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 Emergency Room.
So we'll cut out the illegal aliens. Then the US citizens who can't afford insurance have to be next after all you have to be fair. Then of course the children who's parents can't afford insurance must be ousted next. Not all of use are lucky enough to get inexpensive insurance through our jobs. Trying to buy insurance outside of a job can run well into hundreds of dollars a month which is a bit much for minimum wage or less to handle. They are usually more consider about eating first. These folks don't seem to be bothering you when they are picking your strawberries, oranges, mowing your lawns and doing the other work you don't want to do yourself. The illegal aliens are only here because your giving them jobs. We keep taking about unemployment why isn't the unemployment offices forcing the unemployed citizens to do these jobs. Nobody is to blame but us. Most of all I've yet to not receive my hourly wage because I've taken care of an uninsured person. Usually these people are nice, quiet and thankful. Unlike some of the whining B!+@hing nurses I'd rather see deported.

that was well said. i think americans can be the most ungrateful people. why? because alot of americans don't know what it is like to live in profound poverty. we feel we have the right to be choosy about jobs, where we live and so forth. there isn't anything wrong with that, but we need to respect these people that are willing to take jobs for more than 65% less than what we would work for. our government is well aware of the financial burden that illegal aliens pose and if they wanted to do something about it they would.

okay, here it goes. i hope i can remember everything i was thinking that i wanted to say while reading this thread.

first of all, i agree with giving good, quality healthcare to everyone. but, i also agree that we need to worry about our own people first! something needs to be done to take care of us and not worry about everyone else in the world until we are taken care of.

that said, one person mentioned how if you don't have medical insurance through work it can cost you hundreds a month. well, my husband has good health insurance through work and it still costs us approx. $400 a month out of his paycheck. so, we are still paying as much and sometimes more than those who don't have insurance through work. it's insanity! (and i think, well then what's so great about working where he does?)

and to this:

"it is frustrating to see people who are not citizens and who do not have jobs receiving free care while many people with insurance avoid going to the doctor because they don't have the $15 for the copay."

i say amen!

i also agree with the person that said that not reporting illegal aliens is basically the same as not reporting child abuse. i would be appalled if someone didn't report child abuse and i am appalled that nurses are unable to report illegal aliens because of privacy laws.

this:

how about the folks who come for a "visit", fly in first class, have their babies through public healthcare funding, and fly home with a brand new us citizen?

disgusting but i believe it happens, that's for sure.

i also agree with this:

i always found the biggest wasters of the healthcare system were american born. the irony comes when you get an american woman on assistance (always has a nice manicure too) who takes an ambulance to the hospital to deliver when she could have taken a bus, demands we feed her whole family while she's there ("jimmy, tell the nurse to get you a samich!") and wants to take home hospital supplies ("don't you have any more diapers i can take home? what do you mean i can buy my own?") and then complains about those illegals wasting resources. good times...

if you cannot afford healthcare, don't be out spending your money on frivilous things! it really doesn't take a rocket scientist to figure this out. in my house, we go without a whole heck of a lot of things because of our co-pays from all the medical procedures, dr. visits, etc. i cut mine and piper's hair, i do my own nails, i quit smoking (most of the time, unless i bum one from the lady upstairs), you get the idea......

and finally:

i am also incensed to see people on ssd and receiving public $$$ who do not need to be there, but know how to 'work the system' to get to the $$. they choose not to work and prefer to take. our system rewards those who do not want to work for their keep. :(

i was in the public assistance office the other day applying for food stamps for my family (and yes, my husband does work and we would actually be paying out more in childcare than what we make if i worked so we'd still get food stamps) and there were women there on their fifth and sixth child. they were actually discussing about how many fathers they had for their children and bragging about it. i am disgusted. here we are a family of five, barely making it (and just skimmed by to get the minumum of food stamps) and this person is there bragging about how many children they have with how many people and how they had to give some up because they knew they couldn't support them. then, there were a couple of young, pregnant women there and this "lady" had the nerve to say she wanted more children. i just don't get it. i have seen people repeatedly abuse the system and because they do, someone who really needs it is unable to qualify for help.

okay, i think i am done with my tirade! i just got thrown completely out of whack when i read this thread.

Specializes in Registered Nurse.
i admit i have never treated an illegal in ltc. i have treated an elderly people whom were basicaly abandoned in my facility, whom our home was eating the cost of their stay. we would purchase out of our own pockets whatever that person needed, without question. i just feel that their needs to be a better way. i bet if you went to mexico or any other country we wouldn't get the same treatment we give here. yes i believe in america and all it's ideals and treat all my patients with respect ,but i feel chairty begins at home to our people.

you make some good points. we (in this country) cannot afford to rebuild other countries, take in their poor, give up our jobs to them. we have too many of our citizens that need help. i know it isn't a*popular* idea, but i agree with someone who said earlier that we need to close our borders. i don't think many other countries would be helping us if we stepped off a plane and held our hand out. jmho.

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.

The key phase in this article is, "In a 2002 study conducted with the cooperation of immigrant rights organizations..". Gee, I wonder why it took a positive view of illegal immigrants. Sounds like garbage research to me! These people are competing for jobs. They are willing to work for pennies, and there is someone there to exploit them (businesses). What happened to the minimum wage laws? What is the cost of them raising thier children in the US in poverty? Don't you think all those children who are citizens will have to be educated, provided with health care, etc.? Do you think that someone earning $1/hour will pay for it?

What happens is that they drive down wages for the unskilled labor in this country, and the people who perform unskilled labor end up in trailor homes. But a few businesses do get rich because they are breaking the law by hiring illegals. And what will happen to this "BIG WINFALL" from illegal immigration once these 10 million immigrants are all granted citizenship? They all get unemployment, social security, etc.? That "BIG WINFALL" is now a "HUGE DEBT"!

Specializes in Case Mgmt; Mat/Child, Critical Care.

Well, I have to agree with those who say we should curtail services to illegal aliens. I don't think there is anything "ignorant" about wanting to take care of your "own", before those who are not here legally...or even if they are here in some sort of "legal" fashion...but just for the handout (ie: moms here having babies who automatically become citizens, now they all get a free ride).

There is nothing "ignorant" about the huge expense we, the taxpayers, incur because of these individuals. I do not want to deny care to anyone, but come on, the abuse is rampant!

Specializes in Case Mgmt; Mat/Child, Critical Care.

Excellent post, you nailed it!

The key phase in this article is, "In a 2002 study conducted with the cooperation of immigrant rights organizations..". Gee, I wonder why it took a positive view of illegal immigrants. Sounds like garbage research to me! These people are competing for jobs. They are willing to work for pennies, and there is someone there to exploit them (businesses). What happened to the minimum wage laws? What is the cost of them raising thier children in the US in poverty? Don't you think all those children who are citizens will have to be educated, provided with health care, etc.? Do you think that someone earning $1/hour will pay for it?

What happens is that they drive down wages for the unskilled labor in this country, and the people who perform unskilled labor end up in trailor homes. But a few businesses do get rich because they are breaking the law by hiring illegals. And what will happen to this "BIG WINFALL" from illegal immigration once these 10 million immigrants are all granted citizenship? They all get unemployment, social security, etc.? That "BIG WINFALL" is now a "HUGE DEBT"!

Specializes in ER, ICU, L&D, OR.
My Indian ancestors wish you had been around to protect against those "foreign invaders!" At least Custer got shafted!

No shaft just a very close haircut

To be honest the biggest drain on health care at present is the legal system and it is definitely a "non-essential service":D

We were and low litigious society until recently when a change in how the legal fratenity dealt with lawsuits caused a sudden rise in litigation with the concurrent rise in medical insurance passed on as rising cost to the consumer.

We too have a lot of illegal aliens who slip through the cracks or even come over from thier own country to have the operation here on someone's borrowed medicare card but they are not putting the strain on the sytem that the lawyers are.

The biggest drain on health care is not the legal system. It is our privatized health care system and the greedy insurance companies.

Look at the research:

http://www.washingtonmonthly.com/features/2003/0310.mencimer.html

http://www.insurance-reform.org/StableLosses.pdf

that was well said. i think americans can be the most ungrateful people. why? because alot of americans don't know what it is like to live in profound poverty. we feel we have the right to be choosy about jobs, where we live and so forth. there isn't anything wrong with that, but we need to respect these people that are willing to take jobs for more than 65% less than what we would work for. our government is well aware of the financial burden that illegal aliens pose and if they wanted to do something about it they would.

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.

The biggest drain on health care is not the legal system. It is our privatized health care system and the greedy insurance companies.

USA Healthcare Crisis http://www.usahealthcarecrisis.com

Love your web site zenman. I just e-mailed it to a few of my fellow health care advocates. - Thanks!

Specializes in Inpatient Acute Rehab.
The biggest drain on health care is not the legal system. It is our privatized health care system and the greedy insurance companies.

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That is so true!!!! 100% accurate!!!

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