OPINION | In health care debate, don’t fall prey to the politics of exclusion


The health care debate, rather than focusing on how to expand health insurance access to everyone who needs it, is now preoccupied with how to exclude one group: immigrants. In the current proposals supported by the White House and Senate Democrats, undocumented immigrants will not only be ineligible participate in any taxpayer subsidized program, but they will be barred from purchasing health coverage through an insurance exchange even if they can afford to pay for it. Legal immigrants may be required to wait five years to take advantage of any government subsidies to purchase more affordable insurance.

The political calculation here is obvious – that including immigrants would be too divisive to get enough support to pass a reform bill. Certainly, the sentiment voiced by many voters after Rep. Joe Wilson’s heckling of the President on this issue suggests deep levels of fear and resentment towards immigrants in this country.

Just as corporate bosses have tried to divide workers based on ethnicity and immigration status for centuries, our elected leaders would play workers against each other so that we overlook the real culprits behind this crisis, including those in government who have allowed this crisis to grow unchecked for decades as corporate interests trumped the public good.

This scare tactic is unacceptable and unconscionable — both because it takes needed energy away from the critical issue of reforming our highly unequal health care system and because it cruelly suggests that some human beings are less deserving of access to health care than others.

Immigration policy aside, the right to medical care is considered a fundamental human right as described in the Universal Declaration of Human Rights by the United Nations. This is why hospitals must provide care for the indigent regardless of how much they get reimbursed under any plan, because our sense of humanity prevents us from allowing the least fortunate to die for lack of care. This same sense of humanity should prompt us to push for the inclusion of everyone in health care reform; doing otherwise smacks of racism and xenophobia.

As an educator, I could try to persuade readers of the facts as they relate to immigration and health care to illustrate that this exclusion is not about the cost of covering undocumented immigrants.

For example, undocumented immigrants are already barred from Medicaid and Medicare; immigrants do not account for rising costs of these programs. Immigrants use far fewer health care resources than U.S. citizens, including visits to emergency rooms. They also tend to be younger and in better health than U.S. citizens; allowing them to buy affordable health coverage would actually help to pay for health care reform as the costs would be spread among more people (see this fact sheet by the Immigration Policy Center for more detail).

As a community member, I could appeal to old-fashioned common sense. Put simply, there’s no impenetrable border around disease and illness where we live, study, and play. Not to mention that immigrant families often have individuals with different legal status living in the same households, so there’s not a definitive distinction between legal/illegal that is practical when it comes to health.

Denying health care coverage and preventive care to immigrants makes no sense in today’s interconnected world. How it can possibly be in anyone’s interest to allow some members of our community to not get treated for illness when our children attend the same schools, when immigrant workers prepare the food that we eat, when we work and shop in the same places?

But I wish to appeal to my fellow members of the labor movement as workers. The reason many immigrants don’t have health coverage is because they overwhelmingly work in low-wage jobs where benefits are scarce.

Organizing immigrant workers and pushing for comprehensive immigration reform have become major policies of both the AFL-CIO and Change to Win. These strategies would ensure that all workers have access to workplace protections and that wages of all workers would not be depressed by the exploitation of immigrant workers. As Pablo Alvarado said so well at the AFL-CIO Convention, migrant workers are union brothers and sisters in waiting.

Yet labor will not be successful in its efforts to help pass comprehensive immigration reform in 2010 if we allow unchecked anti-immigrant sentiment to drive the health care debate. Only corporations benefit by denying full rights to all workers and turning us against each other to weaken our collective demands, whether that be for access to health care or the right to organize.

This is the time for labor to stand up and act as a vocal ally to the most vulnerable workers among us. We cannot afford to be silent now if we believe that literally an injury to one is an injury to all.

Mary Bellman teaches immigration, globalization and many other topics for the University of Minnesota Labor Education Service. She has a Ph.D. in political science from the University of New Mexico and has lived and worked in Guatemala.

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