This past week, The New York Times’ iconic, smooth-brained boomer wunderkind, Thomas Friedman, wrote a column about how uncomfortable he is with the leftward drift of today’s Democratic party. It probably shouldn’t surprise anyone that someone like Thomas Friedman — fattened from years of writing asinine books, torturing metaphors, and puffing up dictators — would object to any potential changes to a status quo that has provided him with a career so disproportionate to any apparent writing talent or critical thinking skill.
During a pearl-clutching sequence in which Friedman begins four consecutive paragraphs with “I was shocked…” (shocked!) he combines fusty, nonsensical metaphor (“I think people should have to ring the doorbell before they enter my house or my country”) with what were once rightwing talking points:
“I was shocked at all those hands raised in support of providing comprehensive health coverage to undocumented immigrants. I think promises we’ve made to our fellow Americans should take priority, like to veterans in need of better health care.”
The troops, the troooops, won’t someone think of the troops?
As long as Friedman is bemoaning some leftward drift in Democratic politics, it seems important to both puncture this dopey myth of “comprehensive health coverage for undocumented immigrants” and track its drift from rightwing call-in radio into the column of a theoretically left-leaning editorialist at the presumptive lead paper of the #resistance.
“This is not complicated! Just nominate a decent, sane person,” Friedman wrote, a paen to the kind of “rational” centrist we already had as president from 2008-2016, who couldn’t so much as wear a tan suit without getting called a Communist Muslim by the right-wing noise machine.
On June 26th at the second Democratic debate, NBC anchor Savannah Guthrie asked the candidates, by a show of hands, who would support “comprehensive healthcare for undocumented workers.”
The following day, the New York Post ran a picture of the raised hands along with a typically shrieking headline, “Who wants to lose the election?” “All major Dem candidates raise hand in favor of free healthcare for illegal immigs.”
Apparently, that’s Friedman’s latest grift, rewriting bellicose right-wing New York Post headlines as paternalistic centrist New York Times opinion columns. Sadly, it’s a typical example of the center right/center left simply agreeing to debate on terms defined by people who despise them. “Just be nicer!” they shout, as militiamen dip their pitchforks in pig’s blood.
“Foreigners are takin’ all your stuff!” is and has been the central tenet of rightist chuds the world over since the beginning of time, and there is literally no take easier to write than “let’s stop givin’ foreigners all this free stuff! After all, that’s free stuff we could be givin’ to us! And like, the troops!”
The “comprehensive healthcare for undocumented immigrants” canard is just the latest iteration of that, and what’s striking about it is how completely it falls apart under even the most basic scrutiny. Like most immigration rhetoric, it conveniently ignores the basic details of how things happen now, in the real world, in order to appeal to some vaguely fair-sounding kindergarten-wall principle.
So let’s break it down.
First off, what does “comprehensive health coverage” actually mean? Does it mean, say, being able to go to a doctor when you’re sick? Or does the “comprehensive” part mean like butt injections and elective toupeé surgery? One seems to say “comprehensive” when one wants to make health coverage sound like an extravagance. When they want to make it sound like not dying is some hobby for hypochondriacs and elective surgery obsessives. The fact that this same wording was invoked by the anchor for the opposition party-aligned television network during a debate between Dems, even before the Post and Tom Friedman got a hold of it, is a marker of just how much we allow conservatives to set the terms of debate.
It was tailor-made for a fake gotcha moment, and anyone could’ve seen the inevitable NY Post headline, or the Trump tweet about it from miles away. “All Democrats just raised their hands for giving millions of illegal aliens unlimited healthcare. How about taking care of American Citizens first!? That’s the end of that race!” Trump tweeted the following morning.
The unasked question: how do these people think things work now?
Here’s how it works: undocumented workers, who “are generally barred from enrolling in Medicaid or Medicare … prohibited from buying insurance through the marketplaces set up by the Affordable Care Act … ” and whose children “do not qualify for the Children’s Health Insurance Program,” generally wait until they’re pretty sick, thanks to the aforementioned barriers, and then go to emergency rooms when they can’t wait anymore.
Emergency rooms then treat those people. Because… what would be the alternative? To let them die on the doorstep? Now, the inevitable response from the darkest corners of the chud-o-sphere would likely be that yes, letting people die based on their income or nationality is exactly what should happen. Fine. But if that’s your position, that sick people should be left to die in the streets, then I would submit to you that it’s you who is the outlier. You’re a sick little freak and you should probably leave civilized society for somewhere meaner and more suited to your pure principles. Let me know how that works out, by the way — I bet they have great doctors there.
This may be virtue signalling, but I think it’s a good thing, not letting sick people just die at the door of the hospital. Aside from the basic inhumanity of it, not to mention the messy cleanup, it strikes me that it’s probably good to let doctors and nurses focus on what they’re trained to do. I.E., help sick people get better, rather than turn them into hybrid medical professionals slash bar bouncers slash border patrol agents. Even if I didn’t care about other people dying, entirely selfishly I think I would feel more comfortable with my own care in the hands of people both semi-compassionate and entirely focused on the medical aspects of medical care. I would also like to live in a place where “don’t let people die” is near the top of the social contract.
But let’s go back to the cost.
So, undocumented worker goes to the emergency room, hopefully gets treated and recovers, then gets billed. If they’re in a stable living situation and actually receive the bill — which, like all hospital bills, will likely be jacked up in the hopes that the insurance company presumably paying a fraction of it will actually cover the hospital’s costs — it’s reasonably likely that they won’t be able to afford it and won’t pay. The hospital is then left with the unpaid bill. At which point the hospital either writes the bill off or utilizes certain government grants to cover the cost, which most expect to be incurred. All of which is to say: taxpayers eventually cover it, one way or the other.
In other words… we’re already paying for healthcare for undocumented workers. We’re just doing it through one of the most expensive healthcare systems in the industrialized world, that provides some of the worst outcomes. We’re just doing it in a byzantine, convoluted way that shames and degrades the worker, incentivizes them to leave health problems untreated until they become more expensive, creates logjams in emergency rooms, promotes inefficiency in treatment, bogs hospitals down in unnecessary paperwork, and diverts money that could pay for doctors and treatments into more administrative staff.
Most of the Medicare for All plans stipulate that it would be free at the point of service. That means free to veterans, free to rich people, free to poor people, free to people with or without papers. In that context, “Would you provide healthcare to undocumented immigrants?” is a pretty weird question. It’s designed specifically to inflame the “they took yer jobs!” segment of the population. It’s like someone wanted to build new infrastructure and your first question was “oh so you’re in favor of free roads for illegal aliens?”
Moreover, why are people like Savanna Guthrie and Tom Friedman just mindlessly parroting rightwing talking points? Why would the question, “Do you want to pay for healthcare for undocumented workers?” be posed as a hypothetical when it’s already a reality? Wouldn’t the harder question be how to deny it? “What does your plan for denying healthcare to undocumented workers look like?”
The “leftist” position (and only in the U.S. is this considered a leftist position) somehow gets treated as utopianist fantasy while the far more far-fetched, entirely hypothetical rightwing fantasy world where doctors are empowered to let undocumented workers die is somehow pragmatic to the point that it doesn’t require a follow-up question.
Some friends of mine (U.S. citizens) were recently traveling through Canada. Their daughter got sick and they thought she should get checked out. They took her to a Canadian emergency room, where she saw a doctor within 15 minutes. It cost $0. This in a country that spends almost 7% less of their GDP on healthcare, barely half of what the US spends per capita, whose citizens spend one-fifth of what Americans do out of pocket. They also have a life expectancy three years longer. Is that fantastical?
If we want to have a conversation about legal immigration quotas that offer willfully unrealistic ideas of how many foreign workers many of our industries (particularly agriculture) need in order to function, let’s do it. But any adult debate starts by acknowledging basic realities.