[lbo-talk] Dean Baker on immigration

[Gar Lipow]

On 4/18/06, Marta Russell <ap888 at lafn.org> wrote:
>
>
> That's ridiculous.
> Here is another case of people - you Jordan - not knowing what is actually
> happening on the ground.  This will be a good lesson in public healthcare
> policy 101.  I know most people on this list think public healthcare is the
> answer to the healthcare crisis and I have generally subscribed to that view
> but public financed healthcare is subject to the budget axe and political
> will.  And now there are not enough people involved politically speaking to
> stop the axe from whacking away at Medicaid most everywhere in this country.
>
> It's simple.  In CA, for instance, the government keeps whittling away at
> MediCal benefits (regulations) because it wants to drive down the costs of
> the program which are growing due in large part to an increase in the
> numbers of persons on the program (overcrowding means inadequate increase in  funding to compensate).  One year it will pay for dental caps, the next year  it won't.  So you say people can live without dental caps.  There's more.  One year it will pay for oxygen to be delivered at home, the next year it
> pays distributors so little they won't deliver anymore.  Those dependent on
> oxygen must then use their precious resources if they are even able to drive
> to get the oxygen themselves.  One year it will pay MediCal docs enough so
> they will take MediCal patients, the next year it won't and so many docs
> will no longer take MediCal and the most chronically ill population on
> MediCal have fewer and fewer docs to care for them (this esp hits people in
> rural areas hard where there are fewer doctors).  Or the MediCal docs rush
> their patients through so quickly to make a buck that the complicated cases
> often become victims of malpractice, only they are too poor or dead to sue
> over it.  One year it will pay for hospitalization for certain conditions -
> say an extreme infection that requires an IV - and the next year it
> restricts hospital stays and transfers these people into nursing homes which
> are notorious places to die from neglect because they often don't pay
> attention to one's chart or one's needs.  One year it will pay for people to
> live on their own with an attendant to help them out, the next year it cuts
> back on benefits like Tennessee did and sends its ventilator users into
> nursing homes where the quality of care is abhorrent.  Such people are more
> likely to die prematurely in nursing homes from unnecessary sedation and
> other causes.  In Missouri the state intends to completely eliminate
> Medicaid in 3 years.  How many chronically ill people do you think will die
> when that happens?  On and on.
> Marta
>

Two points here Marta.

One is that the political problem you mention, that there is not
enough poltiical will  pushing for more medicaid funding, comes
because it help only the poor. With a single payer health system,
these kind of cuts would hurt everyone; everyone would scream and
demand more funding. So the problem with medicaid is not that it is 
publicly funded but that most voters are either in private plans, or
in medicare which has different funding .

Two. Stop  blaming the immigrants. You see a tiny view of the costs
and claim knowledge from personal experience. But you don't see the
revenues they provide to medicaid. All the statistics say the pay more
than they cost. You can't claim you have any sort of personal
experience to dispute those statistics, since such personal experience
would have to be auditing the books  of the medical system. So if you
want to scapegoat the immigrants and claim to be speaking factually
you will need to give statistics in turn, not just claim direct 
revelation.

The fact is, if every immigrant (or even every undocumented immigrant)
dissappeared tomorrow you would be a worse position that you are
today. You would be competing for medical against fewer sick people;
but there would be fewer well people to pay taxes; the cuts would come
even faster.  Undocumented people pay more in taxes than collect in 
benefits. Money is fungible. If the money they pay disappeared
tomorrow to you think the cuts would come in prison guard salaries or
subsidies to Arnolds buddies? They would come right out of the budgets
that benefit those with the least political power. Immigrant bashing
gains you nothing; if  you win your situatuion will get worse.

Let's look at your specific example: notices and patient forms in 20
languages? That cost is nothing compared to the thousands of forms
imposed by  insurance companies that  doctors and staff (not patients)
must  fill out.  People filling up the waiting room? Nothing compared
to the doctors and nurses who aren't there because insurance companies
require huge numbers of administrators. One freakin third of our
health care dollar goes to adminstration. Another 10% is probably
stolen via deliberate medical fraud by providers.  Another 5% or more
goes to higher  drug prices that we pay compared to the rest of the
world.

Dearest Marta you are being conned, conned, conned. Yes you see with
your own eyes; but you know that observation is socially constructed.
You can only see a tiny bit of the  world at one time personally. You
must take data outside your  direct experience into consideration.