EVERYBODY IN THE POOL

9/17/09

For a guy who doesn’t have an overall opinion on health care (health insurance, really) reform, I sure seem to be writing a lot about it lately!

One of the schemes being advanced as part of health insurance reform is a nationwide, government sponsored buying co-op, which would bring buyers and sellers together in order to facilitate the purchase of health insurance at an affordable price. Federal subsidies would be provided to those who meet certain income tests, thus rendering any unsubsidized insurance unaffordable for them. As a big fan of free markets and competition, this idea makes a lot of sense to me, though one wonders how well it would work under circumstances (e.g., preexisting conditions) and in an area (health insurance) in which the normal magic of the marketplace often falls flat.

One of the provisions of creation of such a co-op is that illegal immigrants would not be granted access to it, even if they wanted to participate with their own money, i.e., buy insurance without a federal subsidy. President Obama, as pusillanimous as any other politician in Washington, has been adamant about not letting undocumented immigrants access to such a pool. How much sense does this make? None. Such denial has been floated as part of a health care overhaul by the Obama administration because the President, and just about every other politician, does not want to be accused of “coddling illegals.” The “no health care for illegals under any circumstances” argument eliminates a substantial part of the motivation for overall health care reform.

I understand the argument that “illegal” has a very specific meaning, that those here illegally shouldn’t be here and thus, the argument goes, ought to be deported rather than given access to benefits designed for those here legally. But I also understand reality; we have millions upon millions of illegal immigrants in this country, and they aren’t going anywhere any time soon both because apprehending and deporting all of them would be impossible (and in some cases inhumane) and because it would be well nigh impossible, at least in the short to intermediate run, for our economy to function without undocumented workers. All these immigrants, like anyone else, have health care needs. If we don’t allow them to buy health insurance, unsubsidized health insurance, we will continue to provide emergency (and not always in the strictest sense of the word) care for free.

Let me reemphasize the word “unsubsidized.” I am not in favor of providing free or subsidized health care for illegal immigrants, especially when so many of our citizens have no health insurance. But that is precisely why I am in favor of letting illegal immigrants have access to a system that enables them to buy coverage with their own money. Do we want to allow them such access, or do we want to continue doing what we do now, i.e., provide illegal immigrants with free health care?