Franklin Roosevelt may or may not have begun an address to the Daughters of the American Revolution with the memorable line, "Fellow Immigrants." (A curmudgeonly blogger says a reporter made up the quote.) If Roosevelt didn't say it, he should have. It's a great line and perhaps more compelling than ever. The current debate over illegal immigrants - as fractious and divisive as the debate over abortion - has created a fault line that runs through every aspect of our culture.
In an excellent article in the New York Times (registration required) by Nina Bernstein, we read about the effect on access to health care that well publicized "throw them out" legislative initiatives have had on undocumented immigrants. Not surprisingly, these immigrants are sensitive to anti-immigration sentiments. For example, knowing that identity requirements are tightening, Chinese immigrant workers in New York City are shying away from the conventional health system (which in many cases is not exactly welcoming) and relying more on traditional herbal remedies. Bernstein writes of the sad demise of Ming Qiang Zhao, a 52 year old restaurant worker who could not afford to continue treatment for his nasal cancer. He relied on street remedies until he finally collapsed in a coma. The system which discouraged him from securing ongoing treatment readily admitted him on an emergency basis: a very expensive proposition ($5,400 day) involving several near-bankrupt hospitals. Unable to decipher the effect of the herbal remedies that he had been taking, the doctors treated him as best they could until Ming died.
Beyond the humanitarian issues, beyond the inflammatory rhetoric seeking to toss the illegals out, is the reality of having a two-tier health care system. In the system that most of us subscribe to, treatment is readily available, pharmacology is the best in the world, and minor ailments are treated with respect and concern. In the parallel universe of undocumented immigrants, there are bootleg remedies and unlicensed practitioners - until you collapse and are taken by ambulance to an emergency room.
The public health implications of this two-tiered system are alarming. Bernstein quotes James Tallon, president of the United Hospital Fund: "Anything that keeps anyone away from the health system makes no sense at all. It takes one epidemic to change everyone's attitudes about this." (We've already blogged the terrifying conjunction of avian flu and illegal workers in the poultry industry.)
The debate over what to do about illegal immigration impacts every one of us. I highly recommend that Insider readers track the current debate in Washington through Peter Rousmaniere's working immigrants blog, which is devoted solely to immigration-related issues.
Public Policy Parameters
The immigration issue is complex. There are no easy solutions. The problem is going to test us in ways that we can hardly envision. It brings to mind something that Roosevelt definitely did say: "When you get to the end of your rope, tie a knot and hang on. "I would hope to see the debate over immigration guided by a few basic assumptions:
- It's neither feasible nor desirable to deport 11+ million undocumented people and their families.
- Undocumented workers are an important part of our economy. If they disappeared tomorrow, we would all suffer the consequences.
- It's counter-productive to cut off immigrant access to the health care system. You don't want people treated by quacks. Somehow, we must open health care to everyone residing in our borders. It's the right thing to do and it's in our own selfish interests to do it.
- No matter what people think about illegal immigration, we must develop some kind of fundamental accommodation, some way of making every immigrant visible, so that these people are able to engage in the mainstream culture on a basic level.
- As we figure out ways to accommodate undocumented workers, the cost of doing business will definitely go up. When the protective umbrella of fair labor laws and fundamental benefits begins to cover workers who are currently "off the books," the cost of labor will rise.
- You can build walls to keep people out, but walls tend to become prisons for people on both sides.
There are undoubtedly many more assumptions could be added to this list. Insider readers should jump in on the discussion. This problem is not going away. And how we address it as a nation has powerful implications for all of us.