Roy Maynard: Early Returns

Immigration isn't a simple issue. And it's about to get much, much more complicated.

Maybe connecting some dots will help.

The University of Texas Medical Branch in Galveston announced last week that it's considering denying cancer treatment to illegal immigrants who can't pay.

"Certainly it's not a decision we're taking lightly," hospital official Karen Sexton told the Galveston County Daily News. "We are in the process of looking at cancer patients and the demand and the resources we have, and thinking through how to decide who gets care."

The hospital has about $12 million in its budget this year for cancer treatment of indigent patients (its total for all indigent care is $118 million). That's not enough, Ms. Sexton says.

"This is not UTMB's problem," she said. "It's the nation's problem; we're trying to do the best we can to help our physicians and others with a decision by making it not so subjective. We're trying to put up some parameters, but it hurts my heart."

Officials in Harris County are watching closely; if UTMB turns away some patients, they'll likely show up at the public hospitals in Houston.

King Hillier, vice president of public policy for the Harris County Hospital District, says UTMB shouldn't turn away illegal immigrants.

"We do not question citizenship status," he says. "If they live in Harris County and can prove residency, then they are paying taxes. If they're paying rent, then their landlord is paying property taxes to the hospital district."

Smith County's policy is similar; applicants for indigent care funding must prove residency for six months and need. But they aren't asked about citizenship.

If they apply for long-term treatment, they must also apply for Social Security Disability Income.

"They come to us as a last resort," says Smith County Commissioner JoAnn Hampton. "I'm surprised to hear about UTMB, but then again, I'm not. Everyone is having to tighten their belts. And I'm sure that eventually, this will impact us, too."

Historically, there's been some question about the state's obligation to illegal immigrants. The most recent attorney general opinion, issued in 2004 by Attorney General Greg Abbott, says counties and hospital districts can fund non-emergency treatment for illegal immigrants, but aren't required to do so.

That was the first dot. The second dot I'd like to connect involves Texas employers.

At the recent East Texas Summit on Immigration Reform, business leaders said they're hurting for workers.

"Comprehensive immigration reform is essential to the economic future of Texas," said Bill Hammond, president of the Texas Association of Business. "We believe in securing the border, but we believe the only way to do that is to allow enough legal immigration to meet the needs of the employers in the state."

Some people argue that illegal immigrants take advantage of our country's big heart by relying on free education and free health care.

But I believe some employers are taking advantage of that big heart, as well.

There's no question that immigrants come here for the jobs. Employers hire them, but don't often offer health insurance.

(In Texas, immigrants are three times more likely to be uninsured than citizens, according to the state comptroller.)

That means employers are relying on the taxpayers - either the county or the hospital district - to take care of their workers if they get hurt or sick.

Small businesses may say they can't offer affordable insurance to their workers. But that's only half the story. They're really saying they can't afford insurance, so they'll let the taxpayers take care of their workers. How is that different from what the illegal immigrants are saying?

Some employers, of course, do offer benefits to their workers.

Now, here's where we connect the dots.

Hammond contends that those in favor of immigration reform "were out-shouted" in the recent national discussion on the issue. He acknowledges that the public has a problem with many of the proposals.

Employers could generate a lot of goodwill by taking better care of the workers they draw to this country. If the issue blocking reform is the perceived drain on public coffers, then businesses could help counter that perception by helping to staunch the flow of funds.

I'm not talking about a government mandate. I'm talking about a strategic decision on the part of businesses to deflect a very powerful argument aimed at the comprehensive immigration reform they want.

This could be one piece of an acceptable fix.

No acceptable solutions are coming to light on this issue in our state's or nation's capitals. Perhaps as human services agencies find themselves overwhelmed and under-funded, our lawmakers will be forced to find new solutions.


Early Returns is the political observations column of staff writer Roy Maynard, who can be reached at 903-596-6291 or at roymaynardtmt@gmail.com.

Roy Maynard
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