Friday, September 11, 2009

The Shout Heard 'Round The World

Congressman Joe Wilson (R-SC) claims that his appalling behavior at the President's speech to the Joint Session was due to being overly emotional, that he was caught up in the heat of the moment.

I don't think so.

I think it was pre-planned and calculated to inject a not-so-subtle racism into the health care debate, coming as it did when President Obama asserted that the new program would not pay for the health care of undocumented immigrants. And it had its intended effect.

From the Sacramento Bee:

On national television, President Barack Obama contended this week that his plan to overhaul the country's health care system wouldn't spend a single federal dime on undocumented immigrants.

As he spoke, a Republican congressman called the president a liar - once again bringing the incendiary issue of illegal immigration to the forefront of the national debate on health care. ...

Few dispute that undocumented immigrants pose some financial drain on the nation's health care system, but some experts say the extent of that cost has been wildly exaggerated.
[Emphasis added]

The assumption is that undocumented immigrants, who mostly don't have health insurance, are the biggest abusers of 'free' health care. This is a tricky assumption, because it rests on another assumption, that citizens and immigrants here lawfully all have insurance, which is simply not the case, according to a study done by UCLA.

Here's a graphic based on the UCLA study that accompanied the SacBee article

20% is still a pretty substantial portion of the uninsured, those most likely to use an emergency room for health care, but certainly nowhere near the number usually implied by those who complain that the undocumented are getting a free ride at the expense of those who have insurance. The argument is that because the hospitals lose money on the uninsured illegal, they have to raise the costs of care on those who have insurance, thereby resulting in increased premiums. Even that argument is based on a false assumption (several, actually):

In fact, the biggest source of uncompensated care - $7.7 billion - is attributable to federal underpayment for services provided to Medicare and Medi-Cal patients.

Of the $11.3 billion in uncompensated care California hospitals reported last year, about $1.5 billion was attributed to undocumented immigrants.

That's roughly 10%.

But those numbers are only part of the story, although apparently our congress critters think they are an important part. What isn't often expressed are the potential costs of not providing health care, something the SacBee article also noted.

At the same time, health officials worry that denying health care to undocumented immigrants could have costly consequences to public health, particularly in controlling communicable diseases, such as tuberculosis and H1N1 flu.

Unfortunately, that argument hasn't made it to the table. I suspect that it's too nuanced for our penny-wise politicians. It's much easier to blame the illegals than to work for the public good and certainly more lucrative.

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Anonymous Wellescent RA Forums said...

While I won't go so far as to agree that the Congressman strategically made the comment, I have to agree with your analysis of the costs associated with illegal immigrants and the scapegoating that is taking place. Blaming those who might cause 10% of the problem and quietly ignoring the other 90% is simple political expedience.

Nothing beats a good simplistic statement as to the cause of a problem especially when you can get people fired up over the issue.

5:06 PM  

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