Patterico's Pontifications

2/10/2008

L.A. Times Ignores the Elephant in the Room in Story on Overcrowded ERs

Filed under: Dog Trainer,General,Immigration — Patterico @ 12:37 am

A piece in the L.A. Times is titled ERs fail as the nation’s safety net. (H/t: Mike H.) The article manages to discuss every possible cause for overcrowded emergency rooms except for one. See if you can guess which one that is.

The story opens:

The long waits that government inspectors say endanger emergency room patients at Harbor-UCLA Medical Center can also be found in backlogged hospitals across the country, according to emergency care experts who have been trying for years to draw attention to the nation’s overloaded safety net.

The article explains that this is a crisis, and that patients are not merely being inconvenienced — they are dying as a result. One in five ER doctors surveyed said they knew of patients who had died because of an overly long wait.

So what is causing the overcrowding and long waits? The article mentions numerous factors: increasing demand, a shortage of beds, a nursing shortage, an aging population, and a lack of specialists willing to be on call. We are also told:

The growing number of people without medical insurance also contributes because the lack of reimbursement, along with ever-shrinking payments from both public and private insurers, has turned many emergency rooms into money-losers and driven some hospitals out of the emergency-care business. Federal law requires hospital emergency rooms to treat patients regardless of their ability to pay.

So what is causing the increase in emergency room demand? And what is a major cause of the increased in uninsured patients?

Let me introduce you to the giant elephant in the room, which the L.A. Times editors appear determined to studiously ignore.

That elephant is called illegal immigration.

elephant-in-the-room.jpg

Above: L.A. Times editors gather to discuss what causes overcrowding in emergency rooms.

A recent study by the U.S. Congressional Budget Office confirms what most people suspect as a matter of common sense: that emergency rooms are feeling a strain from the millions of illegal immigrants in our country, especially in the border states.

[B]ecause unauthorized immigrants are less likely to have health insurance, they are more likely to rely on emergency facilities or public hospitals for treatment of nonemergency illnesses and other health-related problems.

The study cites studies by the RAND Corporation and the Pew Hispanic Center which estimate that 60-65% of illegal immigrants are uninsured. This results in tremendous health care costs. According to the Phoenix Business Journal:

Undocumented immigrants are more likely to access emergency rooms and urgent care facilities because most do not have health care, the study said. In Arizona and other border areas, states paid nearly $190 million in health care costs for undocumented immigrants in 2000, the study reported. The amount, which the study says likely has risen since then, represented one-quarter of all uncompensated health care costs in those states that year.

The amount clearly has risen. A January 2007 story in the San Diego Union Tribune says:

In California, hospitals spend about $700 million annually on emergency room services for illegal immigrants, said Jan Emerson, spokeswoman for the California Hospital Association in Sacramento.

And in 2005, U.S. Senator Jon Kyl put the number much higher for the nation as a whole:

The estimated annual cost to hospitals and other providers of emergency health care nationwide for illegal aliens is $1.45 billion.

Illegals tend to use the ER as their source for non-emergency medical care. The reason: it’s the only way they can afford to see a doctor — because in the ER, taxpayers are footing the bill:

Illegal immigrants can get emergency care through Medicaid, the federal-state program for the poor and people with disabilities. But they can’t get non-emergency care unless they pay.

The rise of the uninsured, which the L.A. Times describes as one of the major problems facing ERs, is also in large part a problem of illegal immigration. USA Today reported in 2005:

The increase in the number of people without health insurance has occurred largely because of illegal immigration, a study found.

Researchers at the RAND Corporation, a non-partisan think tank, analyzed data received from about 2,400 people in Los Angeles County in 2000 and 2001, and applied that information to the nation’s undocumented population at large.

The number of uninsured adults in the United States grew by about 8.7 million between 1980 and 2000. If the trend for Los Angeles County held true for the rest of the country, about a third of that growth can be attributable to illegal immigrants.

Hospitals recognize the problem:

For hospitals, “the burden of the uninsured immigrant is huge,” says Jeff Spade, vice president of the North Carolina Hospital Association. “It’s exploded the amount of work that they have to do.”

A senior economist at RAND had this to say:

“There are pros and cons of providing insurance to the undocumented that should be debated openly,” he said. “Undocumented immigrants make up too much of the issue to be ignored or hidden by polite silence.”

Tell that to the editors of the L.A. Times. Polite silence on this is all they have to offer.

It’s plainly irresponsible to write an article on overcrowded ERs that doesn’t say a single word about the millions of illegal and uninsured immigrants that have entered ERs over the years.

The editors know damn well that the elephant is there, but they choose not to discuss it. Even if the elephant goes on a rampage and starts squashing everyone in the room, the survivors plan to sit there, hands folded, pretending like it’s not happening. After all, getting stomped by a rampaging elephant is bad — but the alternative is far worse: somebody might call them insensitive.

47 Comments

  1. “The increase in the number of people without health insurance has occurred largely because of illegal immigration, a study found.”

    At over 4K a year the number is going to soar in the coming years! But it will be US citizens in crisis.

    “Undocumented immigrants make up too much of the issue to be ignored or hidden by polite silence.”

    Of course they mean law breakers, criminals, even if they have not yet committed another crime in our country, just being here is against the law!

    … “but the alternative is far worse: somebody might call them insensitive.”

    Actually they would call them a racist SOB! Then go into a diatribe about NAZI or some such.

    BTW; there have been a couple large scale busts by ICE here in UT of recent. Meat packer Swift for one, a few months ago. Seems every single one of the illegals working there had correctly and legally filled out an I-9! Even though they verify SS#’s through a new govt program, none of their workers were flagged.

    NONE! Not a single person, out of 80 or such, with stolen or forged papers was flagged!

    Another 57 were just hauled off from a metal fabrication plant a few days ago. No details as of yet.

    It’s not just one elephant in the room, it’s a heard!

    Comment by TC (1cf350) — 2/10/2008 @ 1:11 am

  2. About 4 years ago, LAT magazine had a very long article about the problem with the ERs. Again, there was absolutely no mention of them being flooded with nonpaying illegal immigrants. It was like reading Pravda.

    Comment by tired (5e1281) — 2/10/2008 @ 2:01 am

  3. Forgot to mention. The article in LAT magazine talked about because doctors don’t get paid, they refuse to be on call to the ER. So, even if you are fully insured, if you have a serious accident on a Friday night and are taken to an ER, you may have to wait until Monday before a specialist can see you.

    Comment by tired (5e1281) — 2/10/2008 @ 2:07 am

  4. Many Er docs are but interns.

    Think 20 somethings that really don’t give a crap about anything sans getting a license. Oh and evidently a pay check.

    (resisting the urge to include potential lawyers into this post).

    Comment by TC (1cf350) — 2/10/2008 @ 3:10 am

  5. Our children’s hospital has an interesting system. Their large ER admitting room funnels into two different treatment areas, Emergenncy and Urgent Care.

    They do triage right there. If your “emergency” turns out to be “I couldn’t be bothered to make an appointment for my kid at the doctor’s office” or “I don’t have health insurance and I have a hangnail” they smile sweetly and ask you for your fee upfront. If you don’t want to pay they courteously recommend that you see your own doctor as soon as possible. True emergencies are ushered into the Emergency system immediately.

    I think this could be a significant improvement if it were widely adopted.

    Teri

    Comment by Teri (0aa1ce) — 2/10/2008 @ 7:01 am

  6. My wife is an ER/Trauma nurse working in Brawley (near the US/Mex boarder). You’ve hit the nail on the head with this issue – Illegal immigrants are the biggest “user” of the ER, and they know the “special word” that gets them covered – Medi/Medi = Medicare/MediCal. Other issues that impact the quality of care in the ER:

    1. Nursing Shortage – Hospitals are tight with $$$, the first place that they will cut costs is with the nursing staff (no hiring of Travel Nurses, no overtime, etc…), making the patient to nurse ratio at 5:1 or greater – not good when some of your most critical patients show up in the ER. When things get real tight at a hospital, the nurses are the first to go.
    2. Closure of services – this is a result of the legal system (sorry P and the other Lawyers who read this). When Hospitals are forced to close services due to high insurance costs, these patients go to the nearest ER for care – delivering babies in the ER is getting to be more common than it use to be.
    3. Reimbursement for Medicare/MediCal – some hospitals rely on this to keep the doors open (Hi Desert Hospital in Joshua Tree is one that I’m familiar with – last year it operated in the red by about $750K to $1M,the CEO left before the yearly report came out). When reimbursement is less than 25% of cost, and the facility is already in dire straits financially, there is the chance that the small rural hospital is thinking about closing the door. BTW – TriCare (the military’s health “insurance”) pays the worst – 10% is about average (and this is the reason why so many docs don’t like to see military patients or their families).
    4. EMTALA does not allow for ER staff to turn away patients because they are not insured – ER’s have to provide care for anyone walking in the door, regardless if they can pay or not.
    5. Staff – “you pay for what you get” is the matra here. If you want to keep payroll costs down, you usually get the docs, nurses and support staff that are “questionable” in their education or skills. Better paying facilities, usually offering bonuses or paying for additional training or education usually get the better staff to join them.

    Small hospitals are closing or reducing services because of this issue – and it’s probably impacting the hospital near you. Illegal immigration is bleeding the medical system dry, and there needs to be a “sane” way of fixing the problem (and, no I do not believe that “socalized” medicine is the way to go – TriCare is crap, and that is a government plan for military, retirees and their families).

    Comment by fmfnavydoc (affdec) — 2/10/2008 @ 7:12 am

  7. Illegals tend to use the ER as their source for non-emergency medical care. The reason: it’s the only way they can afford to see a doctor

    Afford is one of those tricky concepts. People who are strapped for cash are going to conserve it whenever the opportunity for doing so presents itself. They might not be able to afford the week’s groceries at Safeway, or the gasoline that will get them to work. Not to mention a cell phone plan or cable TV. However, in the absence of alternatives, most find a way to pay for these necessities.

    Since these patients doesn’t have to pay for ER care, that becomes, inevitably, an item that they can’t afford.

    The picture is clouded by the bizarre system of multiple levels of pretend pricing and further (lower) levels of real pricing for medical services. Hospital X might have “lost $300″ for ER services that it billed at $300 but was never paid for. However, under its contracts, it might have recouped only $175 from a patient insured by Blue Cross, $140 for one covered by Aetna, $80 from Medicaid, and so on (numbers are made up). So it’s hard to be confident in the figures that the various parties toss around in these debates.

    Comment by AMac (c0a63d) — 2/10/2008 @ 8:20 am

  8. This article is all part of the run-up to the election to ensure a Dem is elected; the LAT will tout health care as the top issue because it takes the focus away from national security.

    Here’s another thinly veiled Dem pre-election program: college freshmen will be indoctrinated…interviewed by pollsters on immigration and health care opinions and then offered re-education on these issues in a daylong forum. Push polling taken to the next level!
    Democracy Project

    Comment by Patricia (f56a97) — 2/10/2008 @ 8:49 am

  9. This article is full of lies! People don’t wait for health care in america.

    But it sounds like everyone wins if these immigrants get jobs that have insurance coverage.

    Comment by stef (e870b9) — 2/10/2008 @ 9:36 am

  10. My post is full of lies! Illegal immigrants don’t crowd ERs.

    But it sounds like everyone wins if the illegals get deported.

    Comment by Patterico (4bda0b) — 2/10/2008 @ 9:41 am

  11. stef will say:

    “But wait! Illegals don’t win if they get deported!”

    May I pre-respond?

    But wait! Americans don’t win if illegal immigrants take their jobs!

    Comment by Patterico (4bda0b) — 2/10/2008 @ 9:43 am

  12. Stef– right, because there are just tons of jobs with health insurance, and they all pay so well!

    More folks win if we ship the illegals out when we catch them, work to keep them out and actually just enforce the laws currently on the books.

    Result: fewer workers, thus higher demand for workers, thus higher pay offered to get those who have desired skills. (hey, while I’m day dreaming, maybe there will actually be enough demand to get the 35 year old guys out of the counter shift in McD’s, and high school/college kids will start getting part-time jobs again.)

    Now, let’s look at the other option… Make everyone legal.
    Well, that injects a huge number of uneducated works into the force, and the demand for their work will go down quite fast when they have to be paid a legal wage. That will create demand for the NEXT wave of illegals, wash-rinse-repeat. (I’d like to point out that we already tried the “legalize them” route– I seem to recall it was former President Reagan. Didn’t work. Insert wry statement about the definition of insanity.)

    Comment by Foxfier (74f1c8) — 2/10/2008 @ 9:52 am

  13. It’s even worse than it’s pictured, stef. Here’s one example. In Chicago, the Fire Department will bill you for its ambulance responding to a 911 call — about $450.00. Responsible people, who can pay, will call a cab, or a medicar, or a relative to drive them except in a real emergency. The illegals who use the ER as their primary physician will think nothing of calling the ambulance for a sore throat and runny nose because they do not worry about collection action against them for the bill. It’s gotten to the point that the CFD has to subcontract to private ambulance companies and at peak times there are still not enough ambulances. Sometimes the wait may be as much as two hours and that’s for a patient with chest pains, shortness of breath and a history of heart attacks.

    Comment by nk (315ffd) — 2/10/2008 @ 9:55 am

  14. This is just another way the criminal Mexicans are killing American citizens. How long before the revolution (a shooting type) begins? I have to believe even a brain dead democrat will wake up when a member of they’re family dies of ‘waiting in the ER.

    Comment by Scrapiron (d671ab) — 2/10/2008 @ 10:03 am

  15. Teri your suggestion re: the procedure followed by your children’s hospital triage sounds very good. The cynic in me worries that there is a capper who has access to the list of folks turned away waiting to refer them to a bilingual law firm to play the L.A. litigation lottery with either a discrimination claim or malpractice claim.

    Comment by dcrane (bf4b0f) — 2/10/2008 @ 10:05 am

  16. NK is 100% correct and I served on a rescue squad ambulance for six years. Criminals and welfare riders ‘ride’ emergency services all over the country.

    Comment by Scrapiron (d671ab) — 2/10/2008 @ 10:07 am

  17. “But it sounds like everyone wins if the illegals get deported.”

    Not the health care industry: less demand for it.

    And also immigrants don’t win either. But you get that. Its just that you think that more people working is a problem. Me? I think the problem is they’re not paid enough for their work. They should get paid more, buy more things — like cars and auto insurance and health insurance — and then we get closer to everybody winning.

    Comment by stef (513533) — 2/10/2008 @ 10:33 am

  18. The number of uninsured adults in the United States grew by about 8.7 million between 1980 and 2000. If the trend for Los Angeles County held true for the rest of the country, about a third of that growth can be attributable to illegal immigrants.

    The study cites studies by the RAND Corporation and the Pew Hispanic Center which estimate that 60-65% of illegal immigrants are uninsured. This results in tremendous health care costs.

    1. LA Times should address this aspect I agree. But in fairness by only focusing on the illegals it leaves out some important facts.

    2. It is too easy to forget about our fellow LEGAL citizens who don’t have insurance in our haste to tag it all on the illegal immigrants. If Lou Dobbs waved a magic wand and all the illegals disappeared would a one third drop in patients solve the crisis? Depending on who you want to believe the estimates for uninsured Americans is as high as 45 million people. http://aspe.hhs.gov/health/reports/05/uninsured-cps/index.htm#Insurance)
    This translates to about five legal citizens for every illegal immigrant. Use Kyl’s figures as the baseline and the annual cost for our legal citizens runs to 7.5 billion per year.

    Some will use your logic to justify forgetting that other elephant in the room.

    Comment by voiceofreason2 (81699f) — 2/10/2008 @ 10:39 am

  19. VOR2…and of the 5 legal citizens who don’t have health insurance, 2 of them CHOOSE not to have it, for various reasons, at least from the stories I have heard.

    Yes, a lack insurance is a major factor, but, it is not the only factor. Illegals are a huge drain, as are those who lack insurance.

    But, make a choice: BILLIONS AND BILLIONS for health insurance from taxpayers, a large majority of whom are working to make it, or, enforcement of the existing laws to lower the costs that taxpayers are already footing for those who use emergency services for their health care.

    My choice: enforce the laws first.

    Comment by reff (99666d) — 2/10/2008 @ 10:58 am

  20. Not the health care industry: less demand for it.

    It doesn’t help them when they fill demand and don’t get paid for it. There’s a high demand for loans too, but the banks don’t win if they approve them all and don’t get paid back.

    Comment by Pablo (99243e) — 2/10/2008 @ 11:00 am

  21. VOR2…and of the 5 legal citizens who don’t have health insurance, 2 of them CHOOSE not to have it, for various reasons, at least from the stories I have heard.

    Yeah. Young, healthy people who at most get an annual physical have no need for basic insurance. Major medical is a nice idea in case of catastrophic illness or injury, but why should they pay thousands a year to cover a $100 checkup (If they even get that…I didn’t until my mid 30′s) and the maybe $150 they’d have to spend on the random ear infection? It makes sense for them not to have health insurance, unless they’re getting it dirt cheap through an employer.

    Comment by Pablo (99243e) — 2/10/2008 @ 11:03 am

  22. Pablo,
    Once that young person marries and has children it is a different ballgame altogether. When are couples generally the poorest in their lives? Usually it is early on as they are starting their careers and having kids. 10-15 years into a marriage with kids and most are okay. But early on many have to make a concscious choice to forego health insurance on their kids because they can’t easily afford it. I have one relative who would have to pay 20% of her gross income to have insurance for her kids, husband and her. There are many others like her.

    Comment by voiceofreason2 (81699f) — 2/10/2008 @ 11:17 am

  23. and of the 5 legal citizens who don’t have health insurance, 2 of them CHOOSE not to have it, for various reasons, at least from the stories I have heard.

    Pablo,
    Even if this is correct (and I would prefer to see some proof) that is still a 3 to 1 ratio of legals to illegals or some 25 million who don’t have insurance. It is a problem that needs to be solved. I’d be rich if I knew the answer to accomplish that without using a federally run program. But I think we downplay the severity of the problem all the same.

    Comment by voiceofreason2 (81699f) — 2/10/2008 @ 11:22 am

  24. Off-topic. Xrlq’s site is down. Any idea why?

    Comment by nk (315ffd) — 2/10/2008 @ 11:35 am

  25. VOR2 – I believe that 45 million figure people bandy about includes illegals. It also includes elderly eligible for medicaid who have not applied for whatever reason, others who have not applied for medicare or other forms of public assistance, people between jobs who have elected not to pay for COBRA coverage, the healthy who have deliberately chosen to go without coverage, as well as those too poor to purchase coverage on their own.

    If you strip out those eligible for coverage elsewhere, those voluntarily opting out of the market, and the illegal immigrants, you have a much more realistic picture of those structurally without healthcare coverage in the U.S. and it is in the teens of millions according to the studies I have seen.

    Comment by daleyrocks (906622) — 2/10/2008 @ 11:37 am

  26. vor2…

    I understand your point, but, for example, your relative with a husband and two kids didn’t think that health insurance was important when they decided to have kids, did they? Yes, there are some who have lost jobs/have injuries that create problems for themselves and their families, but those numbers are very low, even when compared to illegal aliens.

    My wife and I have one daughter, and we both started our careers as teachers, so, we were able to get insurance. However, I also have friends who work hard from check to check and decided to have one/two kids, and can’t afford the costs.

    Personal decisions are just that, and I’m very sorry, but, for so very many, their personal decisions are going to cost me tax dollars, and that is simply selfish on their part.

    As for the answer: the private sector will always be a better answer for health care than the government ever can be.

    Comment by reff (99666d) — 2/10/2008 @ 11:38 am

  27. “It is a problem that needs to be solved.” Really? If yes VOR2, it is by the 25 million themselves. Thanks, but I look after myself and mine. The others are on their own. You can help if you want but I opt out; please feel free to pay whatever you think my share should be.

    Comment by MikeD (e1e29a) — 2/10/2008 @ 11:45 am

  28. Reff,
    There is the ideal and the reality. What 18 and 19 year old kids really make that many well thought out choices?
    Given that is not unusual, there should be some form of affordable insurance. A family that stays together and raises their kids as a couple is an overall plus to society and lowers costs on other fronts such as welfare and subsidized housing.
    Those same kids will someday be the taxpayers that society needs for its military and essential services.

    Comment by voiceofreason2 (81699f) — 2/10/2008 @ 11:51 am

  29. It sounds like a lot of these problems are just crummy administration, probably exacerbated by tax-funded reimbursements for losses due to crummy administration. Hospital emergency rooms in most places don’t have to treat people with sore throats, and ambulances don’t have to transport people with sore throats. All they have to do is say, “Sorry this is not not emergency. Either show an ability to pay before you get service or go away.”

    Comment by Doc Rampage (01f543) — 2/10/2008 @ 11:57 am

  30. Thanks, but I look after myself and mine. The others are on their own. You can help if you want but I opt out; please feel free to pay whatever you think my share should be.

    Comment by MikeD — 2/10/2008 @ 11:45 am

    Ok Mike. Let’s start with your tax deductions – you are taking care of yourself and don’t need the handout so let’s put those dollars to better use.

    Comment by voiceofreason2 (81699f) — 2/10/2008 @ 11:59 am

  31. I fully agree with the difference between ideal and reality. But, no one talks about reality when dealing with this. We don’t educate children on all this, and then they-you-complain about the end result. All the while, the “government health care” lobby, like yourself, cry for an answer….when the answer is to make people responsible for themselves as much as is possible. Rather than the law forcing me to pay for others’ healthcare, the law should force them to pay for non-emergency services in as many cases as is possible. If they have a job, they get garnished. If they are eligible for Medicare/Medicaid, they must sign up, and prove their eligibility, and maintain it. I like the system mentioned above, where the ER makes a determination about status, and you must pay upfront for services. People must be held responsible for their own healthcare, and the healthcare of their children/families. Our system cannot continue to exist the way it is, and the alternative system is either Canada or England, where they are having trouble getting doctors to follow basic hygiene rules.

    Oh, and those same kids will not be taxpayers in the future….Hillary/Obama will continue to play the soak the rich game on taxpayers…these kids are not in the top 50% of wageearners now, and won’t be for the most part in 20 years, then only the top 40 percent of wageearners will be paying taxes….and they’ll have “free” government sponsored health insurance….

    Comment by reff (99666d) — 2/10/2008 @ 12:06 pm

  32. Doc #29,

    Who knows what the caller says to the 911 operator? The default position is that the ambulance responds. Once there, the paramedics evaluate the patient, within their training and competence, and call in to the ER doctor on call over the radio for advice. He tells them what to do. In every case, it is the pro-patient decision.

    Comment by nk (315ffd) — 2/10/2008 @ 12:07 pm

  33. I’m supposed to be studying for my board recerts,so I’m playing hookey.I’d like to makea few well thought comments.First,most people can afford some catastrophic insurance.golden rule or something like that.That’s to cover the car crashes,cancer,etc.Secondly,with Wal Mart setting the lead,the price for the cardiovascular diseases (htn,adult onset DM,cardiac) has plummetted.a patients meds went from $240/month to $12.Big difference.Thirdly,I have no way of estimating the costs,but they don’t report non ER stays.When my father was in practice (Chula Vista-between SD and the border)he had to do an average of a couple /call day of women who came across or presente inwhat we call’active labor’.L and D and or surgical suites cost money also.
    A good friend’s wife is far left person.She’s a
    radiology tech at a local hosp.I’ve become so amused at her anti illegal complaints-all aimed at GWB-as the hospital had to tighten up to take care of the cost the ilegal care.And,I hasten to say,it’s one of two tertiary hospitals in town.and the other is uprooting into the ‘burbs and leaving the problem.

    Comment by corwin (5c8013) — 2/10/2008 @ 12:07 pm

  34. vor2 #30…

    The Fair Tax would be the answer to that one….but that’s another string….

    Comment by reff (99666d) — 2/10/2008 @ 12:08 pm

  35. “It doesn’t help them when they fill demand and don’t get paid for it”

    Thats why they should get paid for it. I propose we find a way for these people to work so that they can pay for their health care. That way everybody gets more business and more work.

    Comment by stef (16bb7e) — 2/10/2008 @ 12:15 pm

  36. We don’t educate children on all this, and then they-you-complain about the end result. All the while, the “government health care” lobby, like yourself, cry for an answer….when the answer is to make people responsible for themselves as much as is possible.

    You misread my comment. I am not for government managed health care. I am in the Tricare prime for military retirees which is little more than the failed Clinton proposal in his first admin that was forced on the military. Believe me I know all too well what a goat rope it is. I can be denied treatment for cancer or similar catastrophic illnesses if the condition is deemed to be too costly.

    “As much as is possible” is where we may have agreement. Make people responsible for their health care but force the HMOs to index it in a way that younger folks can get rates they can afford. As they get older and in careers where they are offered better plans by their employers they don’t need to rely on this kind of help. Helping young couples set themselves up for success is the right way to solve the problem for the long term. In the interim middle and elderly citizens may need the indexed rates to transition to a more sensible way of having health care.

    It is not an all or nothing proposition as others have suggested.

    Comment by voiceofreason2 (81699f) — 2/10/2008 @ 12:27 pm

  37. I read the article, Patterico, and I have a great idea: let’s do for the illegal immigrants precisely what the Mexican hospitals do for their illegals (of which they have plenty, coming north from Central America).

    Reciprocity is hardly imperialist. Especially given the petrodollars funneling into a few pockets in Mexico City.

    After all, Mexico needs us to take their workers. If we didn’t, Mexico would have a revolution on its hands.

    Comment by Eric Blair (d57d58) — 2/10/2008 @ 12:37 pm

  38. I like your suggestions…glad we have common ground….

    And, I thank you for your service…

    Semper Fi….

    Comment by reff (99666d) — 2/10/2008 @ 12:40 pm

  39. Thanks Reff. Have a good day and thanks for your service.

    Comment by voiceofreason2 (81699f) — 2/10/2008 @ 12:48 pm

  40. “But it sounds like everyone wins if the illegals get deported.”

    - Patterico

    Just the bad ones, you mean? The Criminals (exempting illegal status as a crime in and of itself)?

    Comment by Leviticus (2098b0) — 2/10/2008 @ 1:17 pm

  41. Just the bad ones, you mean? The Criminals (exempting illegal status as a crime in and of itself)?

    Why are you exempting illegal status as a crime in and of itself, Levi?

    Illegal status is a crime in and of itself, no matter where they come from, even if they’re white, Christian, rich and vote Republican.

    Comment by Paul (bcc0a7) — 2/10/2008 @ 1:23 pm

  42. Illegal status is a crime in and of itself, no matter where they come from, even if they’re white, Christian, rich and vote Republican.

    Comment by Paul

    Exactly– and very well said.

    If someone is willing to break into my house, why should I let them chill on the couch so long as they don’t break other laws?

    Comment by Foxfier (74f1c8) — 2/10/2008 @ 1:37 pm

  43. Too bad the idiots who call themselves editors at the LA Times haven’t dug deeper into other aspects of the ER problem. Those of us who happen to pay taxes are the ones getting hit with the bills imposed on us by illegal immigrants crowding ERs. But when we need help at the ER we are turned away. To thinking people, this is called “taxation without representation”. Others call it plain ole robbery.

    Comment by Mescalero (13d307) — 2/10/2008 @ 2:22 pm

  44. The L.A. SLIMES is ignoring the elephant and the 800 lbs gorilla

    Comment by krazy kagu (f24007) — 2/10/2008 @ 2:36 pm

  45. Thats why they should get paid for it. I propose we find a way for these people to work so that they can pay for their health care. That way everybody gets more business and more work.

    How? the gov’t? The gov’t should find them jobs, order how much they should be paid, etc? If that is your answer, you have no concept of how economics actually works. Socialism has been proven, over and over and over and over and over and over again to fail. The new crop of young socialists in america will not have any more luck making socialism work

    And, while we are at it – why does america have to provide mexican citizens with jobs and health care? Maybe if the socialist mexican government gave up on socialism and turned to capitalism like the U.S., they would not be such a poor country with their people forced to flee looking for work. Ever think of that?

    Comment by Great Banana (aa0c92) — 2/11/2008 @ 9:06 am

  46. “How? the gov’t? The gov’t should find them jobs, order how much they should be paid, etc? ”

    Nope. I think these people can find jobs on their own. Thats not whats keeping them from having mainstream jobs.

    “And, while we are at it – why does america have to provide mexican citizens with jobs and health care?”

    We don’t have to. I just prefer it that people come and work and earn money and buy health care and other things and become contributing members of society.

    Comment by stef (a42736) — 2/11/2008 @ 12:03 pm

  47. The only problem with the healthy youngin’ not buying a private insurance policy is the risk of harm from extracurricular activities. If that youngin’ decides to fly insurance free, I suggest they not take up any hobbies or life style practices that could put tham at risk for injury… biking, skating, skiing, surfing, hiking, etc. Lord forbid they should have an accident and have to pay to get their leg reset or a bad gash stitched up. Well and of course, there could be follow up care in the form of physical therapy, once again without insurance that’s gonna be pricy.

    You don’t wait to buy auto insurance until your car is old and beat up, you buy it to be prepared for accidents. Health insurance is the same… you don’t buy it to keep yourself healthy, you buy it to be prepared in case of an emergency. Or, I suppose you could just depend on us tax payers to bail you out since you chose not to protect yourself.

    As for whether to buy your own or use employer coverage… I vote for private policies. Get them while you can, once you’ve got a pre-existing condition you’ll never get insured and having your own policy is better than having one that goes away if you happen to lose your job.

    Comment by Policy Wonk (599c12) — 2/26/2008 @ 4:02 pm

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