we've been having heated - but not yet angry - discussions

Nurses General Nursing

Published

regarding the provision of medical services to undocumented residents - illegal aliens. As students, we've had the opportunity this semester to have clinical experiences that include being with community nurses as they make well-baby visits to the new parents. Seems as if we've all noticed a vast percentage have been to undocumented families.

We're a divided bunch. Some of us can't afford insurance while in school and yet see these families recieving services that they can't get. We've discussed the morals of providing health care to all/any who are in need. The ever-present problems of limited budgeting. Today it was mentioned about the helicopter crash this weekend in Texas. An undocumented mother and her ill child were being flown somewhere for treatment when the helicopter went down. Pilot, mother, baby died. The nurse was critically injured.

A long-time L&D nurse at one of the local hospitals commented when I asked her what her thoughts were (she has some interesting experiences as a Peace Corp nurse in South America, a more global view of nursing than is usually seen here in the midwest) "Well, I've never had to do a drug test on an Hispanic mother, I've never had to call in family services for suspected abuse. I have done these many, many times for 'our own white trailer trash' American residents." She'd rather see the young families have a chance at a healthy start.

It's a puzzlement to me. I'm not sure how I feel about this. Much of my concern is linked to budget. I just see a greater and greater drain on an extremely overtaxed system already. If we have to limit our services - should not our own citizens recieve the first services available?

arghhhhhhhhhhhhh - these ethical discussions make my head spin sometimes. I think I know what I believe and then someone makes a good point and I have to reconsider what I have already concluded to be true.

I feel like Eeyore.... think, think, think, think, think

Specializes in Inpatient Acute Rehab.
What rich person understands the plight on anybody but themselves? The heart of the matter is people would not come here if it were not for the welfare. Why move to another country and starve? A way to stop the problem is to allow for a legal way to immigrate. My family came over in 1914 with tons of others who were also not welcomed at the time. We took cheap labor jobs and brought different cultures/languages. We had to have a sponsor (person willing to pay for immigrant). There were no hand outs, except churces and charities. Also if you were caught with TB, you went back to where you came from. It wasn't being cruel, it was being sensible for the people already living in the USA. I think something like that should be done here. It makes me sick to see people taken advantage of, dying in trailers, treated a step above a slave, etc. There has to be a better way.

You hit the nail on the head!!!

Specializes in ER, ICU, L&D, OR.

I know what it is ti be and be comfortable

When I was in nsg school I was making only 5 grand a yr and managed to scrape by with the help of food gardens

and hunting, venison and rabbit and squirrel and fish were a staple food group for us.

Now I go out to dinner and venison is a delicacy, go figure.

same with rabbit.

course now I make a little over a 100 grand a year also

I have no problem with providing EMERGENCY care for illegal aliens but I believe as soon as they are stable they go straight home.

I also believe the country of origin should be officially billed for that persons stay in hospital.

I don't accept the double standard. We expect tourists to have travellers insurance or health insurance of some kind, we expect citizens to have insurance, why do we drop this standard for illegals?

I believe the illegal should be expected to pay and arrangements should be made for payment through the illegal employer or the illegal before discharge. The hospital my husband had bypass at made sure he had insurance before he got ANY treatment.

In Canada we have people who fly in and go straight to the hospital and demand dialysis and we have to provide it. We do one treatment and then turf them out with the number for social services. They are quite surprised to have to find accommadation for themselves.

I have absolutely no sympathy for this. We have people who waited years to come to canada, they did it the legal way and it is disgusting to see a criminal get the services we have all worked so hard to create.

We will always be a haven for refugees and I welcome them with open arms.

Those that have suffered terribly for their opinions need a safe place to carry on the fight .I refuse to offer that haven for economic refugees.

Do it legally, apply for a work visa and prove that you have a job to go to and welcome to free health care because you are now supporting the service.

Be honest and be an asset.

Every person who enters a country illegally for economic reasons is supporting organized crime. They pay criminals to smuggle them in, they encourage corrupt businesses to continue to break the law..everything about them is surrounded by criminal activity. If you remove the economic illegal the circle of crime that surrounds them can't survive.

I think that if the illegal knows exactly what job they are going to and most of them work for the same farmers year after year they should be given a work visa and all the benefits that come from paying income tax, unemployment and pension premiums. Once it is proven that they are supporting government services they should be given access to them. If you cant meet this test then you get no access except emergent care and a one way ticket home.

Edited to comment on post below:

At what cost do you open your health care to the world? Do you mean everyone should have my standard of health care or just the basics?

Who is going to pay for this?

I would love to announce to the world that healthcare is a right so come on over and don't bother getting a job or paying into the service.

It would be lovely to be so naive.

Healthcare costs money. Everyone has to get paid.

I am not interested in having my wages cut in half so I can care for the world. I don't know any doctors who would be happy having their wages cut in half. How about the pharmacist and the housekeeping staff?

I am not a martyr for healthcare and I am not willing to starve so I can provide care to everyone.

It is lovely that you believe healthcare is a right and everyone in the world should have access to dialysis , open heart surgery, organ transplant, radiation and chemo. Who is going to provide those services? for free?

I don't work for free, I don't want to work for free. I have a family to support and taxes to pay.

But I wont stop you if you want to work for free or for half your wages because if you truly believe we have an obligation to provide everyone in the world the same level of care we have built then be prepared to pay for it personally.

I have no problem with providing EMERGENCY care for illegal aliens but I believe as soon as they are stable they go straight home.

I also believe the country of origin should be officially billed for that persons stay in hospital.

I don't accept the double standard. We expect tourists to have travellers insurance or health insurance of some kind, we expect citizens to have insurance, why do we drop this standard for illegals?

I believe the illegal should be expected to pay and arrangements should be made for payment through the illegal employer or the illegal before discharge. The hospital my husband had bypass at made sure he had insurance before he got ANY treatment.

In Canada we have people who fly in and go straight to the hospital and demand dialysis and we have to provide it. We do one treatment and then turf them out with the number for social services. They are quite surprised to have to find accommadation for themselves.

I have absolutely no sympathy for this. We have people who waited years to come to canada, they did it the legal way and it is disgusting to see a criminal get the services we have all worked so hard to create.

We will always be a haven for refugees and I welcome them with open arms.

Those that have suffered terribly for their opinions need a safe place to carry on the fight .I refuse to offer that haven for economic refugees.

Do it legally, apply for a work visa and prove that you have a job to go to and welcome to free health care because you are now supporting the service.

Be honest and be an asset.

I am sorry but I disagree. I believe healthcare is a basic human right that everyone is entitled too. The US military treats enemy combatants, and I don't think an alien, illeagal or not, is any less entitled to healthcare. Payment should be based on ability to pay only. If we can threaten the world with nuclear weapons costing billions of dollars, then we can give healthcare to the indigent within our borders, no matter how they arrived here.

Specializes in ER, ICU, L&D, OR.

Amen wjf00

Let's respect each other's opinions. Some here believe healthcare is a right. I am in agreement with Moia personally and believe things have gone way to far...apparently in Canada as well as the US.

Specializes in ED, Tele, Psych.
I am sorry but I disagree. I believe healthcare is a basic human right that everyone is entitled too. The US military treats enemy combatants, and I don't think an alien, illeagal or not, is any less entitled to healthcare. Payment should be based on ability to pay only. If we can threaten the world with nuclear weapons costing billions of dollars, then we can give healthcare to the indigent within our borders, no matter how they arrived here.

correct me if i'm wrong...

as i understand the current policy on providing healthcare to enemy combatants, general healthcare is provided to those in custody and under the control of the military (as are all detanies, prisoners, and suspects in custody in the united states). the services provided to non-combatants by the military is dependant on saving the "life, limb, or eyesight" of the individual seeking help.

mike

Nice. I have reflected on this question quite a bit. I don't happen to agree with you. In your mind, my disagreement means I should quit being a nurse. And if I don't want to quit, the healthcare police should take away my license.

Reply by sagarcia210:

I believe you missed my point, but maybe I didn't make myself clear. I did not mean that if you disagree you should not be a nurse. What I meant, is that if one would deny healthcare/help based solely on the fact that the person was undocumented/illegal, then maybe that person should step down and let someone else help that person.

Following are some very good points taken from a website that deals with hispanic issues:

SAN FRANCISCO January 11, 2004 (NYTimes)-Imagine America without undocumented immigrants, the people who flip the burgers, clean the toilets, watch the kids and send their children to public schools.

Would the grass be greener?

The Pew Hispanic Center estimated in 2001 that the unauthorized labor force in the United States totaled 5.3 million workers, including 700,000 restaurant workers, 250,000 household employees and 620,000 construction workers. In addition, about 1.2 million of the 2.5 million wage-earning farm workers live here undocumentedly, according to a study by Philip L. Martin, a professor at the University of California at Davis who studies immigration and farm labor.

That is a whole lot of cheap labor.

Without it, fruit and vegetables would rot in fields. Toddlers in Manhattan would be without nannies. Towels at hotels in states like Florida, Texas and California would go unlaundered. Commuters at airports from Miami to Newark would be stranded as taxi cabs sat driverless. Home improvement projects across the Sun Belt would grind to a halt. And bedpans and lunch trays at nursing homes in Chicago, New York, Houston and Los Angeles would go uncollected.

While hospitals and clinics in Los Angeles County, for example, bear huge health care costs associated with uninsured undocumented immigrants - one study put the total at $340 million in 2002 - the federal government enjoys a "bonanza" from many of the same immigrants who pay federal taxes but receive no benefits in return, Mr. Yzaguirre said.

Mr. Yzaguirre suggested that Social Security would go broke without the payments of undocumented workers, many of whom, contrary to popular perception, do have regular payroll taxes deducted from their paychecks by employers. (In some instances, undocumented workers use false Social Security numbers, while others have valid numbers from when they had worked legally.)

Mr. Yzaguirre also rejected suggestions that Americans would maintain their standard of living without the low-wage contributions of those workers. He agreed with Professor Borjas that some Americans would enjoy fatter paychecks, but he said all Americans would be punished by having to pay more for everything from a McDonald's hamburger to a new house.

In a 2002 study conducted with the cooperation of immigrant rights organizations, researchers at the Center for Urban Economic Development at the University of Illinois at Chicago concluded that the 300,000 or so undocumented immigrants in Chicago did not use government benefits at a substantial rate. The study also estimated that 70 percent of the undocumented workers paid payroll taxes, like Social Security and unemployment insurance. The researchers calculated other economic benefits, finding that consumer spending by undocumented migrants generated more than 31,000 jobs and contributed $5.34 billion annually to the gross regional product in Chicago.

That's it! Can you imagine if all the illegals were legal workers? You think that would be the right thing to do here but the loss of taxpayers money would be far greater than leaving it the way it is. All the pickers, packers, ditch diggers, etc and their families would then be eligable for the tax incentives b/c of low income. 5.2 million X 500? to $1500? $$ each? Payed to them by us via our government. The credits, EIC, dependent, etc would pay them through IRS. Yikes! The $$ the migrant workers generate is far greater than the cost to educate them and take care of thier health. They would also qualify for HUD programs taking even more $$$ from our tax dollars under assistance programs. (Another topic altogether on the need for decent housing for these illegals). Unfortunatly the hospitals are on the losing end of all of this. But, we all gain in the end, including the illegal mexican growing and picking the food you eat on your table and the food we export to help balance the import/export ratios. Our economy probably can not afford to get rid of the illegals nor make them all legal. So get used to them and accept it as part of our livelyhood. Your overall quality of life depends on the low paid workers. Many, many Americans would rather sit home on fed asst than dig a ditch or wash your dishes at a resturaunt. The illegals are here to better their lives. They are also here to better your life.

Specializes in Inpatient Acute Rehab.
That's it! Can you imagine if all the illegals were legal workers? You think that would be the right thing to do here but the loss of taxpayers money would be far greater than leaving it the way it is. All the pickers, packers, ditch diggers, etc and their families would then be eligable for the tax incentives b/c of low income. 5.2 million X 500? to $1500? $$ each? Payed to them by us via our government. The credits, EIC, dependent, etc would pay them through IRS. Yikes! The $$ the migrant workers generate is far greater than the cost to educate them and take care of thier health. They would also qualify for HUD programs taking even more $$$ from our tax dollars under assistance programs. (Another topic altogether on the need for decent housing for these illegals). Unfortunatly the hospitals are on the losing end of all of this. But, we all gain in the end, including the illegal mexican growing and picking the food you eat on your table and the food we export to help balance the import/export ratios. Our economy probably can not afford to get rid of the illegals nor make them all legal. So get used to them and accept it as part of our livelyhood. Your overall quality of life depends on the low paid workers. Many, many Americans would rather sit home on fed asst than dig a ditch or wash your dishes at a resturaunt. The illegals are here to better their lives. They are also here to better your life.

Well said Flower Child, well said!!!! Agree 100%!!!!

Specializes in ER, ICU, Hyperbarics/Wound Care, Psych.

Everyone should have to pay something. It should be based on income to make it affordable to all. Just not totally free, because any service that has no cost has no value. But it cannot be restricted by race, or citizenship, or haircut. I would not want to be denied care because I was in Florida and I was from Mexico. If I am illegal, that is another issue, send me home. But do not deny care to at least stabilize the patient.

I have many times been faced with finding drugs on a patient, or treating murderers, rapists, etc. I have to divorce myself from the actions of the patient and take responsibility for my actions as a nurse. I made the choice to do what I do as they made the choices that got them where they are. How they handle their life is on them. I have to look at my face in the mirror, and live in my own little cranial garden. I treat them the best I can and go home knowing that I did the right thing.

I don't handle billing, I don't do police work, I don't work for immigration. I take sick people and try to make them better. I have not always been Mr. Rogers and God knows I am a long way from achieving the level of Karmic repair I seek, but this is the path we all choose as nurses. If you can think fecal matter and not show it in the way you treat the person, more power to you. I can't, so I have to look beyond my initial feelings and find the person in the patient. I can't do that if I am seeing his crimes, or his skin color, or his green card. I try to think of each one as he might been, or could be. Many times they see it in me and become that person, at least for the length of our interaction. Many times they don't. The few are worth the many.

iowacindy said something that so far i feel many of you have missed.

some of us can't afford insurance while in school and yet see these families recieving services that they can't get.

right now i live paycheque to paycheque, and they're too few and far between. i work part time, so i don't qualify for any kind of benefits. i somehow make too much to qualify for state aid as well. i don't spend frivolously (my copy of the tightwad gazette is worn & dogeared to near death, my pc and net connection are gifts), but i can't seem to save, either.

i have had terrible root canal gone bad for the last two years, because i feel that feeding my son and keeping a job so i can have somewhere to live is more of a priority than pain. so many people have said to me, 'don't you think that it would be worse for you and your son if you had to go to the hospital over this?' well duh. but i can't. yes- life isn't fair, i have learned that the hard way and am slowly crawling out of the barrel.

so why is it that someone here illegally gets home visits and use of the er as a well-baby while i can't even be seen??

i believe that is the main point of iowacindy's argument- not whether the care should be given or not(from reading this thread that seems to be a choice made by the individual caregiver, not the system), nor how good that care should be.

anyhow.. back to life, eh?

Specializes in ER, ICU, L&D, OR.

If life was fair I wouldnt be here Im sure

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