Thursday, August 20, 2009

More Immigrants Than Non-Immigrants are Uninsured

A memorandum by the Center for Immigration Studies finds that more immigrants than non-immigrants are uninsured. This would seem to contradict my post of yesterday that immigration is good for the economy, since providing medical care for uninsured residents tends to drive up medical costs for everyone else.

I'm looking at it a bit differently though. Many businesses that need low-skilled workers rely on immigrants to do these jobs. When there are fewer immigrants, the jobs go unfilled. Sometimes it's because citizens won't take those jobs. Immigrants tend to stick to these jobs to bring money home for the family while Americans will quit and go elsewhere to try to earn more.

But low-paying jobs mean people cannot afford to pay health insurance premiums. Oh, here's an idea! Why not develop a health care system that will provide low-cost premiums for people in low-paying jobs; get insurers to come down a bit in their premiums and partly subsidize the plan so the insured pays what they can afford. It will certainly cost less to subsidize premiums a bit, helping keep people healthy, than to pay the full cost of emergency care for serious illness brought on by lack of access to preventive health care. And this plan gets the insurance providers to share the burden.

Oh, wait -- that's what the current health care reform is all about!

Instead of seeing health care reform as government intrusion, let's look at it as another choice being put into the mix. Along with current insurance options and insurers, there would be an additional option for people who have low-paying jobs or may be long-term unemployed. Let insurers bear part of the burden, the government bear part of the burden, and the individual and company s/he works for bear part of the burden.

Small businesses could opt for a subsidized plan that covers their employees but is affordable for both the business and the individual. Why is that so threatening? Wouldn't it cost less, in the long run, to keep people healthy through preventive health care? Wouldn't business owners rather be able to say, "yes, we're small but we can provide basic health insurance."?

The current health care system has a lot of problems; rising costs -- skyrocketing costs -- among them. We need to work on containing those costs. Let's acknowledge first that among the reasons for those costs are several factors that don't improve health care (rewarding physicians for unnecessary medical procedures comes to mind) and a number of factors that are directly related to good health care or illness (research into diseases and treatments, covering medical costs for the uninsured, unhealthy lifestyles, etc.).

We need a health care system that provides preventive health care for all, shares the cost-burden among all the players as much as possible, provides incentives for good health care, eliminates excesses where they don't improve health care, and reduces costs by helping create a healthier society.

I don't know that any reform plan out there does all that. But I do believe that current reform efforts are a step in the right direction. If we move in the current reform direction, I believe we can help immigrants get health insurance, get better preventive health care, and reverse those numbers derived by the Center. And that would be good medicine in my book.

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