Monday, January 09, 2006


In our hopelessly PC world, we aren't supposed to talk about illegal immigrants. But let's be bad and do it anyway. This proposal diverts most of the $2.1 billion tax to emergency-room care and to health coverage for children -- two services that, in California, provide outsized assistance to illegal immigrants...

California already pours vast sums into free health insurance for children. We are probably the most generous state, offering Healthy Families and other programs to families who need not even be poor. You can earn around $50,000 and get Healthy Families coverage as good as a private plan, and you don't need to be in the state legally. John Graham, director of health-care studies for the fiscally conservative Pacific Research Institute in San Francisco, tells me: "If your child hasn't got health care in California, you are a negligent parent. There are 900,000 children who qualify for Health Families and other programs. ... They are eligible, but still not enrolled due to parents' inattentiveness, laziness, or the feeling that the kids are healthy so they don't give a hoot." Smokers should take the hit for this? Graham, who will soon release a study of California insurance, says "The number of children not insured, who are not eligible, is probably very, very close to zero in California. We don't have a crisis of coverage here. We have a crisis of parents not taking appropriate parental action."

The other sneak feature of the proposed $2.1 billion tax is its intent to spend vast sums on ER care -- a staggering $902 million each year. As Graham notes, "If this were a rational tax, it would go to programs on smoking cessation and curing lung cancer. But it is not rational. The overuse of emergency rooms in California -- the use of the system is highly biased toward illegal immigrants and not toward smokers."

Illegal immigrants badly overuse ERs instead of tapping into often-free health-care clinics or finding a family doctor. Their behavior cries out for reform, not encouragement. California should spend dough to educate immigrant families to stop using costly ERs as a replacement for the family doctor. Again, we are not supposed to talk like this. But if the misuse of the ER system ended, we'd quickly discover that taxpayers are pouring more than enough into California ER care, and people with true emergencies would be far better served.

More here


For greatest efficiency, lowest cost and maximum choice, ALL hospitals and health insurance schemes should be privately owned and run -- with government-paid vouchers for the very poor and minimal regulation. Both Australia and Sweden have large private sector health systems with government reimbursement for privately-provided services so can a purely private system with some level of government reimbursement or insurance for the poor be so hard to do?

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