Obamacare for All

Jim-Mangia-blogAmerica’s immigrants have a human right to health

 By Jim Mangia, MPH, President & CEO, St. John’s Well Child and Family Centers

I’m a child of immigrants.  My grandfather emigrated from the slums of Naples to escape Fascism.  He gained his American citizenship by fighting in the first World War.  He worked as a doorman, opening doors for the elite on the upper east side of Manhattan during the week and shined shoes on the weekends to support six children – two of whom died young in the dilapidated tenements of the lower east side.  Despite the hardship, he was proud to be an American citizen and he was forever grateful for the opportunities this country afforded him and his family.  He spoke little English and was proud of his heritage.  Our house was always filled with strangers he had met, more down on their luck than he, who my family would feed and clothe – even though we barely had enough for us.

What he drilled into us every day was the importance of education.  My generation was the first to attend college.  My parents and grandparents did nothing but struggle to make sure we had the opportunities they never did.

Now, almost two generations later, I have the privilege of leading a large network of nonprofit health centers in downtown and South Los Angeles, which provide healthcare to more than 160,000 patient visits each year.  My cousins are doctors, and lawyers and businessmen, with houses in the suburbs and children in the best universities of our country – all as a result of my immigrant grandparents’ backbreaking sacrifices.  The patients who come through our health center doors get care regardless of their ability to pay or their health insurance status.  So many of them are new immigrants, not yet citizens. Fathers from Jalisco, Mexico. Mothers and children from El Salvador. Young men from Guatemala.  Like my grandfather before them, they’re in the United States working to make a better life for themselves and their families and fleeing repression.  They are proud and hardworking and they sacrifice for their children to have the life they never could.

I know who America’s immigrants are.  I sit with them in our health center lobbies every day.  In our waiting rooms I talk to patients like Gustavo, who washes cars for 10 hours a day, on his feet in the baking Los Angeles sun, surrounded by toxic chemical fumes, getting by on barely $10 an hour (if he’s lucky enough to receive enough tips from the car owners).  I see the children of these immigrants whose moldy, roach-infested apartments are making them sick, requiring constant breathing treatments for asthma, or watching our pediatricians pull cockroaches from their children’s infected ears.  Like my grandfather before them, these more recent immigrants are building this country.   They are proud of their heritage and they are grateful to America for the opportunities we provide.  And I believe with every ounce of my being that these patients and indeed everyone in this country have a fundamental right to health.  In fact, isn’t that the very least we can do in exchange for the hard work and dedication immigrants show and have always shown for the American dream?

We have an opportunity as a nation to address the health status and access to care which our immigrant populations are currently denied as politicians in Washington begin the debate over immigration reform including how long it should take for a “pathway for citizenship” for the nation’s 11 million undocumented residents.

My grandfather lived to be an old man because he had health benefits through the Veterans Administration.  My grandmother, ravaged by diabetes, died when I was six.  She didn’t have access to the same benefits, nor could they afford health insurance.  And she died before President Lyndon Johnson began the war on poverty which provided funding to the community health center movement from which the health centers I lead grew.

America’s greatness was built by immigrants, whom we welcomed and rewarded with the honor of citizenship.  Let’s give our immigrant populations the healthcare they deserve so they can fully participate in continuing to build this country – the tradition and promise that was and still is America.  Let’s support them in living their dream.  Without direct access to healthcare services, immigrants often put off accessing care, or they use expensive hospital emergency rooms when they get sick, rather than regularly accessing primary care services at private physician offices and community health centers because they lack health insurance.  This is a huge cost to our society that could be eliminated if newly legalized residents could have access to Medicaid and be allowed to purchase insurance on the state insurance exchanges created by the Affordable Care Act.  But ensuring access to healthcare is more than a cost issue – it is a moral issue.

Immigration reform must include a guarantee of the right to health to every immigrant residing in this country.  Immigrants must be afforded the same right to healthcare that Obamacare provides to all American citizens.  The rallying cry for this effort: “Obamacare for all.” Let’s make sure that our immigrant populations can be healthy and productive members of our society.  Let’s make sure that on day one of the passage of immigration reform, America’s new legal residents will have healthcare access for them and their children.  That’s an America my grandfather would be proud of.

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3 Responses to “Obamacare for All”

  1. www.trenchlesstechnologies.net/ Says:

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  2. jimmangia Says:

    Thanks very much for your post and for reading my blog. While I agree with you that the U.S. Government does not tend enough to the needs of current American citizens, I don’t agree that’s a justification for not providing health care to new immigrants. Under the Affordable Care Act (Obamacare) – every American citizen will have access to health coverage. Leaving the moral issue aside (i.e., I believe we have a moral obligation to provide health for everyone living in the U.S.) – it also makes good economic sense. If we provide primary care (which is inexpensive) to undocumented immigrants on the front end – we save a lot of money in emergency room use on the back end. Many immigrants do not have access to primary care and therefore wait until they are very sick to seek health services. Emergency rooms cannot turn anyone away because of obvious ethical obligations. Providing health insurance for immigrants now will significantly reduce healthcare costs for all Americans in the short and long term.

    I have been in many countries around the world – from El Salvador to France to Italy. I have always received healthcare services in those countries when I needed it. In most European countries, healthcare is provided to “foreigners” free of charge. It’s a basic issue of human rights.

    As the richest country in the world (and the richest in the history of the planet) – I believe that everyone living in this country has a fundamental human right to health. I believe we can afford it. And it saves costs down the road. But most importantly for me – it is the moral and ethical thing to do.

  3. ytauma Says:

    I may sound offensive but we must look into reality. These people are foreigners but want Americans to pay their health bill. You want Americans to convince government to open that gateway for them. Remember our government barely attends to the needs of their own citizen (check our economy for one) therefore why attend to foreigners.
    America has a bad habit of interfering with other nations’ issues but not addressing their own. Plus some of these immigrants are not even legal! Therefore blocking passage for those trying to enter the correct way.
    In addition, should an American enter these other countries needing care will that country pay for him? Rather he must split the bill himself since he’s an alien?

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