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Healthcare debate must include costs for treating illegals

The civil case against a Florida hospital draws to a close this week. A relative of an illegal alien sued Martin Memorial Medical Center when it repatriated the man after treating him for nearly three years at an un-reimbursed cost of $1.5 million. The relative/legal guardian wants an unspecified six-figure judgment for alleged false imprisonment and nearly $1 million in economic damages for the medical care he has not received since 2003. That’s when Martin Memorial paid $30,000 to charter a jet to take Luis Jimenez to a medical facility in Guatemala. Jimenez now lives with his mother.

Carol Plato, the director of corporate business services for Martin Memorial in Stuart, says Jimenez is an example of what happens when hospitals treat illegal immigrants. Martin Memorial also is treating an illegal Mexican immigrant for severe brain damage. The man has no family in this country. He’s cost Martin Memorial about $1.5 million over the past two years. Plato says Martin Memorial has contacted the Mexican consulate and the U.S. government about returning the man to Mexico, but no one’s helping.

In addition to this patient, Plato says six illegal immigrants use Martin Memorial three days a week for dialysis with no reimbursement because of their status.

Listen closely, but you’ll be hard-pressed to hear anyone in Washington, from the White House to Capitol Hill, placing medical coverage for illegal immigrants as a priority in the healthcare debate. They don’t want to address it seriously, because then they’d have to find a solution to the overall problem of illegal immigration.

Uncompensated costs to hospitals and other healthcare providers run into the billions of dollars annually. The Florida Hospital Association estimates that in 2007, treatment for illegal immigrant patients cost $100 million. A 2004 study by the Federation for American Immigration Reform put California’s annual cost at $1.4 billion.

States bordering Mexico take the biggest hits. A study by the United States/Mexico Border Counties Coalition found that hospitals serving the 24 U.S. counties along the border ate $190 million in the year 2000.

The Emergency Medical Treatment and Active Labor Act requires all emergency departments to treat all persons coming in seeking medical care, regardless of residency status or ability to pay. Hospitals cannot legally ask residency status of patients, which thwarts attempts to determine accurately the scope of the situation.

A few years ago, the U.S. Government Accountability Office looked for available federal funding to help hospitals offset the costs of treating illegal immigrants. GAO surveyed 503 hospitals and interviewed Medicaid and Medicare officials in ten states, only to determine that an accurate assessment of these uncompensated costs “remains elusive.”

Conservative estimates place the number of illegal immigrants in the U.S. as high as 10 million. Nearly 60 percent of the illegals do not have health insurance, according to the Pew Hispanic Center. That means 40 percent have health insurance, mostly provided by their employers. If that’s the case, then around 4 million illegal immigrants receive health coverage because they’ve supplied their employers with false or stolen Social Security numbers.

Here in Texas, the state and local hospital districts spent about $677 million on uncompensated health care for illegals in FY 05, according to the Texas Health and Human Services Commission. The Harris County Hospital District provided $203.5 million in uncompensated care, according to the study, which hospital district administrators say is twice what they really lost. The study, however, did not include figures from the University of Texas Medical Branch in Galveston, which lost $140 million a year, according to published reports.

“Last year, 6,540 visits from undocumented immigrants cost Parkland Hospital System in Dallas $7 million, and Memorial Hermann in Houston incurred over $4 million in cost for their care,” says Kay Bailey Hutchison (R-Texas). “Hospitals in Connecticut, Delaware, Florida, Louisiana, Nevada, and other states have drawn 100 percent of the available federal aid to help defray the costs associated with providing care for illegal immigrants.”

Unless Congress comes up with a way to fix the illegal immigration problem, the continued strain on the healthcare system by undocumented individuals will cut into any cost savings of a universal healthcare plan.
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Houston paper buries lead in sob-sister story of illegal’s suicide

The lead is one of the hardest, yet most essential, elements to a news story.  It sets the tone for the article and captures the reader’s interest by using a minimum number of words.  And speaking of minimum, the good lead offers, at minimum, the meat of the story: the who, the what, the when, and the where.  The why and the how come later.

Journalists learn lead writing in Journalism 101 classes.  They hone their skill through class assignments.  They perfect the art with the help of editors or producers.

So what happened at the Houston Chronicle last week?  Someone either (1) forgot how to write a lead or (2) the Chronicle, once again, demonstrated its penchant for shoddy writing and agenda journalism.  Of course, neither alternative is mutually exclusive.

Here’s what readers gleaned from the first three paragraphs of the front-page story of the city/state section under the headline, “Teen’s hanging in jail fuels many questions”:  17-year-old Arturo Chavez sat dead in solitary confinement in the Galveston County, Texas, jail after twisting a blanket into a noose around his neck within 48 hours of his arrest on an initial charge of making an illegal left turn.

Three paragraphs to tell us a 17-year-old may have committed suicide in the county jail after a traffic stop.

By the end of the fourth paragraph, the reader gets the idea this will not be a story about an apparent jail suicide, but rather a sob-sister account of an illegal alien from Guatemala who spent much of his time improving his English and working to send money to the folks back home.

The fifth graph introduces his older brother who says Chavez killed himself because he was “so beaten down he couldn’t take the pain.”  And then, if the reader had any doubts of the paper’s agenda, the sixth paragraph tosses them out by explaining that Chavez’s life was similar to those untold others who “live in the shadows” because of their immigration status.

Reading on in the eighth graph, we learn his parents filed a federal lawsuit against the police department, the county, and the county sheriff alleging authorities didn’t do enough to prevent the suicide.

The paper devotes the next 16 (count them, 16) paragraphs on Chavez’s dissatisfaction with his tips from loading baggage at a Guatemalan bus station; the 15 days he spent sneaking into Mexico and the U.S.; the $3,500 he and his family and friends forked over to coyotes; his rise from busboy to waiter at an unnamed restaurant owned by Mario Garcia (yes, the story named the owner, but not the restaurant); the $100 a week Chavez sent home; his classes to learn English; his pride of Guatemala, the U.S., and his Mayan heritage, his happiness with his 15-year-old girl friend; and his traffic stop.

Not until paragraph 25, more than halfway into the story, do we learn Chavez was in the U.S. illegally with no driver’s license or auto insurance, and in possession of a fake identification card.  And then, the paper takes two more paragraphs before describing how Chavez escaped from jail, scrambled up a wire-topped fence that cut his hands as he resisted arrest, and how police had to zap him twice with a taser and thwack him several times in the head with a baton before he gave up.

The remaining 16 paragraphs reflect the tone of the first 24 by painting an illegal immigrant who escaped from jail and resisted capture, who endangered lives and property, and who carried what may have been someone’s stolen identity as a hard worker whose poor family had to raise the cash to return his body to Guatemala.

There is nothing wrong with telling Chavez’s story to explain why the young man chose to kill himself rather than wait for the court to release him so he could continue his voluntary life in the shadows.  The Houston Chronicle, however, did a great disservice to its readers and to all legal immigrants and naturalized citizens by burying Chavez’s criminal activities and by portraying him as an innocent victim of a racist and uncaring society that beat him down until suicide was the only way to stop his pain.

I don’t have a problem with well-written, sob-sister, agenda journalism.  Just don’t put tripas on a plate and serve it as tournedos.

 

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Shunning may be the answer to illegal immigration

Lost amid news about rising fuel costs, falling stock prices, mortgage foreclosures, and one African-American’s nutty surgical wish are stories of push backs by communities fed up with illegal immigration. 

Out in Thousand Oaks, Calif., earlier this month, some residents scored a small victory by effectively closing down for a day a city-sponsored day-labor center. Last year Judicial Watch wrote the mayor about the organization’s concerns that the city was violating federal immigration laws by spending more than $133,000 of public funds between 2001 and 2007 to subsidize what amounts to city-sanctioned criminal activity, since mostly illegal aliens hang out at the center. 

A small group of residents gathered on the sidewalk to wave placards and US flags at passing motorists. They also used video cameras to tape folks trying to hire illegals, which considerably cut down on business for the day. 

Out in Aurora, Colo., city council members this month will take up a proposal to change the definition of a temporary employment agency after citizens and business owners complained about people gathered at an intersection looking for temporary work. Some of the job seekers reportedly jump in front of vehicles or urinate behind the buildings. The proposal would force day laborers to stand 1,500 feet from the newly defined employment agencies. 

Lou Barletta, the three-term mayor of Hazelton, Pa., wants businesses there to work with a company that uses a federal data base to check on employees’ immigration status. Illegal immigration is the cornerstone of his campaign to oust a 12-term member of Congress. He also convinced the city council in 2006 to approve an ordinance denying business permits to companies that employ illegals. The ordinance also allowed for fines against landlords who rent to illegals, and it required tenants to register and pay for a rental permit. A federal judge said “No, no, no.”  

Federal courts around the nation struck down other attempts by cities to staunch the flow of illegals into their communities. Up in Farmers Branch, Texas, a federal judge this month quashed the city’s ban on renting apartments to illegals. Now, the city is thinking about following Hazelton’s plan.

The Fremont, Neb., city council is considering a proposal to ban the harboring or hiring of illegals or renting to them. And, officials in Escondido, Calif., want to enact ordinances that outlaw picking up day laborers from along some streets. They also want to discourage multiple families from sharing houses by requiring a permit for overnight parking.  

Opponents of the Fremont and Escondido plans say the cities’ attempts are unconstitutional. And, they’re probably right. Cities and states can’t enact laws governing immigration. That’s the job of the federal government. Plenty of laws exist to control immigration; they just need to be enforced.  

We’re starting to see some that enforcement. A few days ago, feds in Rhode Island raided six courthouses and arrested 31 illegals from Mexico, Guatamala, Honduras, and Brazil hired by contractors for the state court system. Then there’s Mack Associates, Inc., owner of eleven McDonald’s restaurants in Nevada, fined $1 million this past week after admitting to hiring 58 illegal immigrants. In Morgan City, La., Lenny Dartez, a former member of the state’s Democratic Party central committee and husband of former state representative Carla Dartez, faces up to five years in the pokey and up to $250,000 in fines for employing illegals from Trinidad at one of his companies. Citizen tips led to the arrests in all three of these cases. 

And, there is the answer. The illegal immigration issue may be a national concern, but it’s really an issue that can be addressed only on the individual level. 

Here’s what I mean. A couple of years ago, my mother-in-law nearly died after an illegal immigrant made an unlawful u-turn and rammed into her vehicle. My mother-in-law wanted to talk with her city council member and write letters to her state representatives about passing stricter immigration legislation until I pointed out that neither the city nor the state has jurisdiction. 

It’s up to you and your friends to do something about it, and that something is simply shunning those who purposely hire illegal workers, I said. Folks concerned about crime in their neighborhood establish neighborhood watches to keep out miscreants. Residents fed up with prostitution chase away the customers from the street corners. Citizens tired of drugs run off the dealers. They don’t wait for the government to enforce laws already on the books. 

Her preacher frequented the Mexican restaurant that hired the woman who hit her, so I suggested she tell the preacher to either stop going there or else they’d find a new minister. She didn’t like the idea.  

Shunning is not easy. She lives in a small Arkansas town. Shunning business owners and neighbors she’s known for decades would make it uncomfortable for her whenever she went to the country club or attended a Kiwanis meeting, she admitted. 

Some places encourage illegals to settle in their communities. But folks living in other cities, like the one’s mentioned earlier, want the illegals to go away. They can’t pass city ordinances, but they can take individual action. 

One person becomes two, who become four, which then becomes a movement. When the government won’t enforce its laws, the individual must turn his or her back on those who hire and harbor illegals. Non-violent community pressure in the form of economic and social shunning, also known as boycotts, may be the only solution.

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Agenda journalism: A tale of two papers

Most readers of the daily news, whether they find the news online or on the doorstep, do not have the time to compare and contrast the coverage of a particular subject.  E-readers may sample the coverage of, say, Kosovo, by using their favorite search engine to find all of the online stories about Kosovo for that day.  (On the day of this writing, a Google search returned twenty-four hits on the first page, although none linked to a U.S. news outlet.)  The really curious reader may open each of the links for a particular headline to see how different news organizations covered the story.

Every now and then, one has the opportunity to read the original story from one newspaper and the edited version carried by another newspaper.  This can lead to responses ranging from amusement to outrage.  Such was the case with a story that originally appeared in The New York Times (“Mexican Migrants Carry H.I.V. Home [www.nytimes.com/2007/07/17/world/americas/17mexico.html?hp]) and which the Houston Chronicle (“Researchers fear AIDS crisis as migrants return to Mexico) extensively edited for its print edition.

Cutting a thousand words from a 1,300-word story is not easy if one tries to retain the original sense and credibility.  The Chronicle did poorly.  Here are some examples:

The Times story said, “As sweeping proposals for immigration-law changes founder in the United States, the expanding AIDS crisis among the migrants is largely overlooked on both sides of the border.”  The Chronicle edited the sentence to read, “As immigration reform founders, the expanding AIDS crisis among the migrants goes virtually unaddressed on both sides of the border.”

The terms “largely overlooked” and “virtually unaddressed” are not synonymous.  The Times piece tells us government and health officials have not given much thought to the significance of AIDS among Mexicans working illegally in the U.S., while the Chronicle’s edited version implies policy makers know about the situation and refuse to do anything about it.

The next sentences in the Times story point out that, “Particularly in Mexico, AIDS is still shrouded by stigma and denial.  In the United States, it is often assumed that immigrants bring diseases into the country, not take them away.”  The Chronicle story says simply, “In Mexico, AIDS is shrouded by denial.”  The paper cut the rest of the paragraph.

The word “particularly” in the Times story is of particular importance, as is the word “stigma” that the Chronicle editors deleted.  This is because the Times story refers later to studies that show one in ten Mexicans working illegally in Los Angeles and hanging around job-pickup sites are so desperate for money that they perform oral and anal sex for cash.  The Chronicle deliberately deleted all references to homosexuality and its “stigma” among Mexicans, thereby eliminating gay sex as one reason for the spread of AIDS in Mexico.  The Chronicle also removed the sentence regarding the assumption that “immigrants bring diseases” into the U.S.  By now, one suspects the Houston paper is pushing a political agenda.

The Times story goes on to note that a new study found the greatest risk of contracting AIDS faced by rural Mexican women having sex with their returning husbands is the refusal of their spouses to use condoms.  The Chronicle rewrite, however, placed the blame on “the women’s inability to insist that their husbands use condoms.”

The Times story points out that “AIDS has not yet exploded in Mexico and is focused mostly among prostitutes and their clients, and drug users and gay men.”  The Chronicle turned “prostitutes” into “sex workers” and edited out their customers.

The Chronicle also left out some additional relevant information, such as the percentage of Mexicans with HIV who used to live in the U.S. fluctuated between 41 percent and 79 percent in the 1980s and early 1990s; the percentage of illegal workers from Mexico in Los Angeles who take money to participate in gay sex; and that Mexico’s northern and southern borders are magnets for prostitutes and drug dealers drawn by migrating illegal workers entering and leaving the country.

The Times put its warm and fuzzy spin on the story by using the term “migrant workers” when referring to illegal immigrants.  It further attempted to evoke sympathy for these individuals by telling us they are “displaced” from their homes.  Victims of natural disasters or wars are displaced from their homes; these folks left of their own volition.

Probably the most tortured phrases came when the Times quoted a researcher who tried to explain why these workers do who they do.  According to the researcher, they are vulnerable, isolated, exposed to different sexual practices, hampered by language barriers, depressed, lonely, and abused.

But the worst aspect of both articles is the subtle implication that illegal immigrants come to the U.S. disease free and return to Mexico with AIDS and HIV without infecting anyone in this country.  It is ludicrous to believe they have sex only with prostitutes who give them AIDS or, in some cases, become prostitutes for men who give them AIDS.

In the end, a story giving the sad and disturbing truth about the spread of HIV/AIDS among the returning illegal immigrants and their families turned into a justification for their philandering and an indictment against our nation for not having the programs in place to make them less vulnerable, less isolated, and less likely to hook up with a hooker or to bend over for a buck.

Yes, it is a horrible problem, but it is not our fault.

Mundus vult decipi

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No easy solution to immigration's Gordian Knot: Just ask the Chinese

On April 9, 2006, Internet sites that carry my column ran the following piece.  Events of recent days, and last night's debate against Bush by Democrat presidential candidates, made me consider reprising the column here.

No easy solutions to immigration’s Gordian Knot:
Just ask the Chinese

Before things get more out of hand, it is time for folks to take some deep breaths and think rationally about the next steps in undoing immigration’s Gordian Knot before it becomes our undoing.  This will not be easy (that’s why it’s a Gordian Knot!), and empty political rhetoric from Republicans, Democrats, Socialists, and political pot stirrers will just add to the confusion and delay reasonable resolutions. 

A sane and productive debate does not use the fates and fortunes of people as opportunities for political head knocking.  Not to pick on Democratic Party jeffe Howard Dean, but he just happens to be the latest high-profile politician to unleash another contender for the Mother of All Ironies. 

During a visit last week to California’s Alameda County Central Labor Council offices, Dean accused the president and the Republicans of scapegoating illegal aliens for political gain.  Dean’s audience included labor, community, and interfaith leaders who have their own reasons for exploiting illegal aliens; reasons that include increasing sagging union membership and assuring the future employment of individuals who make their living by taking public and private dollars to perpetuate poverty and the idea of victimhood.  There is no need to go into the hopes for political hay on the parts of Dean and the Democrats.

And others are out there.  

Like the Spanish-language DJs who used their airtime to promote and encourage the first marches by Mexicans and other Spanish-speaking immigrants.  Did they do it out of the goodness of their hearts, or out of the desire to increase ratings, considering they were just coming out of the winter ratings period and entering the spring sweeps?

Like the people passing out large, new Mexican flags.  Sure, many Mexican families own their country’s flag and proudly wave it on Cinco de Mayo; but, no rational person would doubt the existence of Mexican flag foisters hanging out of the back of trucks.

Like the people who work behind the scenes to encourage middle- and high-school students to cut classes and march on city hall.  These political puppet masters are no dummies.  They know kids are safe and make great front-page photos and tv news video.  They also know kids are safe because no city official wants to see images of tear gas and attack dogs unleashed on children.

History has an uncanny ability to shake off the dust and smack us up the side of the head.  Look closely and you will see a dust cloud coming, and that rushing sound you will hear shortly will be the prelude to a mighty reminder that we have been down this ugly road before.

Just ask the Chinese.

(Disclaimer: My grandfather was an illegal immigrant who left China in the early twentieth century and crossed into the U.S. from Canada.)

Immigrants from southern China started showing up along the Pacific coast about the middle of the nineteenth century, because of natural and manmade disasters and China’s collapsing rural economy.  Most of them were men who left their families, hoping to make some money and return home.  The first Chinese included professionals and merchants; laborers followed. 

Everyone got along until Chinese gold miners started making money from digs abandoned as worthless by American miners.  Then folks started looking around and saw that Chinese were working as cooks, launderers, and domestic servants.  By the depression of the 1870s, a few years after the completion of the Chinese-built transcontinental railroad, Americans saw Chinese as serious competition for the limited job opportunities.  Violence against the “Oriental Menace” spread from California to Wyoming, led by an Irish immigrant in San Francisco.

Not everyone saw the Chinese as a threat.  In 1876, David Phillips, in his “Letters from California” (http://memory.loc.gov/ammem/cbhtml/cbhome.html), wrote that to take the Chinese out of California, “its industries would be ruined, and the lands, now so productive, would be cultivated without remunerative results.  They supply, by their toil, nearly all the vegetables and much of the poultry.  They are doing a large share of the farm-work, and build all the railroads and irrigating canals and ditches.  They do much of the cooking, and nearly all of the washing and ironing.”

Mark Twain wrote in “Roughing It”, published in 1872 (http://memory.loc.gov/ammem/ndlpedu/features/timeline/riseind/chinimms/twain.html), that “No Californian gentleman or lady ever abuses or oppresses a Chinaman, under any circumstances . . .  Only the scum of the population do it – they and their children; they, and naturally and consistently, the policemen and politicians, likewise, for these are the dust-licking pimps and slaves of the scum, there as well as elsewhere in America.”

By 1876, a Republican Congress decided to investigate the Chinese immigration problem, which resulted in the Report of the Joint Special Committee to Investigate Chinese Immigration, Senate Report No. 689, 44th Congress, 2d Session, issued Feb. 27, 1877 (http://cprr.org/Museum/Chinese_Immigration.html).

The committee found that California and the Pacific coast developed rapidly thanks to cheap Chinese labor.  The committee also found, however, that “laboring men and artisans” opposed Chinese immigration because the Chinese worked for less money and, therefore, took many of the available jobs.  This attitude, according to the report, led to widely held fears that low wages would turn the white working class into a servant class. 

The future of the Pacific coast was clear to the committee:  It would become either “American or Mongolian.”

“There is a vast hive from which Chinese immigrants may swarm, and circumstances may send them in enormous numbers to this country . . .The Chinese do not come to make their home in this country; their only purpose is to acquire what would be a competence in China and return there to enjoy it . . . It further appears from the evidence that the Chinese do not desire to become citizens of this country, and have no knowledge of or appreciation for our institutions.  Very few of them learn to speak our language . . .”

The committee believed Congress had to act before the West Coast became a province of China instead of the United States.  The American population of the region was patiently waiting for Congress to act, the committee said.

Congress passed The Chinese Exclusion Act of 1882, the nation’s first law banning immigration by race or nationality.  The law barred all Chinese except for travelers, merchants, teachers, students, and those born in the United States.  Congress repealed the law in 1943, when China became an ally in the war against Japan.

It is time for responsible people to replace rhetoric with reason and to learn from the well-meaning mistakes of the past.  Our nation’s current predicament did not spring forth fully formed like a border-crossing Athena of immigration.  It will not be resolved by political knee jerking.  Just ask the Chinese.


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