Treating illegal alien cancer patients

One scripture-based way of looking at this is found in the answer to "who is my neighbor".

Of couse, we find Lazarus on our porch.

Doing what we can to keep Lazarus off our porch is one thing, but once there...

"Unless one believes that everyone in the world is entitled to free medical treatment in American hospitals, it's morally licit to refuse this kind of treatment to illegal aliens."

Well, that's quite a strawman. I don't, of course, believe that "everyone in the world is entitled to free medical treatment in American hospitals." But the facility, which according to the story has a specific mission to serve the poor, is not dealing with abstractions, but with the reality of actual people who will die if refused treatment the facility is capable of providing.

Also, the story says the facility (which, again, has a special mission to serve the poor) has set aside $12 million of its own funds (some, most, or all of which are likely governement funds)this year to provide indigent care to those with cancer; residency status is used to determine eligibility for Medicaid and the implication of the piece (though it's not quite explicit) is that non-citizens don't get Medicaid funding. So I'm a little confused: poor Texans who don't have insurance get covered by Medicaid, poor illegals get covered by the hospital indigent fund (to the degree that funds are available), which leaves only one group who could benefit out-of-the-loop: lower-to-middle class Texans, presumbably working folks, who don't have insurance. It's an amazingly screwed-up system, but not quite as simple as it might appear.

As the father of a child-cancer survivor and, yes, as a bleeding heart liberal Catholic, I can't imagine turning away an actual person at the door whose very survival is contingent on receiving care that can be provided. It's a death sentence. (Fortunately, we had great insurance that paid for my child's care, which was very expensive but almost fully covered over a four-year period). I sympathize with the hospital administrators who are clearly pained over the choices they face, but I don't think access to life-saving care (we're not talking elective surgery here) should be contingent on residency status.

Just invoice the Mexican government.

Istead of trying to fix Texas' broken health care system for the indigent and health care system generally, I can see how turning away cancer-ridden illegal immigrants makes sense. Next we can deny care to prisoners, then maybe the mentally ill, then who knows. As long as we can keep poor people fighting over tiny crumbs and therefore fight with each other, we can ignore the bigger problems.

Istead of trying to fix Texas' broken health care system for the indigent and health care system generally, I can see how turning away cancer-ridden illegal immigrants makes sense.

Sure, the prospect of making citizens wait in line in excruciating pain for treatments while their taxes pay for illegals in the same line will really make them big fans of socialized medicine.

Is there a precedent for restricting health care based on legal status? Are there hospitals in other border states that do this or have similar policies?

There is all sorts of precedent for private and public discrimination. The federal government used to gaurentee home loans in subdivisions with covenants that prohibited blacks. During the Great Depression, there was an old saying about a young Catholic man having apostasized three times that day so that he could eat at the soup kitchen. How white boys get scholar ships from the United Negro College Fund? It's certainly a worthwhile organization, but let's not kid ourselves here.

The reason they can't afford the care is because the health system doesn't have the money, because the state of Texas has made health care as a low priority.

Once Texas started paying for anyone who showed up, regardless of origin, the costs would explode because anyone and everyone would show up.

Like it or not, Daniel, you have to draw lines.

The reason they can't afford the care is because the health system doesn't have the money, because the state of Texas has made health care as a low priority. This isn't about socialized medicine, this is about basic funding. It's all about priorities, and the state of Texas refuses to make public health a priority. Illegal immigrants is just a charade to mask the benign neglect.

This totally dodges the moral issue here. The answer is always, "Spend more money," which is easy to do when it's not your own money. It is not at all illegitimate to ask what right a foreigner has to expect citizens of a country he broke the law to enter to care for him through very expensive medical treatments. Moreover, this is not simply a case of providing costly treatments. We do not have an infinite number of doctors, and an infinite number of hospital beds. Here in Dallas County, our public hospital is overrun by illegal immigrants requiring care. They get care, but poor and uninsured US taxpayers are being denied the kind of care they deserve so the system can accomodate these people.

Daniel, if you had to depend on public hospitals, would you be willing for your children to be denied a certain level of care, or denied timely care, so the public hospitals can first meet an illegal immigrant's medical needs?

"This totally dodges the moral issue here."

Actually, it doesn't. The immorality of providing substandard health care for poor people that leads us to this crisis is the issue. We must have different definitions of morality.

"Daniel, if you had to depend on public hospitals, would you be willing for your children to be denied a certain level of care, or denied timely care, so the public hospitals can first meet an illegal immigrant's medical needs?"

I would be unhappy that my child was forced into this situation because of the way society treats poor people. I'd probably be unhappy that someone who is undocumented is ahead of me in line, but I'd hope to avoid being pulled into the pit bull match you are creating of pitting one group of poor people against another group of poor people fighting over minimal table scraps.

Hopefully, I'd be able to rely on my faith and realize that we are all God's creatures and that the line between me and that undocumented family ahead of me in line is pretty thin.

But that's my morality and faith. YMMV

Emergency room access is governed by another federal law. An person appearing in an Emergency has the right to be treated until they are stable.

To try and answer Insane Kitten's question better, these are the protected classes under federal law:
Race, Ethnicity, Religion or sect, Color, National origin, Age (40 and over), Sex, Familial status (As in divorced or have children), Disability status, or Veteran status, or Political affiliation. These is no inherent protection for immigration status, legal or otherwise. Legal immigrants would tend to fall under other classes of protection though. In some States they do have additional protections much like in some states you can't descriminate based on sexual orientation.

If you think he would turn away sick immigrants, well, you have a much different understanding of the Gospel than I do.

Paul addressed this situation a couple of times. As a Christian, your first duty is to your family and your fellow Christians. In general, basic theological understanding was that you have an expanding circle of duties to your fellow man. Basically it starts at the family and works its way out. So, you go with family, fellow Christians and neighbors, etc. If providing care to illegal aliens impacts the care that is provided to legal residents, it is not immoral to say we are going to take care of our own first.

Just invoice the Mexican government.

I believe someone tried that once and lost in court.

What would Jesus do? If, Rod, you think he would turn away sick immigrants, well then, you have a different understanding of the Gospel than I do.

I'm frankly not sure how I come down on the illegal alien/cancer treatment issue. But the WWJD question is, from a Christian perspective, absurd.

What Jesus actually did when grilled on purely secular and public policy questions was to turn the questions around, saying "Render unto Caesar..." and, significantly, to refuse to intervene in an inheritance dispute brought before him.

There is an essential concept of social justice that flows from the Christian conviction that every human person has equal dignity before God, having been created in His image and likeness. That concept has consequences for public policy to the extent individual believers, using their own God-given talents and reason, conscientiously try to apply it to particular issues before them.

But it's a misuse and misunderstanding of the Gospels to imagine Jesus as a hospital administrator or Texas taxpayer and simplistically ask WWJD, as though the Sermon on the Mount were some sort of discourse on public policy.

Simon, I like your last post very much.

Since no one seems to want to try it, I offer the business model angle:

A public hospital should never offer a service it can't afford to offer to everyone. Cancer treatment is, as far as I know, the most expensive of any ongoing, medium- or long-term treatment. That includes both the cost of the treatment and the numbers receiving it, btw.

Someone made a bad business decision. Instead of diverting funds (from any source) to try to treat all comers, UTMB should simply close its oncology department, and use the freed-up funds to better deliver basic care in keeping with its service to the poor mandate (or mission).

A public hospital should never offer a service it can't afford to offer to everyone.

And I suppose you have a magic crystal ball to let them know how many foreign tresspassers will show from any and all corners of the world for free care.

"Well, look, you tell me, then, what you say to an impoverished American citizen who is not getting cared for properly because public resources are being claimed by foreigners who are in this country illegally"

Well, there is a way to increase public resources. Its called taxes ie we as a society could ensure that everyone got treatment if we cared to, but we don't so they don't.

In any case, talk about false alternatives. I completely reject the way you framed the argument. You created this zero sum game in which some people (eg illegal immigrants) are getting treatment at the cost of others (eg poor american citizens).

Presumably, this is outrageous because some people deserve to have their cancer treated, while others don't. I assume you think that there is a clear,diving moral line here between illegal immigrants and American citizens.

But ya know what? I am of the opinion that we should be the kind of place to alleviate and treat anyone who has a horrible disease that is causing them horrible pain and will result in their deaths. Are you willing to tell the 40 year old man, dying of prostate cancer, with four children, that he can't have treatment cause he's here illegally? How would that make you feel?

In any case, you are missing the forest for the trees. The issue isn't whether illegal immigrants get care and poor americans don't. The issue is that poor people don't get care and rich people do, that's the real issue.

Enlighten me to why poor people shouldn't get medical care.

"Well, look, you tell me, then, what you say to an impoverished American citizen who is not getting cared for properly because public resources are being claimed by foreigners who are in this country illegally"

Well, there is a way to increase public resources. Its called taxes ie we as a society could ensure that everyone got treatment if we cared to, but we don't so they don't.

In any case, talk about false alternatives. I completely reject the way you framed the argument. You created this zero sum game in which some people (eg illegal immigrants) are getting treatment at the cost of others (eg poor american citizens).

Presumably, this is outrageous because some people deserve to have their cancer treated, while others don't. I assume you think that there is a clear,diving moral line here between illegal immigrants and American citizens.

But ya know what? I am of the opinion that we should be the kind of place to alleviate and treat anyone who has a horrible disease that is causing them horrible pain and will result in their deaths. Are you willing to tell the 40 year old man, dying of prostate cancer, with four children, that he can't have treatment cause he's here illegally? How would that make you feel?

In any case, you are missing the forest for the trees. The issue isn't whether illegal immigrants get care and poor americans don't. The issue is that poor people don't get care and rich people do, that's the real issue.

Enlighten me to why poor people shouldn't get medical care.

The implementation of all this seems hard. The Christian position does not. A 14 year old Amish girl, realizing that the crazed man who had taken she and others hostage was about to begin killing them, offered her life first. Another did the same. To be willing to die for your brother, your sister, another human being...that is the definitional Christian act. "Greater love hath no man than this..."

So, in point of fact, if I am indeed a Christian with cancer, and an American citizen, and the treatment that would have gone to me is instead given to an indigent illegal immigrant, then I have fulfilled that mandate. I am, and should be, willing to give my life for another. That's what Christ did...that's what we are called upon to do.

No extenuating circumstances were laid down on this concept. No ordering of family first, Christians next, the world last. Laying down your life for your poor brother, illegal or not, is unquestionably a Christian act, however improbable, unlikely, or politically untenable or impractical it sounds.

And I see no scriptural way around that fact that isn't mere smoke and mirrors for our own self-interest and unwillingness to follow in the example laid before us by Christ.

Anon (above posts), I don't think you're being too harsh, and I'm glad you raised the questions you did. (I appreciate your courteous tone; I, too, don't want to appear ungracious to our host.) You don't need to apologize for your comments. I happen to agree with you.

My suggestion to be Christlike is that those of us who are ourselves afflicted by a disease requiring expensive treatment voluntarily forego that treatment
although we shall then surely die of said disease so that more of the limited resources will be available to the indigent and to immigrants both legal and illegal.
Perhaps my Catholic church might consider such behavior a new type of martyrdom. I believe St. Maximilian Kolbe is considered a martyr for Christian charity because he accepted death by starvation so that a fellow prisoner might live. Is it possible that the Church might accept death by voluntary self denial of expensive medical treatment so that another might live because of access to that same expensive treatment as true martydom? Perhaps this is the answer to the WWJD question. But only for oneself, not for real dependents.

We are called to be martyrs for the poor and denying ourselves limited health care for their sake may be the way of martyrdom open to us in our contemporary world.

But legalize medical marijuana.

"The United States simply cannot treat every sick person in the world."

How much does the US spend on weaponry?

Just curious.

Undocumented aliens are my fellow Christians and neighbors. They even go to my parish.

That's nice Daniel. Are you paying for their care or are you foisting that care onto someone else so you can feel morally superior? Also, you're telling them that it is un-Christian behavior to be in the country illegally? Or are you ignoring scripture about Christians obeying the law?

"Telling people the rules up front, that you will have to pay for your own medical expenses or else you will have to find someone else or an institution (for profit or non-profit) to pay your medical expenses creates conditions where citizens are trained to be responsible and to act responsibly.

"Why should the non-drinker have to pay taxes to fund health care for the alcoholic who created his or her own health care problems? The answer is: He shouldn't unless he wants to and can afford to."

I think I'm on the wrong blog, and will get off shortly. I must have missed the swastika at the front. The idea that it is possible, much less necessary, to stay healthy by behaving responsibly, is the dumbest thing I have ever heard. Yes, there are certain health conditions that are generated or aggravated by irresponsible conduct (but not necessarily the conduct of the patient, BTW. Babies and small children often suffer for the sins of their parents, most notably including drinking and smoking.)

But there are lots of others that are generated or aggravated by the irresponsible conduct of the patient's employer, or the proprietors of various polluting industries, or the bad driving of truckers who pass through the area. Are we to let those schmucks off scot-free, while expecting their victims to "act responsibly," merely because the schmucks are rich and powerful, while the victims are poor and powerless?

And there are still other medical conditions that "just happen", though they seem to happen somewhat more often to poor people, like just about every other misfortune except being crushed to death by a pile of gold bullion. How is a responsible person to behave in the system you advocate, if he lacks the resources to pay for medical care and, for some reason, can't find (or perhaps is too proud to appeal to) the appropriate charity--just lie down and die with dignity? How is this consistent with the right to life? (Or does the right to life apply only to the pre-born)?

Not being a Christian, I do not feel called to ask what Jesus would do. But what would a decent human being do?

You have no free medical treatment for impoverished people..

Actually, there is treatment for impoverished people. Medicaid covers the poor. Illegal aliens are being treated, at our expense. The problem is this, among other things, helps drive up the costs that middle- and working-class people pay, in both insurance and up-front medical procedures. The problem wouldn't go away if we adopted a Euro or Canadian system, as taxpayers would still be stuck with the bill for people who simply should not be in the country.

I teach ESL to Mexican women at my church on Wednesday nights. I don't know if they're legal or not, but I've noticed that the ones who get chronic illnesses seem to go back home for treatment. Anyway, I think Christian doctors/hospitals/clinics should treat illegals the same way you'd treat people on a foreign mission field--as a service, paid for by Christian churches. Fortunately I've found three or four doctors in Birmingham who'll treat my Mexican students, and (this is the part that makes me so sad) their sick children. I can tell you that it's a lot harder to think about all of this in a detached way once you come to know these people as friends.

"There's a reason medical facilities in American US/Canada border cities are overrun with Canadians, and NYC and LA hopsitals have foreign patients."

Of course. We have the best medical care money can buy. Of course, there are people in NYC and LA living less than a mile from those hospitals with all those wealthy foreigners who are dying from their inability to get medical care. People don't die on the streets of London or Barcelona or Toronto because they couldn't access health care.

SiliconVallySteve wrote:

Since the heathcare system is all tied together and those that don't pay are subsidized by those who do, we all end up paying for this service. And I say, I don't have it in me to turn away sick people to die a horrible death without care. Not for citizens, not for the undocumented etc. If my health care is reduced or the premiums are higher, so be it. Cause ya know, I just can't get this out of my mind: "Then he will say to those on his left, 'Depart from me, you accursed, into the eternal fire prepared for the devil and his angels.
For I was hungry and you gave me no food, I was thirsty and you gave me no drink, a stranger and you gave me no welcome, naked and you gave me no clothing, ill and in prison, and you did not care for me.'
Then they will answer and say, 'Lord, when did we see you hungry or thirsty or a stranger or naked or ill or in prison, and not minister to your needs?' He will answer them, 'Amen, I say to you, what you did not do for one of these least ones, you did not do for me.'
And these will go off to eternal punishment, but the righteous to eternal life "

As a Christian, I just can't get around that.

I salute you, Steve, and I'm so glad a Christiam posted this in contrast to the posts parsing exactly whom Jesus would have us care for.

Mrs. Pringle

I must have missed the swastika at the front.

For shame, Marian. The reductio ad Hitlerum is always an admission of intellectual defeat.

Since no universal health care proposal involves turning everything over to the government, I am less worried about Erin's parade of horribles especially since those opposed to universal health care have utterly failed to offer a proposal beyond maintaining the dysfunctional status quo. If the government did provide health care for those who can't currently access it through employer mandates or a government plan, it does mean that poor women will be able to access pre-natal checkups and obtain the kind of care that now results in us having the highest infant mortality rate of any major industrialized country. That would be a tremendous step.

I'm all for more charity support, but what do we do until that point? Since charity cannot currently meet the demands already placed on it to feed and house the poor, do we really expect charities to now shoulder the cost of providing medical care for the poor too? It's a lovely idea, that sadly isn't grounded in reality.

I love this blog for many reasons. But one of my favorites is the occasional paradox of belief that can be amusing, if the issues were not so close to home. First, cancer in this day and age, thanks to dedicated researchers and clinicians, is in many cases curable, or manageable, like heart disease or diabetes, if cancer is detected early and appropriate treatment is provided.

Someone with cancer can be treated and return to society in a productive and functional role, able to interact with, and participate in the greater culture.

We are also able to maintain severely brain damaged people who are not likely to recover, antidotal cases aside, and tremendous cost of both material and emotional resources of the goverment and families, and we will expend tremendous resources (all together now, Terry Schiavo) to make damn sure it happens at a cost of millions, for one individual damaged beyond all hope of repair.

This comes at a cost http://www.reallivepreacher.com/node/1441. 80% medicare/ medicaid dollars are spent on men and women during the last 3 years of their lives, lifespan is not extended, quality is not enhanced, public health is not improved.

Or consider the cost of "mainstreaming" profoundly disabled children, children who make no progress with intensive help and therapy in our public schools with cost exceeding 50-80,000 a year in most cases. Again for a single individual, who will not function, influence, or very often interact.

There are better ways to allocate health care dollars. Immunizations, education, wellness programs and incentives, public health initiatives.

Illegal aliens are criminals. But it is not right to deny someone care that will result in their restoration when we spend billions on vegetative persons, or people who are going to die no matter what we do, or people who demonstrate no improvement.

Quite frankly there really isn't a very strong obligation to provide cancer treatment for one's kin. The question up front was whether it was immoral. Don't get me wrong, I really shouldn't be getting that second home in Martha's Vineyard if I'm unwilling to do my part to get Grandma treatment. But on the other end of the scale, prudence doesn't dictate me selling my home and moving into the trailer park. While dying from cancer is horrible, we will all meet our maker.

Texas does things very backwards. If the illegal immigrants were covered under Medicaid they would be treated. In Texas, hospitals provide free care in exchange for favorable tax treatment. So SVS can be happy and have his premiums go up to pay for this care if this hospital chose to make the accomodation that way. Personally I wouldn't have an issue with them doing it. All the same, there are many people without insurance who are inelligible for Medicaid that can't get cancer treatment unless they find a way to have it paid for. Personally, I would prefer to go a pubic system so that the costs are born equally across society. However, even in such a system, foreign nationals would still have to pay for their own care. If you vacation in Canada or Britain, you will receive a nice bill if you use their services. Medical care doesn't grow on trees.

Caroline, I love your 6:12 pm post.

How would one view a Catholic who filled out an advance directive specifying no long term tube feeding, so as not to consume resources that might be better used elsewhere?

Martyr to charity? Or opponent of the Culture of Life?

M.Z. Forrest:

Exactly my point. So an illegal immigrant cancer victim could go perfectly legally to an emergency room over and over and over to get "palliative care" (presumably morphine in the final stages) but couldn't get chemo. Gee, THAT makes sense.

Rod:

Interesting that you say the U.S. can't afford to treat all the sick people OF THE WORLD. Here you may have genuinely identified why we have such different opinions on illegal immigration.

Illegal immigrants, IMHO, are not "people of the world." They are people who have chosen, at great personal peril, to filiate themselves with the United States for one reason or another. Granted, it may only be for work -- but immigrants have been coming to America since time immemorial solely for economic opportunity, and in retrospect no one blinks an eyelash. (Though many of the immigrants -- from the Irish to the Chinese and Japanese to the Italians and Slavs -- certainly met hideous racism in their own times from the centuries-old version of today's talk radio callers, the "Bill the Butcher" Know Nothing/KKK types.)

I also grant you that illegal immigrants may not learn English (ahem, they're working 60, 70, 80 hours a week -- when do they have time?) -- but their kids do, and their kids are often born in America and thus have birthright citizenship anyway. In other words, illegal immigrants put down far more roots in America than you give them credit for.

Now you may say they have no right to put down those roots. But I would also contend that they would gladly do things the legal way if the system would allow it. Who wants to willingly risk their lives with coyotes (the human kind) and the 120 degree Sonoran Desert and the like? Fix the system, IMHO, fix the problem.

Frankly, something someone on CC said recently makes perfect sense as well. All immigrants have had "stacking" and tenement-like conditions (back then, in actual tenements) and overcrowding and what have you throughout American history. The difference is, up until now, it was exclusively in urban neighborhoods. Now, it is happening in suburban neighborhoods, where it is much more visible and inevitably causes the most culture clash. (No one blinks an eye at the illegal immigrants in my own New Brunswick, New Jersey -- which physically is a city, NOT a suburb.)

Overall, in the phenomenon of illegal immigration to the U.S., I see something with negative consequences, no doubt, but where the intentions are benign (on the immigrants' part; perhaps not on the part of their EMPLOYERS) or even benevolent. (Yeah, yeah, I know where that road leads, too ...)

But you see something far more sinister, Rod -- in the system (I might not disagree), though I hope not in the people themselves.

Daniel said, "Erin, I wonder if your fear of government involvement extends to school vouchers for private schools or homeschoolers. Surely the hand of government is so tainted that you wouldn't want it handing over checks so parents could sent their kids to private schools. I mean, charities should be paying for that, not the government. Right?"

I can't speak for those who might personally benefit from vouchers for private or religious schools; if they think they could benefit from a voucher system they can, of course, make a case for it.

But one of the (many) reasons I choose to homeschool is that government involvement in religious education is one of the things that pretty well destroys religious education. The parochial schools I attended taught the exact same curricula, using some of the same materials, as the public schools with the exception of religion class, which at some "Catholic" schools I attended in the South was only held a couple of times a week so as not to offend the growing numbers of non-Catholic students and their parents. The unique Catholic character which made Catholic education what it was in this country in previous generations has been completely obliterated, largely, I suspect, due to the levels of government involvement; one could even argue that in many parts of the country today Catholic schools exist more for the purpose of economic segregation from the public schools and their woes than for any other purpose.

As for homeschooling, the first government official that would try to hand me money would regret it, believe me. Government money always comes with strings attached, and the strings are connected to a price tag that indicates for just how much you've sold a portion of your liberty.

So you can fault me for not being "compassionate" enough to create a government-run health care system, if you like, but you can't say that I'm inconsistent.

Cause ya know, I just can't get this out of my mind: "Then he will say to those on his left, 'Depart from me, you accursed, into the eternal fire prepared for the devil and his angels.
For I was hungry and you gave me no food, I was thirsty and you gave me no drink, a stranger and you gave me no welcome, naked and you gave me no clothing, ill and in prison, and you did not care for me.'
Then they will answer and say, 'Lord, when did we see you hungry or thirsty or a stranger or naked or ill or in prison, and not minister to your needs?' He will answer them, 'Amen, I say to you, what you did not do for one of these least ones, you did not do for me.'
And these will go off to eternal punishment, but the righteous to eternal life "

As a Christian, I just can't get around that.

Exactly. I shake my head in wonderment at how so many Christians can be so blinded by their distaste for Mexican illegals, that they cannot even remember this.

Rod (of whom I have no doubt as to his sincerity and faith) needs to read and re-read Matthew 25 until it sinks in. There are no footnotes which exclude "illegal aliens" or law-breakers. He's talking to you (and me, and the rest of us self-proclaimed followers of Jesus.)

I'm having a problem in logic here. If someone is already in the hospital, on life-support, and the life-support is removed, this is "murder." A "culture of life" requires that people in vegetative states or in extreme pain with no hope of recovery must still be hydrated and intubated.

If someone is at the hospital door, in danger of dying if they don't receive medical care, it is not "murder" to deny them treatment. It is prudent social policy.

If a developing fetus that has never taken a breath is aborted, it is "murder."

If a child who is already born and loved is having an asthma attack, it is not "murder" to let them choke to death in the ER. It is prudent social policy.

I'm also having a practical problem. According to some posters, poor people, particularly illegal immigrants, alcoholics, smokers, and others (including even Grandma in some circumstances) are not worthy of medical treatment and it's perfectly moral to deny them care. However, it would also be argued--presumably by the same posters--that they are not allowed to kill themselves or request assistance to die. So I'm wondering exactly what is going to be done with these people. Should they lie in bed at home--without care or medication, so presumably writhing and screaming--until they die? But the chances are that they'll soon become homeless, since they will lose their ability to work. So I guess we'll have lots of homeless sick people dying in the streets. Even if God likes this state of affairs, it seems to me it would cause a lot more social chaos than just admitting them to the hospital in the first place.

sigalaris,

Chemotherapy and radiation aren't ordinary medical care. As I said above, palliative care is mandatory moral requirement.

Lena - yes, let's have the same wonderful efficiency of the DMV in our health care!
Can you go peddle your socialism somewhere else? Or just move to somewhere it's been implemented, rather than screwing with MY health care?

Sigaliris - yes, actually taking action to kill someone is murder; not taking action to save them is not murder.
Stabbing someone in the heart: murder.
Not selling everything you own to house the homeless guy you drove past on the way to work, even though he may freeze to death: not murder.
Driving a car even though you may crash: not suicide.
Drinking a draino slushy: suicide.

Well, M.Z., I don't scorn your position, because I agree that there are extremes in health care and it's difficult to know where to draw the line. However, I think that usually standards of treatment are determined by what medical professionals would agree on as "best practices," and by those standards, chemo and radiation ARE the standard of care for cancer. Indeed, they are the only treatments that are effective even some of the time. Surgery used to be the only treatment, but now it is more of an auxiliary strategy, one that relieves some of the symptoms. But, for most cancers, other than things like early stage skin cancers, it is recognized that surgery is just a holding action and if you want to actually kill off the cancer, you need to attack on a systemic level. Further, palliative care can be extremely expensive, too. Especially if it includes end-of-life ICU. And there seems to be a lot of confusion in the Catholic Church about what is and is not required as ordinary care. I can't figure out exactly what the Church is teaching these days, but it certainly sounds as if interventions that would require a hospital stay are required.

So when Jesus says "I was hungry and you gave me nothing to eat . . . ill and in prison, and you did not care for me," you'll instruct him that he is in error about moral requirements?

"You see, Jesus, all I did was fail to act. I didn't actually snatch the bread out of your hands or stab you. So you have to admit, I'm not guilty!"

Exactly right, sigarilis. You and do not see eye to eye on many things, but when you're right, you're right. More is expected of us because we are His children -- we cannot fall back on self-absolving legalistic excuses.

As one of the few foreigners regularly reading this board, I'd like to interject from another perspective. My wife and I have held green cards for about a year. We have advanced degrees and earn middle-class salaries. We have also paid for medical insurance ever since we moved to the USA in 2002.

Foreigners are not crippled infants powerless to help themselves. We do not need American hospitals.

Are there no hospitals in Mexico? Those of you arguing that Mexicans need to be treated for cancer, for FREE, in the USA, are effectively suggesting as much. Believe it or not, Mexico is a wealthy nation by international standards. The GDP/capita there is higher than in my home country. If Mexico cannot provide cancer treatment to its citizens, it is a failure of policy and fortitude on the part of the Mexican people that makes it so.

My father had cancer two years ago. My mother-in-law had cancer three years ago. Both survived. In both cases, my wife and I advocated, advised, visited to help, and sent money, but never did it occur to us to come begging to an American hospital, for which our parents had never paid and to which they had no rights. In any case, for legal immigrants, the obstacles to doing that would have been totally insurmountable. Of course, illegals living outside the law can simply vanish in the middle of the night, buy another fake ID in a convenience-store parking lot, and show up at a landscaping firm to evade tens of thousands of dollars of medical fees.

Mexico's cancer care system is not as good as the American system. But I cannot fathom the mentality that declares that any Mexican who chooses to present himself at an American hospital is entitled to have Americans pay for the highest standards of medical care. Mexicans are not helpless children, and they don't need you to look after them.

Edit: should be $280,000, not $400,000 in that last post.

Daniel,

I agree that if someone can prove that he has paid into the American system, then he is owed something by the American system. By the same token, if illegal aliens were, in the aggregate, paying their way, one presumes that there would not be an ER crisis, cancer ward crisis, etc.

One unskilled laborer working for seven years has likely paid far less than his family has cost the system, and this creates both a free rider problem and a moral hazard. (Not that this is the only moral hazard; obviously, the moral hazard created by inadequate law enforcement is far more serious. It contributes to a vicious cycle in which entire industries come to depend on lawlessness.)

It is not clear to me that a system set up to pay for the medical care of poor Americans extends to poor Mexicans illegally in America. So, while I supporting a tax-paying illegal getting his taxes' worth, I disagree that he should be allowed to displace poor American citizens from the support of a charitable medical foundation set up by rich Americans.

Cantemir, I do not doubt your sincerity, but your understanding of insurance is severely lacking.

The comparisons around X is paying for Y and paying in to get what you need paid out are false. Insurance has never worked that way. Social Security has never worked that way. There is only one formal structure in our society that comes close (very close, if not perfect), and that's private pension plans.

Please look at it this way: so long as you pay into a system, and do not receive anything in return, you are "paying" for those who are receiving something. Once you cross over into the receiving category, all those in the former category are now paying for your benefits. Complaining about it is, if you'll forgive me, ridiculous, because it's designed to work that way.

I do agree that you have a valid complaint -- and I join you in it -- when the government arbitrarily designates tax revenue for social services that are also covered by insurance. The principles of insurance (being why actuaries are needed) are ignored or corrupted by government in such instances. There is no equity in such a system; and I caution you, "fairness" is not a valid concept in insurance.

Something which has bothered me for years when people discuss the morality of situations like this is that most people treat the government as a person with a moral code. A government cannot possibly by moral according to all the people. Even if one's own belief is the full truth and well represented in government, all those misguided others not adhering to the true faith will undoubtedly also be represented. "Thou shalt not murder," applies to unborn children according to one belief system and not according to another. It is only one moral statement we haven't sorted out yet. "A society should take money from some people to help others" is a statement of the same sort.

For the record, like Rod, I'm Eastern Orthodox and think the government has no business in spending other people's money on this project. This does not absolve me from helping any needy illegal alien that crosses my path. I, myself, will be accountable to God for my actions, God help me. What you do, on the other hand, is your business and not mine. It is not for me to take your money and do with it what my morality says is correct since this is a logical impossibility: I cannot use your wealth to be moral myself nor to force morality on you.

So those people who feel that government should pay for this are imposing their morality on me. In a democracy this is unfortunately often going to be the case, but please do not make the case that this is somehow a better thing than my morality. I do not believe it. I would far rather engage with my neighbour who needs my help.

----

On a separate issue (since someone mentioned Britain earlier in these comments) could we make it clear that the National Health Service in Britain is not free. I pay about $500 each month to the government for care that does not include eyes or teeth. I supplement this with about $150 a month so that I can get better, private care from my GP. And the school I work for pays another $60 or so a month for better, private care in hospital should I need it. Whatever you may think of National Health there is a cost. If America wants to go that way be my guest, but take a very close look at the NHS to see if you really like it.

"I think I'm on the wrong blog, and will get off shortly. I must have missed the swastika at the front."

"I disagree with Rock's extreme and misguided libertarianism, but it's not nazism."

Please do your homework. One of the main premises of Naziism is that only the strong and healthy have the right to survive. The others, as soon as they become a drain on the state, can and should be disposed of as cheaply as possible. (The fact that the Fuhrer himself was in pretty poor health in the last few years of his life is a nice bit of irony.)

MZ, Cantemir's unclarified argument, if labeled an actuarial one, is a very poorly constructed one. For the sake of advancing the discussion, and in light of his subsequent post, I'll not pursue that.

Further, my primary point in previous posts is in fact that we should have a single trust, inclusive of all citizens and residents, with due dilligence applied towards definition and calculation of risk. Again, that being very complex even at a general level, I'll proceed.

Cantemir: thank you for clarifying at length. You point to a significant subset of the issues involved, and I agree that they must be examined and addressed. The system is broken. We (mea culpa) tend to get stuck on local examples at the expense of looking towards what can be done to fix it.

There is a structural gap between what we pay for the coverage and what we receive in benefits. That gap, I submit, is not a valid criterion for criticizing care delivery to those who have not paid and/or cannot pay for coverage. All fairness aside, if I pay $12,000 per year to receive the same benefits that you received for $20,000 per year, and the difference is that you live in the southwest and the extra goes towards care delivery for illegal aliens, that is an inequity about which you have every right to complain. My illustration is oversimplified, to be sure, but I submit that it is a much more rational starting point than arguing over which illegals may have "contributed" and which may not have.

Franklin,

>> There is a structural gap between what we pay for the coverage and what we receive in benefits. That gap, I submit, is not a valid criterion for criticizing care delivery to those who have not paid and/or cannot pay for coverage.

I agree, and as a center-rightist rather than a libertarian absolutist, I am willing to tolerate a certain amount of moral hazard and free riding so long as the system as a whole is not put at risk. The people and the state both have an interest in social stability, and no one should be left to die in a ditch.

I have no problem, in principle, with the poor receiving care for which they cannot pay. What bothers me is that Americans think that all foreigners are poor. Mexicans have hospitals. Sick, uninsured Mexicans should go to Mexican hospitals if they are well enough to travel, and if the Mexican hospitals don't let them in, they should write their representatives, and if their representatives do not give them justive, they should throw the bums out. That's how a democracy works. Mexico is a democratic country.

I could spend a few days trolling rural villages in my mother country. I'd find rotten teeth, bowel obstructions, cancer, heart disease, emphysema... an ugly sight. It's just obvious that providing an American standard of care to these people would cost staggering amounts of money. Well, what makes Mexicans so special?

Incidentally, upthread, someone asked how much the USA spends on weapons. Speaking as a European, allow me to assure you that it's no enough. If it wasn't for the Americans, my family would most likely have been exterminated several times over. Wake up, if American withdrew the Pax Americana, the world would descend into unfathomable barbarism inside of one generation. That doesn't mean that I approve of boondoggles, the Lockheed scandal, no-bid contracts*, or any particular war, but it does mean that the American people pays for the peace of the world, and this is (at least so far) enormously beneficial to the American interest.

* although no-bid contracts are about the only way that some kinds of business can be done; the issue with these is about the limits of permissible state intrusion into industry rather than bloodforoylBushitler!!!1!

I absolutely believe we should NOT give free medical treatment to any illegal aliens unless it is to help a keep someone from dying from some immediate injury. After that deport and keep a record of that person for other illegal entries.

I am not a hatefull person but believe this country should take care of ALL of its own people first.

Thank You
Gerald Bassett

National Health Service in Britain is not free. I pay about $500 each month to the government for care that does not include eyes or teeth. I supplement this with about $150 a month so that I can get better, private care from my GP. And the school I work for pays another $60 or so a month for better, private care in hospital should I need it.

Hi there Nickolas, want to review my heath care premiums some time? $210 a month sounds like a bargain to me.

Posted by: Susan

Susan you should have not dropped out of your elementary school.
$500 + $150 + $60 = $710/mo.

Depending on Nickolas age and an area, it may be higher or lower than comparable US insurance.

Since all rates Nickolas cites are, presumably, group rates, I must say it sounds rather high.
My friend in Southern Germany pays less for family of 2 adults in earlier 40th and 2 school age kids.

Franklin Evans
Hospitals who do everything possible to get Medicaid-eligibles care paid for wait for months for every dime. Hospitals and medical systems of every type have worked hard to find economies of scale, better efficiencies in care delivery, and have merged with each other in an often vain attempt to just stay in business, and the vast majority of them have no illegal immigrant burden worth mentioning.

I try not to swear here, but I think this deserves a big 'No Shit'. Hospitals that treat poor are failing, it doesn't have a single thing to do with whether those poor are residents are not. Even hospitals that treat middle class are ailing at this point.

My state, personally, is about to lose Grady Memorial Hospital because Grady can't pay the money it owes, and if it hadn't been able to get said loans, it would be closed already. I'm sure that's due to all the 'illegals' mysteriously running around in metro Atlanta that no one's noticed.

Or, to put it in ways that free market worshipers will understand: There is absolutely no logical reason that we should have a health care shortage, anymore than we should have a drywall shortage or a car wash shortage.

Small shortfalls, yes, and admittedly the lag for producing hospitals and doctors is longer than most products, but we shouldn't have a decade and a half worsening problem, that's insane. People want health care, hospitals and doctors want to provide health care, somehow enough health care is still nowhere to be found.

Why? Well, it's because we're working through a middleman with a vested interest in providing as little health care as possible, unlike, oh, every other industry, where the opposite is true.

This, if you remember your economics, is a decrease in 'demand'. Which increases prices, although this middleman is powerful enough he's managed to rig it where he's still paying the same price as before, via negotiating with hospitals, which he can do by extorting them with the threat of require patients to go elsewhere. But not only does he not pass this savings on to people purchasing services through him, people not going through him now pay even more than the decrease in demand would dictate.

People need to understand that placing a middleman between consumers and companies that make more money the less a good goes through them is possibly the single stupidest economic idea in the universe. It will destroy said industry. It's so obviously stupid that any industry or consumer that realized what was going on would opt out of it, unless it was rigged. Like, for example, it was set up where someone else, like employers, instead of the consumers it actually affected, were in charge of the decisions, allowing the middleman to build up a mass of power that the industry had to play along.

Notice I didn't suggest a solution there, although you can guess which one I favor. But I'm not going to state it and give people the chance to argue with said solution, instead I'm just presenting the problem and stopping. Argue that it is not true, or present a solution yourself.

I would be willing to bet that many, if not most, of the people commenting here have no idea what it's like to be invaded by illegals, the way we have been invaded in Los Angeles. Something like 90% of the wanted murderers are illegals. Taggers killed TWO women a few months ago, women who didn't want their neighborhood ruined and confronted the taggers.
And for those who scream racism, well, it works both ways, believe me.
I think that people are sick and tired of being taken advantage of.
Our financial system is hovering on the edge of oblivion, and some of you want to send us off the cliff.
the United States has always been a generous country, our citizens generous people, but the time has come to help OURSELVES.
Surely, God will not punish common sense.

The $500 I quoted earlier is simply what is taken off of my pay check each month by the government. In Britain we have what amounts to two income taxes. Both are deducted from my pay check each month and the second one of the two numbers is euphemistically called the "National Insurance Contribution". I have absolutely no discretion over this. If I were married and my wife was doing the same job as me then our monthly bill would be $1000. My age and state of health are irrelevant to the amount I pay.

The other two numbers (totalling $210) are discretionary. My school and I don't have to pay them, but we feel that we should so as to get better service. As a teacher, of course, I am considered a good risk so both of these numbers are good, low group rates.

For all the posturing and defending of positions it occured to me to read again that in the original article, "Illegal alien cancer patients". Three of those words are adjectives identifying the noun. My understanding from Abraham to Jesus and beyond is that we are to concern ourselves with the nouns of the world and not get distracted by the adjectives. We can attemot to justify, excuse or explain all our attention on the adjectives, but nothing will absolve us from caring for the nouns.

As to one person getting help when another does not, that seems to be a matter of triage more than attenton to care. But proper triage is based on need, not abilty to pay or worthiness for care. The billing for such is in the hands of the medical/insurance realm, subject to change with or without notice except in cases where notice is or is not given.

what are you people talking about , how are illegal aliens more important to our country and others are not?? this is ridiculus this is not the case , i have never seen no us citizen get rejected for emergency care nor for care in general , you dismiss the fact the most of the time ilegal aliens get care are mostly in times of an emergency and yet we get the bill because they cant get insurance to begin with ..