Impact of Indigent and Illegal Aliens

3.1 Introduction

The inflow of the illegal alien in America has escalated to a level that is threatening not only to the security, economic and political aspect, but, also to health of the nation. Escalating population of aliens seeking care in the hospital had increased from 2.8 million in 2000 to 3.5 million in 2010. (Charlie, L.  2011). Most of the studies conducted related to the effect of the aliens on medical care have been restricted to what is visible. However, the silent consequences are more lethal than what is easily evidenced by the citizens. The impact of these individuals on the field of healthcare must be faced and analyzed and a solution designed.  

The authority must see the bigger picture of presence of aliens in America, rather than restrict their knowledge to humanity and charity. In a statement, made by George Bush (the former American president), he referred to aliens as “strong physical workers who strive hand to support their families and chase the American dream” (DeWeese, T. 2003). These statements can only be viewed as a politically motivated and aimed at owing the aliens votes but does not represent the truth of the matter. The fact inclined to the presence of the aliens in the country is that they are the main beneficiaries of the EMTALA (now the Obamacar) program. The emergency medical facilities receive the highest number of these aliens seeking health services. The American law allows the children born to illegal aliens to benefit from Medicare. This raises the cost of health in the hospital.

The issue of supporting the health of aliens despite their financial status has led to the immigration of individuals in the neighboring countries. These people cross the border to America where they can access healthcare services at a cheaper rate-if not free. The states that border Mexico are the most affected by this influx (Treaster, J. 2004). This act is seen as betrayal to the loyal citizens who are the taxpayers yet are denied the privileges. The government grant health passes to illegal aliens while the inhabitants are expected to pay for their services. This increases the expenses in the hospitals since they end up giving services that are not covered for, by the government. The Emergency Medical Treatment and Active Labour Act enacted in 1985 force the hospitals to serve the uninsured individuals. The law, which has now been changed to Obamacare, does not give the cover for the cost incurred by the hospital.

3.2 Closure of hospitals

Over the past few years, several hospitals in the country have been closed due to insolvency. The contributing factor to the closure of the hospitals is the uncompensated healthcare cost. The hospitals have tried means to cover the cost of Medicare inclined to the aliens and the poor. The EMTALA empowers the government to take legal actions to health care workers who fail to attend to individuals due to financial constrain. These forces the hospital to devise means to reduce the loss incurred. Most hospitals have reduced the number of employees working in hospitals in an attempt to minimize cost (Camarota, S. & Edwards, J. 2009).

Violation of the EMTALA by health care workers could lead a sanction of not less than fifty thousand U.S dollars. The charge is imposed to both the healthcare workers who violate the law and the hospital as well. Moreover, the government can withdraw the license and the hospital administration risks losing Medicare reimbursement. The effect of this law on the growth of healthcare facilities has been detrimental rather that beneficial. Hospital administrations fear losing their capital due to claim of Violation to Obamacare program. On effect to this, they end up closing their hospital. This adds the cost to the genuine citizen who ends up paying extra coins in transport when seeking health services (Charlie, L. 2011).

The uncompensated cost and hard economic crises cause the hospitals to close and refrain from giving services. Between 2000 and 2010, 48 hospitals in California State closed due to the difficulty in managing the hospital. In Arizona State, over thirty health facilities claimed to have incurred a loss of not less than $150 million. The loss was tagged to aliens seeking health services in this region. The major cause of this closure was the influx of aliens from Mexico seeking emergency health services. Ambulances are flowing from Mexico to hospital near the border since they understand EMTALA (Obamacare) policy. It is estimated that at least fifteen thousand aliens crosses the Mexican border in search for health services every day (Goodman, J., Musgrave, G., & Herrick, D. 2010).

3.3 Anchor babies

The alien women are allowed to deliver in the USA hospitals, especially in the emergency care department. This automatically grants these babies legality to be American citizens by birth. The Fourteenth Amendment to American’s constitution is responsible for this impact. Statistics shows that 400,000 anchor babies acquire the legal right to be U.S citizens every year. In 2008, seventy percent of the babies born in San Joaquin Hospital were from alien mothers. The cost of delivering these babies was not accounted for by the government. This left the Hospital to devise a way to cover for this cost. These babies end up benefiting from the medical services offered in U.S.A more than the babies from mothers who are citizens of the country. The cost of a baby born of a citizen mother has to be insured to get services in the hospitals (Marsha, A. 2011).

There are heated discussions in USA to decide whether to end the citizenship right of birth. In 2009, children of illegal immigrants received a total of over $ 42 million through charity welfare. In fact, it has been perceived that raising an alien child has become cheaper than raising a child born of American mothers (Marsha, A. 2011).

3.4 Estimated cost of alien medical

In 1993, Texas Governor’s Office conducted a study that revealed that a hundred and twenty two million dollars were used to cater for health expenses of undocumented aliens in Texas State (Michael, E. 2009). This show how the aliens medical care services cost the state a prodigious sum of money. The money could be used to stabilize the economy or even foster development. In 1994, the federal government conducted a study, which was aimed at checking the implications of the indigent and alien on the medical expenses. This study revealed that the immigrants were draining states resources (Win Group. 2006). However, even after the truth of the matter had been identified, there was little effort channeled in determining the possible solutions. General Accounting Office conducted another report which was documented to reveal the range of uncompensated healthcare cost.

The government is in-depth involvement in what they are referring to as welfare programs that are aimed at helping the immigrants and the poor in the country; among this welfare, is Medicaid program. The estimated cost of all the welfare program has been figured at $564 billion. This money is obtained from taxpayers. Paradoxically, the taxpayers barely benefit from these programs (Michael, E. 2009).

4.0 PROBLEM ANALYSIS

A question that is common to many Americans is why can’t the government do something to solve this issue? A number of issues can be attributed to the cause of this problem. The government failure to regulate the inflow and settlement of the immigrant is a contributing factor to this problem. The government has established policies to help the country fight issues of poor health among its citizens. These policies are most welcome by the citizen, but the extent of those who benefit from them should be limited. California State is one of the states, severely affected by the EMTALA policy (Bastiat's, F. 2009). Consequently, the state has lead in the fight to restrict the number of people benefiting from the taxpayers contribution. For instance, it has restricted immigrants from benefiting from the cover of the Obamacare.

 4.1 Mandatory services

 All hospitals in America are expected to offer health services to anyone who visits the facilities seeking for health services. This policy has a significant drawback since it weakens the ability of a hospital to maintain its operation from the charges for services offered. There is a loophole in the policy since; the reimbursement procedure is not implemented. The increased expenditure among the hospitals lowers the income for the hospital reading to the cutting down of the number of workers in the hospital thus compromising the quality of services rendered (Weber, E. 2004).

4.2 Immigration policies

The illegal Immigrant reform and Immigrate Responsibility Act-enacted in 1996- need to be reinforced. The act contributes to the cases of closure of hospitals due to lack of reimburse by the government. The immigrants end up gaining services in the hospitals without paying, while Americans pays through taxes and premiums. In this essence, the government is portrayed as helping the aliens in the country instead of the real citizens (Martin, J., 2002).

The immigration policy fails the efforts of immigrants to secure insurance service. However, these policies allow the relatives of the immigrant to flow to America creating pool of    low-income members in the country who leave below poverty level. Currently, 20 percent of the non-citizens households are poor as compared to 13 percent of the native households. The level of income earned by these immigrants is low to support their families and pay for insurance premiums. Consequently, they are classified under the category of indigents; qualifying for Medicaid and Obamacare program benefits.

4.3 Medicaid program

Personal Responsibility and Work Opportunity Reconciliation Act aim at restricting aliens from benefiting from Medicaid services. The benefits of the Act are minimal since it did not touch the issue of emergency Medicaid that is mostly used by the aliens. For instance, the flow of Ambulance from Mexico to American hospital along the border should have been corrected by the Act. The beneficiaries of Medicaid in America include over 5 million immigrants as at 2010.

4.4 EMTALA

 Enactment of policies  such as EMTALA and Obamacare have also contributed significantly to the effects of the aliens seeking medical care. These programs allow the individuals who are poor to seek health service in the hospitals at a subsidized cost. The policies also recommend for higher fines to individuals found violating these policies. Therefore, indigent (most of them are aliens) acquires services from the hospitals without    incurring the cost.   

5.0 PROBLEM SOLUTIONS

Currently over 45 million Americans face challenges in access to basic health insurance. The rightful beneficiaries of Obamacare do not leap the benefit since the hospitals are overloaded with aliens (MacDonald's, H. 2011). This causes the country to help foreigners instead of its citizens. Possible ways of solving these problems includes;

5.0.1        Policy revision:

A  revisit to the policies and welfare programs initiated by the government. This will ensure that the individuals benefiting from the welfare programs are the rightful American citizens. The rights of the aliens and the indigents in respect to access to healthcare services should also be revised. Revising the law and Acts, which give aliens the right to enjoy the services of the nation, will directly lead to reduce the cost to the hospital. Consequently, the hospitals will have minimal claims of uncompensated cost. This will reduce the burden on the working citizens who should be benefiting more from their dedication and hard work.  However, a major weakness to this is the rate of implementing policies it America. The policy may take time or even be blocked by human activist.

5.0.2        Negotiation with neighboring countries.

The government should enter into an agreement with the neighboring countries whose citizens’ accounts for the number of aliens in the country. The countries   that borders America, such as Mexico, should be held accountable for any aliens seeking healthcare services in USA. The U.S. government   should find a way that the Mexican country can reimburse the cost of servicing its citizens. A major drawback to this is the extent of individuals involved. This increases the duration of implementation and hence may not materialize immediately.

5.0.3        Close the borders

The government should close the American borders where the immigrants gain access to the country. This will cut short the number of aliens gaining entry to the country thus reducing the expenses of the hospital. This will ensure the rate of closure of hospital go down, thus benefiting the American citizens. A major problem in the implementation is opposing forces from the human right activist.

5.0.4        Withdraw citizenship of anchor babies

The government should also rescind the right of anchor babies from being citizens. This will reduce the number of unqualified citizens in the country. Otherwise, every other person who wishes to leave in USA will only find a way of delivering in the country. However, this will only solve a part of the problem since aliens will still be flowing into the country.

5.0.5   No room for illegal aliens

The government should also impose punishment to illegal aliens found in the country. This will play a role in reducing their influx. Once the immigrants learn that there is vicious punishment for being found in the country illegally, they will refrain from surfacing in America.

6.0 SOLUTION AND ITS IMPLEMENTATION

6.0.1 Closure of the border.

American government should close the borders where the immigrants may use to gain entry to the country. The border enforcement authorities allow aliens into the country. This infringes the right of the citizens to benefit maximally with their country’s supportive programs. The implementations of this solution should involve;

 Deploy enough forces: The government should ensure that there are enough forces to restrain illegal aliens entering the country. This should be at the expense of federal government. This is because; the consequences of the aliens in the country affect the whole country but not the county on the border alone. In fact, this is the most important step and should commence with immediate effect.

Restrict ambulance entry: ambulances felling patient from Mexico and other neighboring countries should be denied access to America. However much we valued humanity welfare, the government should not allow leakage of hard gained resources. Any ambulance felling individuals to the country should be tract for compensation. The authorities along the border should be given the necessary authority from the law to conduct this procedure.  

 Use of efficient devises: the government should ensure that the authorities along the border have updated techno-devices that are able to detect fake passes. Surveillance should be an on-going process at all time and in all areas of border entry. The funding this program should be collaboration from both the county and federal government.

Sanctions to misconduct: persons found violating the law by allowing aliens to gain access to America, should be held accountable and necessary punishment measure taken. This should be the role of the county government. Therefore, the funding should come from the county kitty.

7.0 JUSTIFICATION

The main contributing factor to this problem is the presence of aliens in the country. Measures that will prevent their existence in the country will contribute to a large extent to the solving the problem. Problems such as presence of anchor babies and uncompensated cost will consequently be cubed once the borders are closed. For example the expenditure of the hospital along the border in Texas was valued at $ 45 millions in (2008 Michael, E. 2009). These implementations will lead to reduction in the number of hospitals closing down , hence most citizens will access the health services with ease. Once the solution is implemented, more Americans will enjoy the welfare programs and obtain quality health services.