A hot topic in the past few decades, illegal immigration has now come to the forefront because of America’s current president and his border wall. (For the past 10 years, the estimated number of illegal immigrants in America has stayed relatively stable at about 11 million. During the presidencies of Bill Clinton and George W. Bush, it was steadily rising.) As for brain injury and undocumented residents, there are many cause-and-effect questions that, when answered, are quite sobering.
To begin, what if the illegal immigrant is the culprit? What if the illegal immigrant causes someone to have a brain injury, either intentionally or inadvertently? First, the police or whomever is pursuing the case must find them. Since illegal immigrants are largely undocumented, this can be a hard task. For better or worse, depending on your political ideology, a number of states are now allowing an illegal immigrant to legally obtain a driver’s license and register their car. In January 2015, for example, California signed into law AB60, which, “requires the [DMV] to issue an original driver’s license to an applicant who is unable to submit satisfactory proof of legal presence in the United States.” New Jersey, with the support of Governor Phil Murphy, is now preparing for a similar bill, Assembly Bill No. 1738, to pass. If this bill passes, it will make New Jersey the 13th state, plus the District of Columbia, to allow this. (What the consequences are for an illegal immigrant who inflicts injury on another person, such as through a car accident and even if they are legally licensed, is unclear. They are subject to criminal charges, but civil action may be more difficult. As they are illegal, and many do not submit tax returns, which would show their yearly income, monetary consequences to cover such things as rehabilitation costs are not possible.)
More so, the government does not seem to account for the economic costs of brain injury: For the victim, there will be a lose of future wages as, even if the victim is able to return to work, they will be away for a bit. Additionally, when returning to work, a brain injured individual may have to pursue a career that is less cognitively and/or physically demanding and often less lucrative than their previous occupation. For the Internal Revenue Service (IRS), this means less taxable dollars are earned. Also, the brain injured individual may stay longer or indefinitely on Medicare and/or Medicaid. The government then is required to help pay for their doctors’ visits, their medication, etc.
But, how about when the illegal immigrant is the victim? No one wants to see a person, legal or not, suffer or even die due to lack of medical care. All told, the government is financing about $18.5 billion a year for medical care of unauthorized immigrants. Of this total, “federal taxpayers provided $11.2 billion in subsidized care to unauthorized immigrants in 2016.” (“A relatively small number of undocumented immigrants, perhaps in the tens of thousands, obtain health insurance through private employers,” states a 2016 article.) However, a page on the NIH website, written by an individual who had authored other pages on ethics, as it relates to illegal immigrants, notes that, “the Patient Protection and Affordable Care Act of 2010 ignored the health care of undocumented immigrants and will not provide relief to undocumented patients with catastrophic illness like ESRD, cancer, or traumatic brain injuries.”
There are local health clinics, hospital emergency rooms and free medical school clinics that must treat everyone, regardless of legality.* Additionally, some doctors will treat undocumented immigrants, off the record. Treatment for brain injury though, requires more than a brief trip to the doctor. As an article from 2009, when illegal immigrants were treated differently by the government than now, is titled, “Struggling to find post-acute care for undocumented and uninsured immigrants.” Should ethics trump legality, no pun intended?
*Another article recounts the story of an illegal man, without insurance, who suffered a stroke. Though the hospital legally had to treat him, his care would be uncertain the second he stepped out of the hospital grounds. Would receiving care for his stroke result in a “medical deportation”? Ultimately, the hospital was able to find the man’s family in Mexico, but the trip to return him to his family cost $50,000 and was paid entirely by the government.
Note: The above post is not a personal comment on illegal immigration.