Healthcare a patchwork for Hispanic immigrants

For sick U.S. migrants, healthcare a patchwork
By Tim Gaynor, Reuters, Sep 13, 2009

PHOENIX, Sept 13 (Reuters) - When Mexican illegal immigrant Jose Luis Lopez developed a skin allergy, he went to a doctor and paid $50 for a consultation.

When day laborer Daniel Galindo got an upset stomach, he sought traditional Mexican folk remedies at a local "yerberia," curing himself with infusions of herbs.

When Roberto Robles' wife got sick with diabetes, he took her to the local hospital emergency room for treatment -- and paid nothing.

"They didn't want to treat her, but in the end they gave her an injection of insulin ... they didn't charge us," said Robles, 50, as he touted for work outside a Wal-Mart store in Phoenix.

As President Barack Obama pushes a controversial overhaul of the $2.5 trillion U.S. healthcare system to cut costs, improve care and regulate insurers, Americans are divided over whether the 12 million mostly Hispanic illegal immigrants living stateside will get coverage. On the wane as a hot political issue, immigration flared again over healthcare.

Obama made explicit in his address to Congress last week that the proposal, at a cost of nearly $1 trillion over 10 years, would expand coverage to 30 million Americans who are now uninsured, but would not cover illegal immigrants living and working in the shadows.

But some Republican critics do not believe him -- including Representative Joe Wilson who shouted "You lie" during Obama's speech when he said healthcare for illegal immigrants would not be covered. Wilson later apologized for the outburst.

The facts are difficult to establish, in part as there is no widely accepted national estimate of the annual cost of healthcare for illegal immigrants.

As Democrats and Republican lawmakers continue to spar over the issue, public health experts say migrants currently patch together care from a variety of sources, including paid visits to clinics, trips to traditional healers and yerberias as well as emergency room care.

"If things get really bad, they will go to the emergency department," said Michael R. Cousineau, a specialist in public health at the University of Southern California.

Otherwise they "cobble the care (together) as best they can," he added.

RASHES AND STOMACH ACHES

Around 6.1 million adult illegal immigrants go without health insurance in the United States, according to an estimate by the non-partisan Pew Hispanic Center, which is based on U.S. Census Bureau data from 2007.

Cousineau said migrants used disproportionately fewer medical services and contributed less to healthcare costs in relation to their population share, in part because they were fearful of seeking care.

"The use rate among undocumented immigrants is quite a bit lower than similar people who are here legally," he said.

Standing in the shade of an acacia tree as they sought work in Phoenix this week, several day laborers painted a vivid picture of improvised care, not dissimilar to many Americans among the 46 million people without health insurance.

Mexican construction worker Jose Luis Lopez, 45, said he paid to see a doctor after developing an allergic reaction to insulation materials he handled at work.

"I had a rash ... the doctor charged me $50 and gave me (a course of) little pills for three days," he said, speaking in Spanish.

Odd jobber Daniel Galindo, meanwhile, sought treatment for an upset stomach at his local yerberia -- a traditional store packed with herbal remedies, votive candles and esoteric items such as soaps to wash away bad luck.

"I go to the yerberia if it's a stomach ache," said Galindo, 32, who paid a few dollars for the remedy. "Otherwise I walk, run and cycle, and eat fruit and vegetables to stay healthy," he added.

But when laborer Francisco Cortes, 31, came down with the flu, he said he opted to shrug it off and go out to look for work -- something which is increasingly scarce in the current downturn.

"With flu, fevers and that type of thing it's just a matter of pull yourself together and go out and earn a crust to support your family," he said. (Additional reporting by Matthew Bigg in Atlanta)