The High Price of No Health Insurance
By Viji Sundram

From just the smell of their breath or the look on their faces, Karl Smith could tell which of his students at Dejean Middle School in West Contra Costa County were doing poorly in school.
“There were a number of students I’d have in a week who were visibly not well, and you just can’t learn if you’re sick,” said Smith, who recently quit his job at the Richmond school where he had taught English as a second language to immigrant children for almost 10 years. He said some of his students had teeth so rotten it interfered with their ability to form English words properly.
Nationwide studies show that 45 million people in the United States have no health insurance. In California, about 6.6 million are uninsured. On Monday, California Governor Arnold Schwarzenegger unveiled his much-anticipated health care plan. It’s expected that the $2 billion in tax money that now goes to hospitals will shift to buy insurance for some of the State’s neediest.
The governor might have borrowed provisions from health care plans enacted by Vermont and Massachusetts last year that promised expanded health care coverage to their residents, or he might have drawn upon some of the provisions of the AllKids plan Illinois finalized, that would provide health care for all children in the state.
Whatever plan he chooses, the uninsured in the immigrant community will be watching closely, especially Latinos for whom the problem is more common. In California, nearly 32 percent of Latinos are uninsured. And almost 20 percent of the state’s uninsured are children, the majority of them of Hispanic descent.
Among the undocumented, not having insurance is more complicated than simply a matter of money. Many simply don’t seek treatment because they fear they could be deported if their illegal status becomes known.
Many of Smith’s students were children of undocumented Latinos, so public health care programs such as Medi-Cal and Healthy Kids were unavailable to them. And because private health insurance is too pricey, often the only health care facilities they could go to are community clinics. But these clinics never ask clients about their legal status, not every immigrant knows this and they would understandably be scared to ask.
Often, fear of being reported “keeps them from going to community clinics,” said Fremont resident Agha Saeed, national chairman of the American Muslim Alliance. “For minor illnesses, they self-medicate. Some (undocumented Muslims) seek free advice from doctors while attending prayer services in mosques.
“But I know people with high blood-pressure or poor vision who are too scared to seek treatment because they do not want to call attention upon themselves,” Saeed said.
Study after study has shown that the longer the less educated and less affluent immigrant stayed in the US, the more likely he or she was to report declining health.
“Many folks won’t show up at our clinics until they are in dire straits,” observed Jane Garcia, chief executive officer at the Clinica de la Raza Health Project in Oakland. La Raza offers multi-service, low-cost health care to anyone who needs it.
Racial and ethnic minorities tend not to practice preventative health care says Andres Tapia, chief diversity officer at Hewitt Associates, a global, multi-services human resources firm, which works with health management. As a result, third and fourth generation Asians and Latino immigrants, more often than whites, wait until they are in a health crisis before they visit emergency rooms.
Disputing the myth that newer, undocumented immigrants are clogging up emergency rooms, a new study suggests that undocumented people use them far less than legal immigrants and Americans. According to researchers at Mexico’s National Population Council and the University of California, only 9.8 percent of Mexican adult migrants living in the US 10 years or less visited an emergency room in the past year. That’s less than half the rate among people born in the US.
“Communities with the lowest [emergency department] use tended to have a higher percentage of Hispanics and non-citizens than communities with high ED use,” said the study’s author, Peter Cunningham, a senior fellow at the Center for Studying Health System Change in Washington, DC.
By moving the burden on to individuals for their own health care, the governor is recognizing preventative care as the most important aspect of staying healthy.
“Preventative health care requires the belief that what I do today can prevent a health problem tomorrow,” Tapia said. “But unfortunately, with many Latinos and Asians, there’s a strong sense of external control, a sense of que sera, sera.”
Wade Rose, vice president of External and Government Relations at Catholic Health Service West, believes that “the American psyche defining health care as an individual’s responsibility” is wrong. Health care is “a societal problem” he says, and Americans “should come together as a society and come to a [collective] decision to take care of members of our society.”
As he puts it, “Are we our brother’s keeper? The answer is yes.”
– New America Media


Editor: Akhtar M. Faruqui
2004 . All Rights Reserved.