NEEM Magazine

by, Sapna Pandya, MPH & Prantik Saha, MD, MPH

“You lie!” While we as South Asian immigrants are rightfully proud to see a person of color elected to the U.S. presidency, it is no surprise that the highest office in the nation doesn’t afford protection from such insulting retorts – even from a member of Congress – and during a presidential address. After all, our communities are by no means newcomers to discrimination. However, a debate that is being dragged down to a level of such primitive accusation is neither constructive nor illuminating.

Without question, the current health care reform proposals in Congress provide NO options for the undocumented, besides maintaining many rigid barriers that make it difficult for documented (“legal”) immigrants to access health care (consider the 5 year ban on Medicaid and other government sponsored entitlements). Rep. Joe Wilson was wrong – but there are still plenty of lies circulating with regards to immigrants and our health care system.

Let’s start with the biggest lie of them all, touted by Rep. Wilson and other opponents of health care reform: that undocumented immigrants are the source of our health care woes and that they are an economic drain on our system – based on a contention that they don’t pay taxes, and that unpaid emergency room visits and hospitalizations are a significant portion of our health care expenditures. Criticism of the public option or any type of government sponsored health care has been perversely twisted into an argument against immigrants and immigration. Moreover, even progressives fighting for reform have been taking to scapegoating immigrants, as can be seen in Michael Moore’s Sicko, where he makes the case for supporting public health care financing by suggesting that Americans should receive the same “excellent” quality health care being given to the South Asian, Arab, and Muslim detainees at Guantanamo. Does this health care plan include the waterboarding and other forms of physical and psychological torture, not to mention violations of basic human rights that our community members face?

Consider a recent South Asian immigrant woman in her mid-forties, diagnosed with breast cancer and having to work hard to raise a teenage daughter and make ends meet alone after her husband disappears in the post-9/11 fear that engulfed many in our community. Complicate her struggle by considering the fact that she is not proficient in English, does not have access to the family’s finances, and is at risk of being evicted from her home since her illness makes it difficult for her to keep a steady job. Should this woman be burdened further by having to wait five years to be eligible for public health options? Why is her suffering not considered ‘sufficient’ enough to access needed assistance, which a resource-rich country like the United States has committed – in theory, at least – to making available to those in need?

The truth of the matter is that not only do legal immigrants pay taxes, but so do the undocumented. According to the Social Security Administration, two-third’s of the undocumented pay payroll taxes – to the tune of tens of billions of dollars annually as estimated by the IRS & SSA. However, unlike legal immigrants and US-born persons who also pay taxes, undocumented immigrants do not qualify for Medicare or Social Security benefits. Further, studies have shown that only 1.3% of total government medical expenditures went towards care of undocumented patients, and immigrants utilize emergency room services far less than their American-born counterparts.

So let’s review: for the undocumented South Asian immigrant, a person that is dutifully filing taxes, sometimes paying back-taxes to make up for years they weren’t aware they had to pay (e.g. if they had been seeking asylum), he/she is dependent either upon their employer or themselves to finance their health care. Sounds like the same situation US citizens are in, right? Well, very similar, with one notable exception: the undocumented cannot access the majority of government-run plans – even the new ones being proposed in the current health reform plans. Products like Medicare, the vast majority of Medicaid dollars, welfare dollars, food stamps, and other such benefits are not available to them to finance their health care and support their healing.

Instead of blaming immigrant communities as the problem in health care, let’s get back to the real reason we need health care reform. Without access to health care, individuals have a greater risk of getting sicker, of having prolonged sickness, of falling into further debt, and of death. The Institute of Medicine estimates that lack of health insurance causes 18,000 unnecessary deaths every year in the U.S. Can we really afford to wait? Providing health insurance through a mechanism such as a public option can lower both the number of uninsured and costs by providing much needed coverage that includes primary care preventative services for all people residing in the U.S. Let’s fix the U.S. health care system’s most urgent wrongs – by providing health care to all — – in particular those that are most marginalized and stripped of their basic right to access health care services. It’s definitely no lie that this includes our immigrant communities.