Physicians call for better access to health care for immigrants

April 7, 2011

As the U.S. immigrant population grows it will be necessary to address the vast number of immigrants who do not have access to health insurance coverage, or who face other barriers to accessing health care, the American College of Physicians (ACP) said in a new policy paper released today at Internal Medicine 2011, ACP's annual scientific meeting. National Immigration Policy and Access to Health Care discusses the challenges immigrants face in obtaining health care services.

"Currently immigrants, both documented and undocumented, face many barriers to adequately accessing badly needed health care," said J. Fred Ralston, Jr., MD, FACP, president of ACP. "They are more likely to lack health insurance than U.S. citizens; they may lack the funds necessary to pay for health care services without insurance; and, they may face the additional barrier of being fearful that seeking medical attention may lead them to be reported to authorities."

In order to address these concerns, ACP is calling for the development of an immigration policy on health care that includes:

  • A national policy. Individual state laws result in a patchwork system that is not adequate to address this complex problem.
  • Taxpayers should not be required to subsidize for persons who are not legal residents of the United States and people should not be prevented from paying out-of-pocket for health insurance based on immigration status.
  • The same access to and government-subsidized health care for U.S.-born children of parents who lack legal residency as any other U.S. citizen.
  • Acknowledgement of the public health risks associated with undocumented persons not receiving medical care because of concerns about criminal or civil prosecution or deportation. Immigration policy should include increased access to comprehensive primary and , and vaccinations and screening for prevalent infectious diseases. This will make better use of public health dollars by improving the health status of this population and alleviating the need for costly emergency care.
  • Federal government support for safety-net health care facilities and offsets for costs of uncompensated care provided by these facilities.
  • Acknowledgement that physicians and other health care professionals have an ethical and professional obligation to care for the sick. Immigration policy should not interfere with the ethical obligation to provide care for all.
  • Policies that do not foster discrimination against a class or category of patients in the provision of health care.
"Access to care for immigrants is a public health issue that should be of concern to all of us," continued Dr. Ralston. "Take the case of immigrants with tuberculosis; under the current system they may be afraid that going to a hospital to seek treatment would place them at risk for deportation. If they decide to delay care because of this fear, it could increase the number of people exposed to the disease exponentially. Imagine if those same immigrants were not only unafraid to visit the hospital, but they were receiving regular primary care services. They may be treated before experiencing any symptoms and decrease the public exposure that much more."

The new policy will need to be complex to adequately reflect the complexity of the issue. It will need to take into consideration:

  • The need for the country to control whom it admits within its borders.
  • The need for the U.S. to differentiate its treatment of those who comply with the law in establishing legal residency from those who do not.
  • That hospitals and physicians have an ethical obligation to provide care for residents lacking legal documentation who seek care in an emergency situation.
  • That society has a public health interest in ensuring that all residents have access to health care, particularly for communicable diseases. And, that delayed treatment may be costly and could endanger the rest of the population.
  • That any policy that intends to force the millions of undocumented residents to return to their countries of origin could result in severe health consequences for affected persons and their family members. This could create a public health emergency resulting in enormous costs to the health care system, including costs associated with correctional health care during periods of detention.
"Any national immigration policy will need to balance the legitimate needs and concerns to control our borders and to equitably differentiate in publicly-supported services for those who fully comply with immigration laws and those who do not," concluded Dr. Ralston. "However, access to health care for immigrants is crucial to the overall population of the U.S. We all have a vested interest in ensuring that all residents have access to necessary care."

Related Stories

Recommended for you

High-fat diet in pregnancy can cause mental health problems in offspring

July 21, 2017
A high-fat diet not only creates health problems for expectant mothers, but new research in an animal model suggests it alters the development of the brain and endocrine system of their offspring and has a long-term impact ...

To combat teen smoking, health experts recommend R ratings for movies that depict tobacco use

July 21, 2017
Public health experts have an unusual suggestion for reducing teen smoking: Give just about any movie that depicts tobacco use an automatic R rating.

Why sugary drinks and protein-rich meals don't go well together

July 20, 2017
Having a sugar-sweetened drink with a high-protein meal may negatively affect energy balance, alter food preferences and cause the body to store more fat, according to a study published in the open access journal BMC Nutrition.

Opioids and obesity, not 'despair deaths,' raising mortality rates for white Americans

July 20, 2017
Drug-related deaths among middle-aged white men increased more than 25-fold between 1980 and 2014, with the bulk of that spike occurring since the mid-1990s when addictive prescription opioids became broadly available, according ...

Aging Americans enjoy longer life, better health when avoiding three risky behaviors

July 20, 2017
We've heard it before from our doctors and other health experts: Keep your weight down, don't smoke and cut back on the alcohol if you want to live longer.

Parents have critical role in preventing teen drinking

July 20, 2017
Fewer teenagers are drinking alcohol but more needs to be done to curb the drinking habits of Australian school students, based on the findings of the latest study by Adelaide researchers.

2 comments

Adjust slider to filter visible comments by rank

Display comments: newest first

dsl5000
not rated yet Apr 08, 2011
why just immigrants? Better access to health should target everyone. Ya know, citizens with no money to afford health insurance/care badly needs better access to health care too...

For anyone* to rack up hundreds of thousands of dollars in medical bills is a debt crushing burden.
ryggesogn2
not rated yet Apr 08, 2011
All emergency rooms are required by law to treat everyone regardless of ability to pay.
Access is not the issue. High costs are, for everyone.

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.