illegal aliens with "prenatal screening and treatment for chronic and debilitating diseases." n159 If states choose not to provide illegal aliens with prenatal
care, there would be greater "poor (and expensive) birth outcomes for their infants, who are U.S. citizens." n160 Since these children are U.S. citizens, states
would become responsible for their costly treatment. n161 Furthermore, if states do not provide preventive care for serious, non-emergency, medical conditions
such as diabetes, treatment for their inevitable emergency conditions are going to come at exorbitant costs. n162 Finally, providing preventive care for illegal
immigrants will help protect the public health from a costly crisis because "communicable disease pays no attention to immigration status or borders." n163
Therefore, states should use their legislative authority and "strongly consider passing legislation that would provide
preventive health care services for illegal immigrants" n164 because not only is it economically sensible, but because
it is ethical. n165
The first rule of Project Mayhem is that you do not ask questions.
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Free Market CP Solvency
The right answer for health care lies in consumers and markets.
Romney 09 Newsweek (Romney, Mitt, former governor of Massachusetts) May 18, 2009 U.S. Edition The answer is unleashing markets--not government.
I hear loud and clear from people in my state, and from across the country, what they want to see in health care. They want
it to cost less, have the
highest quality and see that it extends to all Americans--even when they lose their job or when they're sick.
Republicans agree. So do Democrats. Where we disagree is how to get the job done.
Our divide is fundamental: Republicans believe health care can be best guided by consumers, physicians and markets ;
Democrats believe government would do better. Some Democrats would have government buy health care for us; set the rates for doctors,
hospitals and medicines; and decide what medical treatment we would be entitled to receive for each illness. If you liked the HMOs of the '80s, you'd love
government-run health care.
Democrats have been winning. When President Lyndon Johnson signed the Medicaid bill, he estimated it would cost $500 million. Today, it costs
$500 billion. Politicians
have expanded government coverage to more and more people. They propose that we adopt Europeangovernment now spends more per citizen
on health care than do the governments of France, Germany, the United Kingdom or Sweden.
But government can't match consumers and markets when it comes to lowering cost, improving quality and boosting
productivity. Compare the U.S. Postal Service with UPS and Federal Express. Stack North Korea against South Korea.
The right answer for health care is to apply more market force, not less. Here's how:
style, government-financed health care. But, in some respects, they've already gotten us there: the
The first rule of Project Mayhem is that you do not ask questions.
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Open the Border CP
The illegal immigration population is rising but opening the border and granting
amnesty solves their case.
Tyler Grimm * Gender Race & Just. Copyright (c) 2009 the Journal of Gender, Race & Justice The Journal of Gender, Race & Justice Winter, 2009 BIO: *
J.D. Candidate, University of Iowa College of Law, 2009. This Note is dedicated to all immigrants who have ever faced racism or suffered exploitation in the state
of Iowa.
There is also a significant history of employers exploiting undocumented workers, and not insignificantly, current legislative interest in regulating the employment
of undocumented workers. ... In fact, as consumers, undocumented immigrants spend a great deal and actually create jobs in the U.S. economy. ... Worker
Protections for Undocumented Immigrants are Shrinking Historically, all workers, even undocumented immigrants, have enjoyed certain legal protections in the
course of employment. ... The record of DeCoster Farms serves to demonstrate the inadequacy of IRCA sanctions in truly discouraging employers from utilizing
undocumented immigrant labor. ... If allowed to continue on their current trajectory, most states will soon have passed legislation to punish employers who
knowingly, or in some cases even negligently, hire undocumented immigrant workers. ... The chain of events in Arizona tends to support this Note's central
thesis: Tough employer sanctions will lead to shrinking populations of undocumented immigrants and wider channels of legal immigration; not a shift in the
number of immigrants in the United States, but rather a transformation of their legal status. The status of immigrant labor in this country is
troubling. The United States economy is in the midst of a severe national labor shortage. n1 At the same time, more
immigrants are seeking employment in the United States than ever before. n2 Employers are attempting to meet their
labor needs by hiring undocumented immigrant workers, while the national immigration debate focuses on building
fences and keeping immigrants out. n3 The number of undocumented immigrants in the United States is rising
steadily. n4 It is still a common fear that immigrants take jobs from American citizens and overuse public services. n5
While the belief that undocumented immigrants take more from the economy than they give is largely a myth, there
are other reasons that a large population of undocumented immigrants is undesirable. n6 Our economy relies heavily on
immigrant labor. n7 Immigrants? Documented or not? are in fact a boon to the economy and [*416] culture of the United States. n8 But accepting the premise
that immigrants in general are good for the United States does not mean that a large population of undocumented immigrants is also good. Undocumented
immigrant workers are highly susceptible to abuses in the workplace. n9 These immigrants are routinely forced to sacrifice both their basic workers' rights and
basic human rights for the opportunity to participate in the U.S. labor market. n10 Ideally, the United States should be able to meet its labor needs without looking
beyond the worker pool comprised of citizens and legally documented immigrants. This Note will argue for a somewhat counterintuitive process for improving the
circumstances of immigrant workers while widening the channels of legal immigration into the United States. It will advocate that employers should be held to
strict standards when verifying the legal status of employees, and failures on their part should be heavily penalized. The promise of employment opportunity is,
by far, the single greatest factor influencing the volume of immigration into the United States. n11 Decreasing employment opportunities for undocumented
immigrants is, therefore, the most practical way of discouraging undocumented immigration. Furthermore,
due to the truly robust economic
demand for immigrant labor in this country, reducing the availability of undocumented workers would inevitably lead
to a determinative need for a more liberal immigration policy. Ironically, discouraging the employment of unauthorized
immigrant workers would lead to a policy that allows wider channels of legal entry to greater numbers of immigrant
workers. Given the unacceptable side-effects of undocumented status for immigrant workers, such a policy is
ultimately the best option for both the United States and its potential immigrant workers. Immigration policy is a
complicated issue.
The first rule of Project Mayhem is that you do not ask questions.
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Politics DA Links
A healthcare plan that would include noncitizens would be extremely politically
explosive and destroy bipartisanship.
Dobias 2009. (Matt, Washington Bureau Chief, “As Democrats talk reform ...; ... GOP gets ball rolling with insurance-related bills”, Modern Healthcare,
May 25 2009, http://www.lexisnexis.com/us/lnacademic/results/docview/docview.do?docLinkInd=true&risb=21_T6977333461&format=GNBFI&sort=
RELEVANCE&startDocNo=1&resultsUrlKey=29_T6977333466&cisb=22_T6977333465&treeMax=true&treeWidth=0&selRCNodeID=145&nodeStateId=411en_U
S,1&docsInCategory=11&csi=8291&docNo=2.)
Pressure began to build on Democratic lawmakers seeking to pass healthcare reform to make some sort of concrete
progress. Republican lawmakers beat them to the punch by introducing their own healthcare bill last week, while closeddoor meetings by the powerful Senate Finance Committee on the matter yielded no agreement on how to proceed. But Democratic leaders say that
congressional meetings focused on introducing a reform bill have been productive. On May 20, Senate
Finance Committee Chairman Max
Baucus (D-Mont.) and Sen. Chuck Grassley (R-Iowa), the committee's ranking member, held a private meeting to
discuss ways to pay for a broad overhaul of the U.S. healthcare system. Eight hours later, they jointly called the session ``productive''
but tempered expectations that an agreement could be reached on some of the more controversial initiatives now under discussion. The meeting officially
completed a trilogy of so-called legislative ``walkthroughs,'' where lawmakers, staffers and other invited guests go over measures that could become the building
blocks for a massive healthcare reform bill due later this summer. The goal, they say, is to determine what's viable and what isn't in a
bipartisan fashion. So far it has been a heavy lift, but Baucus insists there has been movement. ``You can feel a convergence in what we all have to do,''
he said. ``It's clear that some measures are starting to evolve toward'' a little more agreement than others—if not
consensus. One area of apparent agreement is that an effort to expand health insurance coverage would not include
undocumented immigrants. In talking about it, Baucus called the issue a political land mine. ``We're not going to cover
undocumented aliens—undocumented workers,'' he told reporters one day after the private committee meeting. ``It's too politically
explosive.''
The first rule of Project Mayhem is that you do not ask questions.
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Spending DA Links
Providing healthcare for uninsured noncitizens would cost tens of billions.
CEPR (Mark Weisbrot Chair co-director of the Center for Economic and Policy Research in Washington, D.C. “Health Care Reform Is Needed Now More than
Ever,” 7/11/2009, http://www.cepr.net/index.php/op-eds-&-columns/op-eds-&-columns/health-care-reform-is-needed-now-more-than-ever/
With the collapse of private spending, the federal government must act as the consumer of last resort – hence the vital
importance of the $787 billion stimulus package that Congress passed last week. Fortunately this package did contain at least some
health care stimulus. In included $87 billion for Medicaid payments to the state governments, $25 billion towards helping
unemployed workers extend their employment-based health insurance after being laid off, and $19 billion for health
information technology. But health care reform would do vastly more. President Obama has proposed a reform that would, while
keeping the employer-based health insurance that covers most Americans, create a public health insurance system
for the 46 million that do not have insurance. Large employers would be required to either pay into this system or
provide their employees with insurance that is at least as good as the federal system. Individuals without insurance
could buy into the public system, and the federal government would subsidize these payments so that they would be affordable for low-income
households and those without ties to the labor force. The White House estimates that their plan would cost $50-65 billion annually,
but it would be better to spend much more than this, with more federal subsidies to employers to cover uninsured workers and improve existing coverage. As big
as it may seem, the $787 billion stimulus bill passed by Congress amounts to less than 2.7 percent of GDP.
The first rule of Project Mayhem is that you do not ask questions.
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Magnet DA 1NC
A) Uniqueness: Overall illegal immigration is decreasing in the status quo –
economic conditions are deterring them.
MIRIAM JORDAN, FEBRUARY 13, 2009 After the Boom | Dispatches From the Downturn As U.S. Job Opportunities Fade, More Mexicans Look
Homeward; The Wall Street Journal
Mexicans who reside in the U.S. sought Mexican citizenship for their U.S.-born children in record numbers last year.
Unemployment Hit Hispanics The unemployment rate for foreign-born Hispanics hit 8% in the fourth quarter of 2008 compared
with 5.1% in the same quarter a year earlier, according to the report by the Pew Hispanic Center. Read the report. The recession is hitting Hispanic immigrants
especially hard, according to a new report by the Pew Hispanic Center, a nonpartisan research organization. The unemployment rate for foreign-born Hispanics
hit 8% in the fourth quarter of 2008, compared with 5.1% in the same quarter a year earlier. During the same period, the unemployment rate for all U.S. workers
climbed to 6.5% from 4.6%. "There is
strong evidence that inflows to the U.S. from Mexico have diminished, and the
economic distress is likely giving immigrants already here greater incentive to return home," says Rakesh Kochhar, the Pew
economist who prepared the report. The number of people caught trying to sneak into the U.S. along the border with Mexico is
at its lowest level since the mid-1970s. While some of the drop-off is the result of stricter border enforcement, the weaker U.S. economy
is likely the main deterrent.
B) Links: New social services act as a magnet for new immigrants. The plan would
cause an overwhelming increase in immigration.
Chris McDaniel July 27, 2007 Mississippi State Senator http://www.chrismcdaniel4ms.com/immigration.htm FEDERAL SOLUTIONS: Illegal immigration
is a crime.
Government authorities need to make an unambiguous commitment to immigration enforcement. The first step to solving our illegal immigration problem is to
secure the border. Until sufficient resources and manpower are placed at the border to stop the influx of illegal aliens, the problem will continue to worsen. The
federal government must be encouraged to take responsible action to solve the illegal immigration problem. In addition,
any hope of amnesty must be eliminated, since amnesty is as strong a magnet for illegal aliens as are jobs and free social
services. There cannot be any amnesty for the millions of illegal aliens within our national border. The cultural cost of legalizing a record number of
uneducated and low skilled immigrants would forever alter our nation. With nearly two-thirds of illegal aliens lacking a high school diploma, one of the primary
reasons they create a net fiscal deficit is their low education levels and resulting low incomes. Low skilled illegal aliens combined with our already bloated federal
entitlement system are adding fuel to the big-government fire. Similarly, how can our nation expect to assimilate a large number of illegal immigrants -- especially
when many illegal immigrants do not wish to be assimilated? And that's without even mentioning the war on terror and how our nation's security is being
exploited by the current open border policies of the federal government. While most illegal immigrants may come only to seek work and a
better economic opportunity, their presence outside the law furnishes an opportunity for terrorists to blend into the
same shadows while they target the American public for their terrorist crimes. From a federal standpoint, a temporary worker
program should only be instituted if there is a real worker shortage, not if there is a shortage of workers willing to work at substandard wages. Furthermore, any
temporary worker program must be just that – temporary. It must include a mechanism to ensure that workers return home immediately after the program is over.
In discussing a temporary worker program, lawmakers must take into account the past failures of such programs. In sum, the federal government must
implement numerous reforms, including (but not limited to) securing the border, beefing up federal investigation capacity, asylum reform, documents
improvements, major improvements in detention and deportation procedures, limitations on judicial review, improved intelligence capacity, greatly improved
state/federal cooperation, and added resources. Since the federal government is failing in its responsibility to secure our national border and protect the nation
from illegal immigration, Mississippi must stand up for the rule of law. Simply put,
the people of Mississippi are quickly losing confidence in the
federal government’s ability to solve the illegal immigration problem. Therefore, it is time for Mississippi (and other states) to
address the illegal immigration problem on its own level. In fact, many states are already taking the initiative. Last year, 30 states passed
some 57 laws to crack down on illegal immigrants, according to the National Conference of State Legislatures. That flurry of legislation reflects states’ mounting
frustration with federal inaction. Mississippi must act to protect its taxpayers. Once the illegal immigrants have broken the law and entered
the country, Mississippi – not the federal government – is unfairly burdened since it is forced to pay for benefits like
welfare, education, health care, and law enforcement. Mississippi’s systems of welfare, education, law enforcement,
health care, and employment benefits are being stretched not only to provide help for tax-paying citizens, but also to
absorb the demands of people who have broken the law to enter the country, and then break the law again by
accessing support programs to which they have no legal entitlement. Social benefits awarded to illegal aliens
must be eliminated.
The first rule of Project Mayhem is that you do not ask questions.
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C) Impacts: New waves of immigration will cause economic, educational, health, and
societal collapse, culminating in a civil war.
By Pastor Chuck Baldwin April 11, 2006 host of chuck Baldwin live radio show and founder of a presidentially recognized church in Penescola, FL
NewsWithViews.com
While American troops are hunkered down in "safe zones" in Iraq trying to stay out of an escalating civil war, our
government seems oblivious to a
growing threat of civil war right here in the United States. As anyone can see, millions of illegal aliens living here are
becoming more vocal, more demonstrative, more belligerent, and more violence-prone by the day. Unless our
government takes deliberate and significant action immediately, America could be in for serious civil unrest real soon.
It is absolutely incredible that our government would tolerate people who are not even legal residents of our country to generate the kind of mass demonstrations
and protests that we are witnessing on a daily basis! It is more than incredible; it is outrageous! According to The Christian Science Monitor (April 10, 2006),
immigrants (most of them illegal) are "mobilizing for major 'action.'" Nearly 100 American cities will soon feel the brunt of this "action." Organizers describe these
coming demonstrations as "the biggest social movement of Hispanics since the United Farm Workers of Cesar Chavez." In addition, organizers predict that
thousands of Muslims will also join millions of illegal Hispanics on what can only be regarded as an anti-America crusade. The
American people need
to understand that the United States is under attack! No, not by Iraq or Iran, but by Mexico! Yes, Martha, you had better believe it. The
Mexican government is deliberately and systematically working to destabilize and undermine the very fabric and framework of American society. And President
George W. Bush and Senators John McCain and Ted Kennedy (among others) are aiding and abetting this effort. Right now, much of Latin America is embroiled
in a serious takeover by Leftist-Marxists. In all likelihood, Mexico's next leader will be an open Leftist. Vicente Fox has helped create an increased appetite for
socialism (not that Mexico ever had a true understanding of freedom and republicanism), and the next Mexican leader is certain to finish the job. However, Fox
has done more than turn his own country leftward. He has superintended over the biggest invasion of the United States in our country's history. That's right,
invasion! A close, personal friendship with President George W. Bush has given Fox the opportunity to purposely allow (or even send) millions of
criminals, thugs, anarchists, and potential terrorists to swarm over our southern border in breathtaking numbers . (As I
have chronicled before in this column, nearly half of all illegal aliens currently living in the U.S. came here since Bush became president in 2000.) Yet, while
Mexican President Fox encourages and even promotes massive illegal immigration to the U.S., his own country's constitution in Chapter 3, Article 33, states,
"The Executive of the Union has the exclusive right to expel from the national territory, immediately and without necessity of judicial proceedings, all foreigners
whose stay it judges inconvenient. Foreigners may not, in any manner, involve themselves in the political affairs of the country." Imagine that. Even without the
massive demonstrations by millions of foreign invaders, America
is reeling from the negative effects that these people have created.
American
schoolchildren forced to sit in overcrowded classes, for American patients forced to wait in overcrowded hospitals, for
American workers whose wages are being undercut, for American drivers forced to sit in interminable traffic jams in over-whelmed freeway
systems, for the victims of organized gangs, for the American college students who are turned away from publicly funded
state universities, for many African Americans who are being literally displaced from their neighborhoods while being moved figuratively, once again, to the
back of the bus, for those environmentalists and conservationists who want to protect open space and slow down urban sprawl, for the American
taxpayers who have had to bear the burden of billions of dollars in increased welfare costs, over-burdened prisons,
extra police and security and even, adding insult to injury, for bilingual education?" (Source: The Washington Times, April 6, 2006) I trust Mr. Maxwell is
In an open letter to President Bush, Ron Maxwell (writer and director of "Gettysburg" and "Gods and Generals") wrote, "Where was the concern for
not holding his breath while he waits for President Bush to respond, because Bush knows the problems his laxity and indifference have created and frankly, my
dear, doesn't give a darn! If anything is going to be done about the illegal alien problem it will be because the American people, conservatives, liberals,
moderates, independents, whites, blacks, Hispanics, Jews and Gentiles, young and old, from blue states and red states, from big cities and small farms,
Christians and unbelievers stand up and in no uncertain terms demand that the Congress of the United States put a stop to it NOW! This means making it a
crime for any employer to knowingly hire an illegal alien punishable with serious fines and imprisonment for repeat offenses. It means demanding that our federal
government seal our borders (especially the southern one) and stop the tide of foreign invasion immediately. If Saudi Arabia can put up a security fence between
itself and Iraq (and it is doing just that), we can put one up between us and Mexico! It means to stop underwriting these foreign invaders by not paying for their
health care, schooling, and food stamps. It means to stop giving them drivers licenses. It means making certain punishment worse than any potential benefit.
We can either deal with the illegal immigration problem now as described above or we will certainly deal with open
civil war in the very near future. The American people better decide right now which it will be, because time is running
out for Congress to be able to fix the problem. Once that happens, we won't have to worry about civil war in Iraq, it
will happen right here in the United States.
The first rule of Project Mayhem is that you do not ask questions.
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Illegal immigrant numbers declining in squo
Aurelia Fierros May 20th, 2009 LA border and Immigration examiner (examiner.com)
The number of undocumented immigrants attempting to cross U.S. borders has decreased 27 percent, according to
U.S. Customs and Border Protection (CBP.) At a Washington’s hearing before the Senate Judiciary subcommittee on immigration, refugees and
border security held this Wednesday, Democratic Sen. Charles Schumer announced reports from the CBP indicate the decrease on the
immigration flows has been mostly along the U.S. border with Mexico.The New York senator specified the number of
individuals arrested between Oct. 1, 2008 and May 15 2009 dropped off to 27 percent from the same period the
previous year. Along the U.S-Canada border, the number was down 13 percent, attributing the phenomena to lower demand for labor in the U.S. and to
more aggressive border enforcement measures.Schumer said "the border is far more secure than it's ever been," adding that it’s time for the White House and
Congress to revamp immigration laws and have a more effective control on the number of people coming into and living in the U.S. "We can pass strong, fair,
practical and effective immigration reform this year," he added.No further details on a precise schedule to start the immigration debate were provided.
Decline seen in number of Illegal Immigrants
New York Times Julia Preston Published: July 31, 2008
The number of illegal immigrants in the country has dropped by as much as 1.3 million in the past year, an 11 percent
decline since a historic peak last August, an immigration research group in Washington said in a report released Wednesday.The report, by
Steven A. Camarota and Karen Jensenius of the Center for Immigration Studies, found “strong indications” that stepped-up enforcement by immigration
authorities had played a major role in the decline. The report, which is based on monthly census surveys as recent as May, added to a growing body of studies
indicating that the population of illegal immigrants in the United States is dropping significantly. The study’s methods and conclusions were questioned by other
demographers and economists, who said the decline might be less than the center reported and was more likely the result of the weak economy, especially in
low-wage construction and manufacturing where illegal immigrants are generally employed.“The
decline can easily be explained by changes
in the economy,” said Steve Levy, senior economist at the Center for Continuing Study of the California Economy in Palo Alto. He said California had lost
134,000 construction jobs since the summer of 2006. The housing sector woes and weakening economy have been known for a
long time and can explain why unauthorized immigrants would stop coming and why some of those here would
leave,” Mr. Levy said.The Center for Immigration Studies is a policy advocacy group that favors reduced immigration and opposes legislation to give legal
status to illegal immigrants. The study supports the center’s contention that border enforcement and a crackdown on unauthorized workers and their employers
would lead many illegal immigrants to leave the United States without being deported. “The evidence presented here suggests that it has been possible to cut the
illegal population by inducing a large number of people to leave the country,” the study said. Federal immigration officials praised the results. “It reinforces what
we always thought, that comprehensive enforcement is a critical part of the reduction,” said Kelly A. Nantel, a spokeswoman for Immigration and Customs
Enforcement. The arguments provoked by the study reflected the difficulties of discussing options for stemming illegal immigration, when researchers cannot
agree on how many illegal immigrants there are and how they are affected by immigration enforcement. Mr. Camarota and Ms. Jensenius based their findings on
census figures for foreign-born Hispanics ages 18 to 40 with a high school degree or less. They estimated that three-quarters of those Hispanics were illegal
immigrants, and that they made up about two-thirds of the illegal immigrants in the United States. Using those estimates, they concluded that the illegal
immigrant population had dropped to 11.2 million, from a historic high of 12.5 million in August 2007. Jeffrey Passel, a
demographer at the Pew Hispanic Center in Washington who studies illegal immigration, said his research also showed a decline in
immigrants. But because of recent changes in the census’s data reporting, he said it was too soon to make precise calculations. Wayne Cornelius, director of
the Center for Comparative Immigration Studies at the University of California, San Diego, said Mr. Camarota and Ms. Jensenius had applied “highly arguable
assumptions” to their data. “They offer no direct evidence that fewer undocumented immigrants are attempting to come to the United States, or that fewer of them
are getting in, or that more of those already here are leaving the United States as a result of enforcement efforts,” said Mr. Cornelius, who has studied the impact
of border enforcement over the past 15 years.
The first rule of Project Mayhem is that you do not ask questions.
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Rising chances of new immigrants receiving health benefits mean long-term
dependency for the immigrants, and increasing permanent recipients
George Borjas march 11, 1996 "The welfare magnet: for more and more immigrants, America is becoming the land of welfare opportunities". National
Review. FindArticles.com. 16 Jul, 2009. http://findarticles.com/p/articles/mi_m1282/is_n4_v48/ai_18111837/
The pattern holds for other states. In Texas, where 8.9 per cent of households are immigrant but which has less generous welfare, immigrants receive 22 per
cent of benefits distributed. In New York State, 16 per cent of the households are immigrants. They receive 22.2 per cent of benefits.The SIPP data track
households over a 32-month period. This allows us to determine if immigrant welfare participation is temporary -- perhaps the result of dislocation and adjustment
-- or long-term and possibly permanent.The evidence is disturbing. During the early 1990s, nearly a third (31.3 per cent) of immigrant households participated in
welfare programs at some point in the tracking period. Only just over a fifth (22.7 per cent) of native-born households did so. And 10.3 per cent of immigrant
households received benefits through the entire period, v. 7.3 per cent of native-born households.Because the Bureau of the Census
began to collect
the SIPP data in 1984, we can use it to assess if there have been any noticeable changes in immigrant welfare use.
It turns out there has been a very rapid rise.During the mid-1980s, the probability that an immigrant household received some type of assistance
was 17.7 per cent v. 14.6 per cent for natives, a gap of 3.1 percentage points. By the early 1990s, recipient immigrant households had risen to 20.7 per cent, v.
14.1 per cent for natives. The immigrant-native 'welfare gap,' therefore, more than doubled in less than a decade.Thus
immigrants are not only more likely to have some exposure to the welfare system; they are also more likely to be
'permanent' recipients. And the trend is getting worse. Unless eligibility requirements are made much more stringent,
much of the welfare use that we see now in the immigrant population may remain with us for some time. This raises
troubling questions about the impact of this long-term dependency on the immigrants -- and on their U.S.-born
children.There is huge variation in welfare participation among immigrant groups. For example, about 4.3 per cent of households originating in Germany, 26.8
per cent of households originating in Mexico, and 40.6 per cent of households originating in the former Soviet Union are covered by Medicaid. Similarly, about
17.2 per cent of households originating in Italy, 36 per cent from Mexico and over 50 per cent in the Dominican Republic received some sort of welfare benefit A
more careful look at these national-origin differentials reveals an interesting pattern: national-origin groups tend to 'major' in particular types of benefit. For
example, Mexican immigrants are 50 per cent more likely to receive energy assistance than Cuban immigrants. But Cubans are more likely to receive housing
benefits than Mexicans.The SIPP data reveal a very strong positive correlation between the probability that new arrivals belonging to a particular immigrant group
receive a particular type of benefit, and the probability that earlier arrivals from the same group received that type of assistance. This correlation remains strong
even after we control for the household's demographic background, state of residence, and other factors. And the effect is not small. A 10 percentage
point increase in the fraction of the existing immigrant stock who receive benefits from a particular program implies
about a 10 per cent increase in the probability that a newly arrived immigrant will receive those benefits.This confirms
anecdotal evidence. Writing in the New Democrat -- the mouthpiece of the Democratic Leadership Council -- Norman Matloff reports that 'a popular Chineselanguage book sold in Taiwan, Hong Kong, and Chinese bookstores in the United States includes a 36-page guide to SSI and other welfare benefits' and that the
'World Journal, the largest Chinese-language newspaper in the United States, runs a 'Dear Abby'-style column on immigration matters, with welfare dominating
the discussion.'
Healthcare for noncitizens legitimizes immigrating illegally to the United States.
JEFFREY W.H. WATTHEY Frederick, 2008 Thursday Regional Edition
Archbishop Thomas Wenski's Oct. 20 op-ed, "Hitting a Wall on Immigration," presented a troubling description of the subject, intertwining issues relating to illegal
and legal immigration to the point of confusion. While many people are opposed to illegal immigration, the vast majority are in favor of legal immigration.
Archbishop Wenski wrote that work-site raids have had a minimal effect on the number of illegal immigrants, but he also said
that the raids and other tactics have created a climate of fear in immigrant communities. That discomfort is
appropriate, to the extent that these communities contain illegal immigrants, and it could help reduce illegal
immigration. Legal immigrants have nothing to fear from these raids unless they have relatives or friends who are
here illegally. Archbishop Wenski also wrote that some organizations that oppose immigration are delighted by the
results of the law enforcement activities he described. I would suggest that most of those organizations exclusively
oppose illegal immigration and usually have no problem with legal immigration. The archbishop's op-ed lacked any condemnation
of illegal immigration. The issue here is that the Catholic Church does not discriminate between illegal and legal immigration. There is no policy favoring only
legal immigration or any suggestion that illegal immigrants should return to their homelands. Illegal immigrants often live under conditions of
dire poverty and are deserving of assistance by charitable groups, but this task should be undertaken without
supporting the illegal basis of the immigrants' presence in this country.
The first rule of Project Mayhem is that you do not ask questions.
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Welfare acts like a magnet to immigrants
George J. Borjas; Jun 16, 1997 Immigration & welfare, National Review; New York. Solving the welfare problem will solve the welfare problem-not the
immigration problem.
Why did immigrant use of welfare rise so rapidly? It's elementary: today's immigrants are relatively less skilled than
those who came two or three decades ago. Since the enactment of the 1965 Amendments, the United States has been granting entry visas to
persons who have relatives in the United States, with no regard to their skills or economic potential. Immigrants who arrived in the mid to late
1960s entered the U.S. labor market with a wage disadvantage of about 17 per cent; today's immigrants enter with a
wage disadvantage of about 32 per cent. In the 1960s, the economic adaptation experienced by immigrants as they found out about job
opportunities and learned to speak English guaranteed that the initial 17 per cent wage gap would disappear within a couple of decades. If today's
immigrants have the same rate of adaptation as earlier immigrants, we can expect that they will have a wage
disadvantage of about 15 per cent throughout much of their working lives. The inherently unstable combination of
unskilled immigration and a generous welfare state has brought us to the current situation. The geographic clustering of
immigrants in the United States is remarkable. In 1990, three-quarters of the immigrants lived in only six states. This clustering has created a mosaic of ethnic
neighborhoods or enclaves in some American cities, and has fostered the creation and growth of ethnic networks that transmit information about life in these
United States to potential migrants in the source countries. Do these ethnic networks provide information about welfare programs to new immigrants? Case
studies of the Russian and Chinese communities leave little doubt that they do. Russian- and Chinese-language newspapers print detailed reports about the
application process and eligibility requirements for particular programs. There are "Dear Abby"-style columns in newspapers to help readers with welfare
problems. And bookstores in Taiwan, Hong Kong, and the United States sell a Chinese-language book that contains a 36-page guide to SSI and other benefits.
Network effects probably grew in importance as the networks became more established. It is well known that "takeup" rates (i.e., the fraction of eligible persons
who actually receive benefits from a particular welfare program) are well below 100 per cent. As the ethnic networks expanded, the take-up rates of immigrants
probably increased. The
welfare state can also have a magnetic effect on immigrants. Welfare programs in the United
States, though not generous by Western European standards, stack up pretty well when compared to the standard of living available
in most of the world's less-developed countries. While it is true that many immigrants come to the United States for job opportunities, decades
of economic research into the determinants of migration decisions have demonstrated that it is potential income that is the
significant factor. And the welfare state provides a lot of income opportunities, especially for persons with few skills. As
a result, the question is not whether magnetic effects exist-they do. Rather, the question is whether these magnetic effects are numerically important. Three
different types of magnetic effects influence immigrant behavior. It is possible that welfare programs attract persons who
otherwise would not have migrated to the United States. This is the magnetic effect most people have in mind, but is also the one about
which there is least empirical evidence. Second, the safety net might also discourage immigrants who "fail" in the United States from returning to their home
countries. A recent study (by economists Randall Olsen and Patricia Regan of Ohio State University) provides the first hint of such a magnetic effect by showing
that the probability of out-migration is greatly reduced if the household receives public assistance in the United States. Finally, magnetic effects arise from the
huge disparities between different states' welfare benefits. In 1970, California's AFDC benefit level was only 68 per cent that of the median state; twenty years
later it was 2.5 times that of the median state. By 1990, California's benefit package was the second most generous in the nation (surpassed only by Alaska's). It
turns out that the fraction of new immigrants not on welfare who chose to live in California dropped between 1980 and 1990, from 30.1 to 28.9 per cent. But the
fraction of new immigrants on welfare who chose to live in California rose sharply, from 36.9 to 45.4 per cent. The evidence, therefore, suggests a clustering
effect upon immigrant welfare recipients as California's benefit level rose above that of other states. The existence of ethnic networks and
magnetic effects implies that immigrants respond to variations in welfare benefits. As a result, it should not be too
surprising that the welfare problem in the immigrant population has grown considerably in the past two decades. In
1996, after years of concern over the link between welfare and immigration, Congress included a number of
immigrant-related provisions in the welfare-reform bill. According to the Congressional Budget Office, almost half of
the $54-billion savings in this legislation can be traced directly to the restrictions on immigrant use of welfare. The
welfare-reform bill banned most types of assistance for immigrants who would enter the country after August 22, 1996 (with the ban being lifted when the
immigrants become citizens), and it mandated that most non-citizens present in the country on August 22, 1996, be kicked off the SSI and Food Stamp rolls
within a year. The welfare-reform legislation was a capitulation by Congress to the idea that the problem was indeed
welfare, not immigration.
The first rule of Project Mayhem is that you do not ask questions.
102
SCFI 2009
Immigration Health Aff
Project Mayhem
___ of ___
Magnet DA – Links
Welfare is an incentive for immigration, as demonstrated by increasing immigrant
participation in welfare programs.
George Borjas march 11, 1996 "The welfare magnet: for more and more immigrants, America is becoming the land of welfare opportunities". National
Review. FindArticles.com. 16 Jul, 2009. http://findarticles.com/p/articles/mi_m1282/is_n4_v48/ai_18111837/
THE evidence has become overwhelming: immigrant participation in welfare programs is on the rise. In 1970, immigrant
households were slightly less likely than native households to receive cash benefits like AFDC (Aid to Families with
Dependent Children) or SSI (Supplementary Security Income). By 1990, immigrant households were more likely to receive such
cash benefits (9.1 per cent v. 7.4 per cent). Pro-immigration lobbyists are increasingly falling back on the excuse that this immigrant - native 'welfare gap' is
attributable solely to refugees and/or elderly immigrants; or that the gap is not numerically large. (Proportionately, it's 'only' 23 per cent) But the Census does not
provide any information about the use of noncash transfers. These are programs like Food Stamps, Medicaid, housing subsidies, and the myriad of other
subsidies that make up the modern welfare state. And noncash transfers comprise over three quarters of the cost of all means-tested entitlement programs. In
1991, the value of these noncash transfers totaled about $140 billion.Recently available data help provide a more complete picture. The Survey of Income and
Program Participation (SIPP) samples randomly selected households about their involvement in virtually all means-tested programs. From this, the proportion of
immigrant households that receive benefits from any particular program can be calculated.The results are striking. The 'welfare gap' between
immigrants and natives is much larger when noncash transfers are included [see table]. Taking all types of welfare
together, immigrant participation is 20.7 per cent. For native-born households, it's only 14.1 per cent -- a gap of 6.6
percentage points (proportionately, 47 per cent).And the SIPP data also indicate that immigrants spend a relatively large fraction of their time participating in
some means-tested program. In other words, the 'welfare gap' does not occur because many immigrant households receive
assistance for a short time, but because a significant proportion -- more than the native-born -- receive assistance for
the long haul.Finally, the SIPP data show that the types of welfare benefits received by particular immigrant groups influence the type of welfare benefits
received by later immigrants from the same group. Implication: there appear to be networks operating within ethnic communities which transmit information about
the availability of particular types of welfare to new arrivals.The results are even more striking in detail. Immigrants are more likely to participate
in practically every one of the major means-tested programs. In the early 1990s, the typical immigrant family
household had a 4.4 per cent probability of receiving AFDC, v. 2.9 per cent of native-born families. [Further details in Table
1].And that overall 'welfare gap' becomes even wider if immigrant families are compared to non-Hispanic white nativeborn households. Immigrants are almost twice as likely to receive some type of assistance -- 20.7 per cent v. 10.5 per cent.The
SIPP data also allow us to calculate the dollar value of the benefits disbursed to immigrant households, as compared to the native-born. In the early 1990s, 8 per
cent of households were foreign-born. These
immigrant households accounted for 13.8 per cent of the cost of the programs.
They cost almost 75 per cent more than their representation in the population.The disproportionate disbursement of benefits to
immigrant households is particularly acute in California, a state which has both a lot of immigrants and very generous welfare programs. Immigrants make
up only 21 per cent of the households in California. But these households consume 39.5 per cent of all the benefit
dollars distributed in the state. It is not too much of an exaggeration to say that the welfare problem in California is on
the verge of becoming an immigrant problem.
The first rule of Project Mayhem is that you do not ask questions.
103
SCFI 2009
Immigration Health Aff
Project Mayhem
___ of ___
Magnet DA – Impacts
Healthcare would trade off with border security and other immigration reform.
Frank Sharry The Washington Times The answer on immigration December 14, 2008 Sunday Frank Sharry is the executive director of America's Voice
http://www.lexisnexis.com/us/lnacademic/results/docview/docview.do?docLinkInd=true&risb=21_T6977218953&format=GNBFI&sort=RELEVANCE&startDocNo=
1&resultsUrlKey=29_T6977218957&cisb=22_T6977218956&treeMax=true&treeWidth=0&csi=8176&docNo=2
On Election Day, the American people hired leaders they believe will tackle and solve tough problems. They fired politicians who cover up inaction and
ineffectiveness with slick sound bites and punchy slogans.
The public wants action - and results - on a range of tough issues. Of course, economic recovery is job number one, but the public
on illegal immigration has been underestimated for too long.
demand for action
Why is illegal immigration now a top-tier policy concern? Is it anger at the illegal immigrants? No. In a recent poll conducted by Sergio Bendixen for NDN only 3
percent of voters blame them. Employers who game the system? Yes, nearly a quarter of voters blame employers, many of whom are seen as unscrupulous
actors who underpay workers and skip out on taxes. But by a 2-1 margin the public blames the federal government and Congress. Failure to solve illegal
immigration is now a symbol of how Washington doesn't work.
This is what most Democrats now get and most Republicans don't. In 2008, Barack Obama and the vast majority of Democratic candidates for Congress
defined themselves as in favor of comprehensive immigration reform. The key elements of comprehensive reform are
strong enforcement at the borders and the workplace coupled with a requirement that those here illegally pass
criminal background checks, pay taxes, study English and get to the back of the citizenship line. This is viewed by the
majority of Americans as the most pragmatic approach to this complicated problem.
In contrast, most Republicans adopted a harder line. John McCain felt compelled to pander to make-'em-all-leave
primary voters with a
promise of "border security first." In contested congressional races, most Republicans trumpeted the enforcement-only position of "no
amnesty" so popular with talk radio and anti-immigration groups.
For too long, unscrupulous employers have engaged in the illegal hiring and exploitation of immigrant workers. This undercuts American workers and law-abiding
competitors. For too long, these same employers have failed to pay their fair share of taxes. And for too long,
we have tolerated the existence of
some 12 million of second class noncitizens living in the shadows of our society. We need reform that ensures all
hiring is legal, protects American taxpayers and creates a level playing field for American workers and law-abiding
employers.
The key elements of our approach are as follows: strengthen border security, crack down hard on employers who engage in illegal hiring and
unfair labor practices, and require that immigrants here illegally come forward, get screened, get legal, pay taxes, study English
and get to the back of the citizenship line. The time for considering increased legal immigration will come later. The priority is to create fairness and order in our
workplaces and in our communities. Our approach will lift the wages of all workers in the lower end of the labor market and generate increased tax revenues, and
do so in a way that is consistent with our commitment to being both a nation of immigrants and a nation of laws.
I ask my Republican colleagues to join us in this significant step toward ending illegal immigration and doing the people's will.
The first rule of Project Mayhem is that you do not ask questions.
104
SCFI 2009
Immigration Health Aff
Project Mayhem
___ of ___
Magnet DA Impact
Immigration turns the case – they will not be able to stop the diseases. This ends in
extinction.
Gibson, 5 (“Illegal Immigrants Are Spreading Dangerous Diseases Across This Nation,” American Daily)
http://www.americandaily.com/article/7751
It is often said that the flood of illegal immigrants into this country is reaching 'epidemic proportions.' While that
statement is true--it is just as true that the illegal immigrants pouring over the U.S.-Mexican border are endangering
this country with actual epidemics. Tuberculosis, hepatitis, dengue fever, chagas, and even leprosy are being
imported into the U.S. inside the bodies of illegal aliens
...And you thought they only carried heroin-filled baloons inside their bodies! A 'hot-zone' of disease can be found in this
nations border states. Illegal immigrants are setting up so-called "colonias" just inside the states of New Mexico, Texas, and Arizona. The shanty towns are comprised mostly of cardboard shacks and huts made with cast-off building
materials. They have no sanitation, and are surrounded by mounds of garbage. The estimated 185,000 illegals share their makeshift towns with armies of rats. Of course, diseases only common to Central and South America run
One of the imports to this country is chagas disease. It is caused by a parasite known as trypanosome.
It is a blood-borne disease and is spread by triatomine insects. The parasite burrows into human tissue (usually in
the face), where it then begins to multiply. In addition to being spread by insects, it can also be contracted through
blood transfusions.
blood donations
For 40
years, the number of recorded cases of leprosy within the United States totaled 900. Today, we know of more than
7,000 current cases of leprosy in the U.S.
rampant in these places.
After cases of chagas were reportedly discovered to have been spread by transfusions in Canada, that nation began testing all
for the disease.
Dr. John Levis of New York's Bellevue Hospital's Hansen Disease Clinic said of America's documented cases of leprosy: 'There are probably many,
many more and they are spreading." Most of those in the U.S. who are suffering from leprosy are from Mexico, India, Brazil, and the Caribbean. However, there are a few documented cases in which the person became infected
Once thought to be nearly eradicated in this country, TB is
now making a strong comeback. In a recent interview with Mother Jones Magazine, Dr. Reichman of The New Jersey
TB Clinic recently said: In the 1990's, cases among foreign born Americans rose from 29 percent to 41.6 percent.
Antibiotic resistant strains from Mexico have migrated to Texas
dishwashers
We sit on the edge of a potential catastrophe." In 2001, New York's Tuberculosis Control Program discovered
that 81 percent of that city's new cases of TB were attributed to immigrants Cases of TB are now being found in
many areas of the country, where there are high concentrations of illegal immigrants.
Washington Post
reported that Virginia's Prince William County experienced a 188 percent increase of TB infections over the previous
year.
run with illegal aliens seeking day-laborer jobs. Last year, the rate of TB in the northern part of Virginia rose 17
with leprosy inside the U.S. The majority of the cases have been discovered in this nation's northeastern region.
. Since three years ago, 16,000 new cases of TB were discovered in the United States. Half were foreign
born. Strains of TB once only found in Mexico have migrated to the border states of Texas, Arizona, New Mexico, and California. It will move north as illegal aliens work in restaurants as cooks,
, and food
handlers.
In March of 2002, The
Yes, the streets of Prince William County are over-
percent. The Va. Department of Health blamed the rise on that region's recent flood of illegal immigrants. Many strains of TB are being found in certain
neighborhoods, which are dominated by illegal Latin American immigrants. The threats posed to our country by illegal immigration are many. However, our political leaders will undoubtedly continue to ignore them. Our own
president is willing to place all Americans at risk, in exchange for securing the Latino vote for the Republican Party.
nation one way or another.
If left unchecked, illegal immigration will destroy this
The first rule of Project Mayhem is that you do not ask questions.
105
SCFI 2009
Immigration Health Aff
Project Mayhem
___ of ___
Biopower Links
The new biomedical neoliberal discourse emphasizes the empowerment of the
individual patient rather than biopolitical control by the state.
Fries 2008. (Christopher, J., Ph.D. in Sociology of Health, Medicine, and the Body, M.A. in Sociology, Professor at University of Manitoba in Canda,
“Governing the health of the hybrid self: Integrative medicine, neoliberalism, and the shifting biopolitics of subjectivity”, Health Sociology Review, December 2008
http://search.ebscohost.com/login.aspx?direct=true&db=aph&AN=35886702&loginpage=login.asp&site=ehost-live)
While the relationship between consumption and health care has been well known to sociologists of health for some
time (e.g. Freidson 1970; McKee 1988; Salmon 1984), ‘wellness’, as a socially constructed discourse, is of more recent origin (i.e.
of the last decade and a half, Sointu 2005). Based upon an interpretive content analysis of British daily newspapers, Sointu (2005)
tracks a movement in the discourse of well being from ‘the body politic’ to ‘the body personal’. The current discourse
of wellness reflects ‘a changed relationship between citizens and the state from that which characterised many, if not
most, liberal democratic societies in the past’ (Henderson and Petersen 2002:1). Whereas under old welfare state models the
state was accorded primacy in the promotion and production of health, the new wellness discourse of neoliberalism
tells us that it is the citizen-come-consumer who is primarily responsible for her health or lack thereof. This creates what
Lupton (1995) describes as an ‘imperative of health’, in which individuals are encouraged by population health promotion schemes to become
concerned and reflexive in the individualised spacialisation of medicine. Rose (1999:86-7) summarises the
consequences of this change in the biopolitics of subjectivity for the spacialisation of medicine: In the new modes of regulating health,
individuals are addressed on the assumption that they want to be healthy, and enjoined to freely seek out the ways of living most likely
to promote their own health. Experts instruct us as to how to be healthy, advertisers picture the appropriate actions
and fulfilments and entrepreneurs develop this market for health. Individuals are now offered an identity as
consumers – offered an image and a set of practical relations to the self and others (original emphasis). In a cultural context which encourages
individual patient empowerment and medical consumerism, the popularity of alternative medicine may be attributable
to what social theorists such as Beck et al (1994) have outlined as the ‘reflexive project of the self’. Indeed, as Lupton (1997) has demonstrated, the consumerist
subject is a good fit with the sociological notion of the reflexive project of the self in which people purposefully reflect upon the
health care practices through which they constitute their self and body.
The mechanisms of twenty-first century neoliberal governance and human
subjectivity have reconfigured biomedicine.
Fries 2008. (Christopher, J., Ph.D. in Sociology of Health, Medicine, and the Body, M.A. in Sociology, Professor at University of Manitoba in Canda,
“Governing the health of the hybrid self: Integrative medicine, neoliberalism, and the shifting biopolitics of subjectivity”, Health Sociology Review, December 2008
http://search.ebscohost.com/login.aspx?direct=true&db=aph&AN=35886702&loginpage=login.asp&site=ehost-live)
Biomedical hegemony was accomplished within the wider social context of the welfare state, biomedical experts and
technocrats, and the ‘passive patient’ (Lupton 1997). Baer (1989:1103) describes how: ... the state increasingly has come to act as an arena of
class struggle and to assume the role of pacifying social dissent and resolving the contradictions of a capitalist society, including those in the health sector.
Because of its role as ‘keeper of the social contract’, the state is forced to balance the many competing interests and
demands of an ever more complex political field. However, the domination biomedicine has achieved over the
medical field ‘is delegated rather than absolute’ (Baer 1989:1103). In the greater interests of social cohesion, the state
increasingly finds itself in a position in which it ‘periodically must make concessions to alternative health practitioners and their clients’
(Baer 1989:1103). The state’s role in the discursive reframing of medical knowledge represented by integrative medicine
can be understood as one such concession. Twenty-first century neoliberal governance, proceeding through
‘technologies of the self’ (Foucault 1988a), has had an apparently paradoxical effect with regard to the spacialisation of
medicine. Once the subject of medical knowledge, humans gave over to the biomedical definition of our selves and
we currently utilize biomedical services at a rate that has policy makers from across the Western Democracies
forewarning an eminent and total collapse (e.g. Organisation for Economic Co-operation and Development 2002a; 2002b). The neoliberal
response to these fiscal pressures has been to shift governance of health more and more towards a micropolitics of
technologies of the individualised self (Petersen 2003:195). But within the cultural flows of transnational social space, human
subjectivity has hybridised, provoking yet another reconfiguration of medical knowledge. The health of the hybrid self In the
context of transnationalism (Papastergiadis 2000), neoliberal strategies for governing the health of the population become a
discursive mechanism with the unintended consequence of problematising formally hegemonic biomedical
understandings of the body within the West.
The first rule of Project Mayhem is that you do not ask questions.
106