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Health Care and Illegal Immigrants

Once upon a time, we had a handle on tuberculosis. We had good drugs to fight the disease, we knew how to use them, and when we used them right, the disease was cured. Not only did people stop dying of TB, we were maybe going to be able to stamp the disease out entirely. Good stuff.

In the 80s, it turned out that we were probably never going to be able to get rid of TB, because we screwed up. To treat the disease properly, you have to keep treating it even after you feel like you’re all better. This means that if, say, most of the TB treatment centers in New York City close down because it’s a solved problem, the couple of hundred people who still get TB have to trek across two boroughs to get to the sole remaining center and they have to keep on doing this every week even after they feel like they’re not sick any more.

No big deal if you can take time off work or you have a car. Kind of a big deal if you’re living paycheck to paycheck and it takes two hours to negotiate public transit.

Thus, we wound up with a lot of people who were half-treating their tuberculosis. They killed off most of the TB bacteria. But not all; the ones that were left were the ones that were resistant to the usual run of TB drugs. End result was a nice breeding population of TB bacteria that couldn’t be treated as easily. Cases in New York City started to increase, dramatically.

Side note: there were other factors. HIV in particular didn’t help, because it messes up immune systems and makes it easier for those infected to catch TB. But the half-treatment problem was the biggie.

Fast-forward to today. Tuberculosis is an epidemic. Not one you hear a lot about, but the WHO is tracking it. It’s not the end of the world; it is a serious problem.

So back to health care. It turns out that infectious diseases do not respect citizenship. If an illegal immigrant has an infectious disease, a citizen can catch it. Denying health care to illegal immigrants doesn’t just affect the person who’s not getting health care; it affects you.

We’re not just talking about TB, either. Consider swine flu. Is there any way in which it is not in our best interests to get as many people as possible vaccinated?

And we’re not talking “oh, those filthy immigrants.” It’s not about a given segment of the population being more disease-ridden. That’s eliminationist rhetoric. If it’s a good idea to treat infectious diseases in citizens, then it’s a good idea to treat ’em in non-citizens within US borders. The ratio of people in each population with infectious diseases doesn’t need to differ for that to be true.

I.e., an illegal immigrant is not at greater risk of transmitting an infection. She’s at the same risk as a citizen with the same disease, and since we think it’s a public good to treat a citizen at that risk, it’s also a public good to treat someone who’s here illegally. This should be pretty obvious.

Health care isn’t just something we do for the benefit of the person who’s sick. We do it for society’s benefit. If you want to deny health care to illegal immigrants across the board, I gotta wonder why you want to increase my risk of illness.

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