Please use this thread to post whatever you’d like. Self-linking is awesome.
The Third Carnival of Feminists!
Insurance companies consider domestic violence a pre-existing condition.
A white reporter who was beaten up for no reason tries to understand what happened. Ta-Nehisi has an interesting take.
Rawles argues that Uhura isn’t diminished by romance in the new Trek film: “Uhura is a black girl and there is no angle from which her actually being allowed to have consensual sexuality, being desired, and being loved (in addition to having her job and intellect, no less) is a fundamental downgrade from what she had before.”
Whedonverse fans should be sure to check out the archive of “Feminism and Joss” related posts at This Ain’t Livin’.
Recursiveparadox has an interesting post discussing, among other things, male privilege from the point of view of a trans woman. (Curiously, when this post was crossposted on Deeply Problematic, it was illustrated by one of my cartoons. Was the cartoon added by RP, or by the DP editor?)
The Terrible Bargain We Have Regretfully Struck
“As long as you’re unconscious, he’s fantastic.” On dealing with sexist doctors.
Interview with John Marcotte, Author of the 2010 California Protection of Marriage Act: “…We are trying to ban divorce. People who supported Prop 8 weren’t trying to take rights away from gays, they just wanted to protect traditional marriage. That’s why I’m confident that they will support this initiative, even though this time it will be their rights that are diminished.”
Alabama Supremes uphold criminalization of sex toy sales; store owner will continue to sell them
For Africans and African diasapora, Caster Semenya Case Opening Old Wounds.
Botfly maggot removed from head — the video
Ben Caldwell drawings of Wonder Woman. He draws real good.
Report Shows Rise in Reports of Sexual Misconduct by Federal Prison Workers (Via.)
Egg and sperm donors shouldn’t be allowed to be anonymous, and shouldn’t be seen as parents.
Why is Afghanistan so hard? Stephan Walt discusses why all “advances” we make in Afghanistan work against us.
Mexico will probably be providing health care for undocumented immigrants from Mexico.
(via)
Anyone familiar with the Rob Reiner film “North”? Apparently it has just about every single racial/cultural stereotypes ever thought up, with a little fat-joke thrown in on one scene.
Anyway, the ever-funny Nostalgia Critic reviewed it awhile ago.
http://thatguywiththeglasses.com/videolinks/thatguywiththeglasses/nostalgia-critic/7838-north
Meanwhile, Fox just aired the series finale of “King of the Hill”. While I wouldn’t consider myself a big fan, I’ll admit that I admired the series for its longevity (it was airing for 12 years) and the fact that Hank is probably one of the very few TV dads who’s not an idiot. He made mistakes, but hey, he’s human, and he’s certainly isn’t like Homer Simpson or Peter Griffin. And for that, I admire Mike Judge for it.
Well don’t link that last one! There goes my money.
First if all LOVE!!! the Mobius Bach (I think Bach would have liked it too)
Over at After cancer now what I posted my bitchy response to the Independent Women’s Forum . And I would like to complain about their name too. Sounds like a groups that readers of this blog would love but it’s a scam!
There’s also Health Care and Firefighting which has been more popular than I expected.
Re: Marcotte’s link to Hullabaloo:
Is there a significant problem for poor elderly people (whom I imagine are in the overlapping category for having ID issues) to receive the Medicare and SS benefits to which they are entitled? I’ve never heard of such. If there isn’t, why is it a problem to require some kind of documentation of one’s entitlement to the health insurance subsidies? I agree with him that the HHS Secretary should be left with the discretion to figure out the best way (and am still waiting to get that bet with Robert sorted out). But sometimes the knee-jerk “having people be required to document their entitlement is TERRIBLE” reaction from progressives strikes me as ridiculous and reinforces the impression among moderates that Democrats are actually just trying to avoid enforcing restrictions they don’t believe in anyway.
I think it depends on what you mean by “significant.” I suspect the numbers are not huge, but for the people affected, it’s a “significant” problem.
NPR reported on a lawsuit over the Medicaid requirements back in 2006 and told the stories of several of the plaintiffs. I couldn’t find anything on how or whether the lawsuit ended. I worked with someone in Arizona in his early 60s who had no birth certificate and for some reason (we discussed it at length and I simply can’t remember right now) was very skeptical he would be able to obtain one if he needed it. He just hoped that his driver’s license would continue to be sufficient for whatever he needed to apply for.
My initial googling does not turn up any requirement to prove citizenship to apply for Medicare and Social Security benefits, in which case the reason we’re not seeing a corresponding problem is that we aren’t asking people to prove their citizenship. I’m thinking this is because they identify you by your Social Security number and you’re not supposed to have one (a real one, anyway) unless you are eligible to work in the U.S. If you know or find otherwise, I’ll stand corrected. (In the FAQs on applying on the SS and Medicare Web sites, they do not discuss ID at all, and on the Medicare Web site, it has a number to call if you are neither a citizen nor a lawful resident alien so you can determine your eligibility. And on a Web site with resources* to help people prove their citizenship for Medicaid, it says in bold the requirements do not apply to Medicare.)
*An item of interest to me – it says that only official and not notarized copies will do. When I went to get my driver’s license when I was 16, I learned that the copy of my birth certificate my mother had been carefully guarding was not official, but only notarized. She had used this to enroll me in school and all manner of other official business, including applying for a passport when I was 11 and for state subsidies for daycare when I was little and they were broke. We all were surprised to learn that it wasn’t official. If it hadn’t come up at 16 (and in another state or another time, it very well might not have), I could have gone my entire life without knowing I didn’t have an official birth certificate. Fortunately, I was able to order an official copy by mail for a pretty nominal fee. However, not all states will do that for you. And with ID theft, some states have made it a lot harder to get copies of your birth certificate.
chingona,
I was thinking of “significant” in the sense of “statistically significant”: either a certain percentage of the total or of particular subgroups (e.g. of people of color, non-native-born, people born before 1930, etc.). Obviously the person affected by a problem will always find it significant, but that in itself is not enough to tell us how we need to shape our policy. I had a problem that was significant to me in getting totally jacked by a handyman last year, but I have no reason to think that this is a problem so common that the city needs to shape policy around it, for example by setting maximum rates for certain handyman jobs.
One doesn’t have to be a citizen to collect Medicare and Social Security; legal permanent residents who have been paying enough in FICA taxes over their lifetimes also receive those entitlements.
Here’s what I think is the relevant chunk of the U.S. code that deals with how states are to determine eligibility for Medicaid and other TANF-type benefits that are run at the state level with block grants from the federal government. There’s a specific “Systematic Alien Verification for Entitlements” program (sorry, Amp, that’s what it’s called) that various agencies can use, but I don’t know much about it. SAVE is the program that Republicans wanted to amend HR 3200 to specifically require be used.
Thanks for the botfly link! I had botfly once, and I always like to see a shout-out for my own personal parasites.
The “Crab Canon” video reminds me of “Godel, Escher, and Bach: An Eternal Golden Braid.” Anyone? Anyone?
Oh lovely, another “protection of marriage act” ballot measure coming to California voters.
*sigh*
I had a problem that was significant to me in getting totally jacked by a handyman last year, but I have no reason to think that this is a problem so common that the city needs to shape policy around it, for example by setting maximum rates for certain handyman jobs.
Conversely, I could argue that the number of people applying for and actually getting federal benefits who are not entitled to them because of their immigration status is so minimal that we shouldn’t shape policy around it, for example, by imposing identification requirements that will hurt some American citizens, even a statistically insignificant number of them.
One doesn’t have to be a citizen to collect Medicare and Social Security; legal permanent residents who have been paying enough in FICA taxes over their lifetimes also receive those entitlements.
I’m confused, then, what relevance you think non-existent ID requirements for Medicare have to potential ID requirements for health insurance.
This post on factcheck.org is somewhat relevant.
The White House is now saying that undocumented immigrants would be excluded even from paying for their own insurance through the insurance exchanges, which strikes me as kind of an asshole move on their part. (However, undocumented immigrants would still be able to buy insurance on the private market.)
Conversely, I could argue that the number of people applying for and actually getting federal benefits who are not entitled to them because of their immigration status is so minimal that we shouldn’t shape policy around it, for example, by imposing identification requirements that will hurt some American citizens, even a statistically insignificant number of them.
Why do you assume it would be so minimal? Illegal immigrants are statistically much more likely to be low-income and in need of government assistance than citizens are (for obvious reasons: it’s increasingly difficult to fake the documentation necessary to get a job as the compensation for that job goes up; a chicken processing plant just needs a SS # and a name, while a law firm will run a professional background check on applicants, so even someone who is competent to work at the law firm but who lacks documentation will be at the chicken plant — or similarly negligent employer — instead).
I’m confused, then, what relevance you think non-existent ID requirements for Medicare have to potential ID requirements for health insurance.
First, the fact that non-citizens such as legal permanent residents (green card holders, basically) can obtain Medicare and SS does not mean that there’s “non-existent ID requirements.” A green card is itself a form of ID, particularly when the info on it matches with a foreign government-issued passport, and I can assure you that my family members who have opted not to pursue citizenship keep very good track of the document that entitles them to stay in this country with their U.S.-born children.
Second, an identification card is not the totality of the forms of documentation that exist. The various state laws on voting illustrate this point. The most controversial laws mandate that voters show up with government-issued photo identification: driver’s license or passport. The laws that are generally uncontroversial will accept something from a neutral third party that has a name and address that matches the voter registration (utility bills are popular).
Suppose that I am one of those strange lifelong Manhattanites who grew up never learning how to drive, and therefore lack a state-issued driver’s license. I’m also uninterested in visiting foreign countries, and therefore lack a passport. Requiring me to have a government-issued photo ID would be somewhat onerous. Requiring me simply to have documentation of my name and current address wouldn’t be difficult at all: I’d just hand you my last ConEd bill.
“Systematic Alien Verification for Entitlements” program (sorry, Amp, that’s what it’s called)
Alien is in fact the term used for non-citzens in U.S. law – IIRC, a search of the U.S. code via http://www.thomas.gov gave me > 1100 hits for it. It has been used as such since U.S. law was first created and was used in the Colonies before that, well before the term was used in science fiction to describe non-humans. In fact, again IIRC it derives from usage in English common law before there were English American colonies. And if you are a non-citizen legally permitted to reside in the U.S., the Federal ID card you are issued says “RESIDENT ALIEN” in about 14-point bold Arial across the top. It’s nothing to apologize for. It’s the proper and non-ambiguous term.
Second, an identification card is not the totality of the forms of documentation that exist. The various state laws on voting illustrate this point. The most controversial laws mandate that voters show up with government-issued photo identification: driver’s license or passport. The laws that are generally uncontroversial will accept something from a neutral third party that has a name and address that matches the voter registration (utility bills are popular).
Depends on who you are talking to if you want to know if they’re controversial. Laws that permit people to vote if they only ever show the latter kind of ID are quite controversial to those who’d like to see the law enforce the concept that only citizens can vote, since such laws only prove residency and not citizenship.
Suppose that I am one of those strange lifelong Manhattanites who grew up never learning how to drive, and therefore lack a state-issued driver’s license. I’m also uninterested in visiting foreign countries, and therefore lack a passport. Requiring me to have a government-issued photo ID would be somewhat onerous. Requiring me simply to have documentation of my name and current address wouldn’t be difficult at all: I’d just hand you my last ConEd bill.
Thus again only proving that you are a resident, not a citizen. OTOH, every state not only issues Drivers Licenses but also issues IDs that require the same proof of citizenship and residence but do not certify that you have earned the privilege of driving. Since you don’t have to prove you can drive it’s easier than getting a Drivers License, and millions of people manage getting a DL every day. How many cases have there been out there where someone who was in fact a citizen couldn’t get a DL because they couldn’t prove citizenship? That doesn’t sound onerous to me. I think the interests of your fellow taxpayers override the inconvenience to you.
RonF,
Your obsession with citizenship in areas where it is not relevant (Medicare, SS, participation in the health exchanges, subsidies, driver’s licenses) continues to disturb me. My uncle is not a citizen. He still got a bloody driver’s license. He’s still paying FICA taxes. He’s still going to get Medicare and SS.
Laws that permit people to vote if they only ever show the latter kind of ID are quite controversial to those who’d like to see the law enforce the concept that only citizens can vote, since such laws only prove residency and not citizenship.
It might be controversial to fools who don’t understand the concept of having to register to vote. The reason you show documentation on the day of the election is to demonstrate that you are in fact Joe Smith of 20 Marigold Lane., who already is registered to vote, and who was legally required to be a citizen to do that.
Oh, no, I don’t have a problem with resident aliens getting drivers licenses, etc., as long as they do so within the constraints of the law. In consideration of the rest, people who are here illegally should not gain any advanatages from the fruit of their illegal acts. The fact that your relatives are here legally and are paying money into SS and Medicare in my view justifies their participation and use of those services. I would have no problem with resident aliens having access to any new healthcare programs.
The way the media has covered this has confused the issue. The people actually talking about problems with HR3200 have said that they have issues with illegal aliens using the system. I’ve never heard anyone say that they’d object to resident aliens using the system. It’s the MSM that likes to use the word “immigrant” without differentiating between people here legally or illegally, or indeed without differentiating among citizens or non-citizens (plenty of immigrants are citizens, after all) and then claim that the opponents of HR3200 object to “immigrants” instead of illegal aliens.
As far as being legally required to be a citizen to vote, that’s somewhat related to the objection that people have with HR3200 – yes, you are legally required to be a citizen to register to vote. In many states, however, you are not legally required to prove it. I was not when I registered to vote. And proposals put forward to change that stir opposition (and, when the proposals pass, court cases). Some on the basis that they would cause problems for people who cannot get the necessary documentation or would be inconvenienced in doing so. Others on the basis that they think that citizenship should not be required to vote.
Why?
I mean, if it’s going to be a federal program, and if the feds putatively don’t want illegal immigrants to come or stay here… why would they want to be involved with them at ALL? Why allow someone to participate and/or benefit from* a federal program when you’d deport and/or jail them if you knew their status? Doing so would be eerily inconsistent.
*Plenty of people benefit from things which aren’t referred to as ‘benefits.’ Whether or not you think that the health care pool should be classified as a “benefit” in a general sense, having access to it would benefit illegal immigrants. Just like having access to, say, the courts, or post offices, or public roads, or town parks: those aren’t “benefits” as we use the term, but people benefit from the use of them.
Why allow someone to participate and/or benefit from* a federal program when you’d deport and/or jail them if you knew their status? Doing so would be eerily inconsistent.
So you don’t believe in the current rules against inquiring into people’s immigration status when they register their kids for school or take them to an ER?
Also, what’s “eerie” about the inconsistency? Laws frequently have conflicting results.
I can assure you that my family members who have opted not to pursue citizenship keep very good track of the document that entitles them to stay in this country with their U.S.-born children.
Exactly. Legal immigrants are the people MOST likely to be able to prove their status. That your non-citizen relatives keep good track of the documents that allow them continued residence and access to their Medicare and SS benefits tells us absolutely nothing about the population that might have a hard time meeting any ID requirements (older, poorer, born in rural areas and/or at home). So I continue to be confused why you even brought up Medicare. You’re saying, basically, that because one group of people have no problem proving eligibility, therefore people in a completely different category also should have no problem.
Why do you assume it would be so minimal?
I’m assuming it’s minimal based on two things. One, the fact that illegal immigrants usually try to do things to avoid bringing their existence to the attention of authorities, and two, when Arizona instituted requirements to prove citizenship on all kinds of public services, they found that around 1 or 2 percent of the people accessing services were not here legally. This in a border state with a huge Latino population. In fact, the numbers were so low that the anti-immigrant yahoos tried to prove the various agencies were lying and covering up to protect their thousands and thousands of illegal alien constituents. Which gets me back to number one – people here illegally try to keep a low profile, generally speaking.
You’re appear to be assuming the ID requirements would effect a minimal number of people with no evidence other than the fact that you don’t know anyone who couldn’t meet them. Why are you assuming the effect would be minimal?
Me too. Really good book.
@20,
That your non-citizen relatives keep good track of the documents that allow them continued residence and access to their Medicare and SS benefits tells us absolutely nothing about the population that might have a hard time meeting any ID requirements (older, poorer, born in rural areas and/or at home).
OK, so we agree that the non-citizens who are legally entitled to access benefits should have no problem meeting requirements of documentation. I’ve already explained that government can require documentation without requiring a particular photo ID, and said that the specific documentation requirements to participate in the new programs proposed in HR 3200 should be left to the discretion of the HHS Secretary.
That leaves us with native-born citizens (since naturalized citizens, like non-citizens, are likely to keep close track of their documents), the population that’s almost certainly English-speaking and that is disproportionately white. How do they prove their eligibility for Social Security and Medicare? The verification is done at the federal level — indeed, state bureaucrats are specifically instructed NOT to require any additional verification for people who receive Medicare/SS if such people are seeking state-level benefits such as Medicaid (these are called dual eligibles/ enrollees).
One can obtain a Social Security card through a combination of documentation such as an employee ID card, school ID card, health insurance card, U.S. military ID card, adoption decree, life insurance policy, U.S. hospital record of birth, or religious record established before age five showing your age or date of birth. Is there a hypothetical person who could obtain absolutely none of these? Sure. Is there an actual person who could obtain none? I haven’t heard of such.
when Arizona instituted requirements to prove citizenship on all kinds of public services, they found that around 1 or 2 percent of the people accessing services were not here legally
Even 1 percent, for a program that costs $450 billion a year (Medicare), is $4.5 billion annually. A billion here, a billion there, and pretty soon you’re talking about real money.
Doug S.:
Have you gone back to re-read it? What a funny, charming (and still sometimes incomprehensible) book.
It’s one of my favorite books; I’ve reread it many times.
I do not like the recent one, “I am a strange loop.” nearly as much.
Even if it weren’t minimal at first, it will become more minimal as we continue: the initial wave of people will remain registered once registered, and the increasing documentation of our existence will mean that future registrants have an easier time.
But at heart, we are simply coming at it from different angles. I figure that it makes perfect sense to try to exclude illegal immigrants, even if we inadvertently exclude some who should be in the program. Why? Well, because setting up an agency for speedy review and fixes for those who are improperly excluded will almost certainly be a lot cheaper than providing health care to those who are improperly included. “Fixing” an improper exclusion is a one-time deal.
Having an appeals process makes sense. Obviously we don’t want to have a complete in-depth analysis of EVERYONE, because it’s too damn expensive and frankly unnecessary. Sure, it would do a good job at flagging illegal immigrants through detailed inspection of records, but it involves too much administration.
And similarly, we don’t want to have only a low-level analysis of everyone. It makes no sense to have to wonder/check whether existing recipients are there legally. It’s not as if we are going to review everyone’s eligibility on an annual basis.
So the best thing to do is to bias the selection process so that we can be reasonably sure that only eligible people make it in the program. Then set up a separate process for getting those who slip through the cracks. The second process is much more limited in scope, so it can be much more detailed.
PG,
Again, the question is not whether the requirements to prove eligibility for Medicare/SS are reasonable. We got on this when you raised Medicare/SS eligibility has somehow the equivalent of whatever might be required to prove eligibility for health insurance subsidies or participation in the exchange. I actually agree with you in theory that having to demonstrate eligibility is not some incredibly onerous thing, but we have right now various regimes for demonstrating eligibility for various services – and some of them are reasonable and some of them are not. And right now, we don’t know what kind of requirements we’ll see for participation in these health insurance exchanges and/or subsidized premiums. The requirements you’re proposing would prove identification and residency but not necessarily citizenship. If that’s what the requirements look like, you can guarantee Republicans will be screaming that it covers illegal immigrants, and they’ll tighten up the requirements.
So my guess is that we’ll see a stricter requirement that some small number of native-born Americans will not be able to meet. What we’re talking about here is which is preferable from a policy standpoint – excluding a small number of native-born Americans who should be eligible or excluding a small number of illegal immigrants who should not be eligible. It’s been demonstrated that there are right now native-born Americans who cannot meet the Medicaid eligibility requirements and prove their own citizenship, so I don’t see why you think that wouldn’t be the case if we end up with similar requirements for health insurance subsidies. You think excluding these people is worthwhile to exclude people you don’t think deserve services. Fine. But don’t pretend they don’t exist. And please, let’s remember that any “savings” we see from excluding illegal immigrants has to be weighed against the uncompensated ER care they use. Those numbers are certainly “real money.” So if we’re trying to weigh the costs and benefits of tighter eligibility requirements versus covering more people, including some we didn’t intend to cover, let’s weigh all the costs and benefits.
The requirements you’re proposing would prove identification and residency but not necessarily citizenship. If that’s what the requirements look like, you can guarantee Republicans will be screaming that it covers illegal immigrants, and they’ll tighten up the requirements.
Have Republicans done this on Medicare and SS? If not, why do you think using the same requirements we have for Medicare and SS for new benefits would draw Republican outrage?
Also, Medicare =/= Medicaid. The fact that states impose more onerous requirements to validate one’s access Medicaid than the federal government does to validate one’s access to Medicare just reinforces my argument that we should use a Medicare type requirement as a good middle point between either the Medicaid type requirement or your apparent preference for no documentation required at all (since so far you haven’t suggested what you think would be an acceptable documentation requirement, only that “in theory that having to demonstrate eligibility is not some incredibly onerous thing”).
You think excluding these people is worthwhile to exclude people you don’t think deserve services.
Quote me saying this? And if you can’t quote me, please don’t claim that you know what I think when you evidently don’t. Even Sailorman has said that he doesn’t want to exclude the valid beneficiaries and that there should be an appeals process.
As for “deserving” services, well, hey, I know lots of people who would love to receive American health care, but they don’t conveniently live in the Western Hemisphere where they just have to get past the border to be in the U.S. I don’t think breaking U.S. law should be rewarded with services that aren’t accessible to people who are respecting the law and waiting in line for visas — visas that are kept at low caps because the high level of illegal immigration feeds into sentiment against allowing more legal immigration. I think the public schools should be educating children regardless of the sins of the parent in how they got the children into the U.S. And I don’t think emergency services should be checking paperwork before saving someone’s life. But beyond that, I don’t understand why you think people who have broken the law to enter this country are “deserving” of services.
From this, I drew the conclusion that you think the number of people who would be excluded by ID requirements is small enough that it’s an acceptable price to pay to keep out the people you don’t think should be getting services because they’re here illegally.
If that’s not your position, I’m afraid I don’t know what your position is. I have not accused you of thinking legal immigrants should not get services. I think we both agreed several comments ago that legal immigrants are not in the category we’re talking about. Nor have I accused you of thinking we should require proof of legal residency to provide emergency services.
I apologize for misrepresenting your views, but if that’s not your view that excluding illegal immigrants is important enough that we need to have these requirements, even if they hurt some, to your mind, statistically insignificant number of native born Americans, I honestly don’t know what your view is.
Yeah. I know this. Which is why I keep asking you why you are acting as if the requirements will be the Medicare requirements and not the Medicaid requirements. Medicare is available to legal immigrants who have paid in. We don’t know yet what kind of status legal (or illegal, frankly) immigrants will have in whatever bill gets passed. We don’t know yet what documentation will be required. If subsidies are available only to citizens or participation in the exchanges are available only to citizens, your list of documents from the requirements to get a SS card will not be adequate.
Quote me saying I have problem with Medicare type requirements.
As for why Republicans haven’t gone after SS and Medicare, I think it’s too politically sensitive. Given the age of participants, there probably would be a lot more people who would have a hard time meeting really stringent requirements, and they don’t want to go there. Also, it’s a lot harder to fake your way into a program that requires a lifetime record of contributions to the system. Given that we are talking about a subsidy program that will benefit lower-income people instead of retirees, I think we’re more likely to end up with Medicaid-type requirements. I’m not sure why you’re so convinced we’ll end up with Medicare-like requirements. As I’m sure you’re aware, “what PG thinks is reasonable” is not the standard by which our laws are made.
It’s not really a matter of deserving or not deserving for me. They’re here. If they’re sick with an infectious disease and don’t get treated, that hurts me. If they’re using the ER for primary care, that hurts me when I need the ER for an emergency. And if they’re not paying that hospital bill, which they probably aren’t, I’m paying for it every time I pay a medical bill or in my insurance premiums. It’s about not cutting off my nose to spite my face.
Actually, I haven’t. I already knew a lot about what it talked about (I took several college courses in formal logic) so I didn’t have any trouble understanding it. It was rather slow reading for some reason, though; I kept putting it down and going back to it.
I was 12 when I read it the first time (hence the “gone back and read it” wording), and even now am not good at logic. But I still love it.
chingona,
do you think that this:
is an unacceptable outcome?
I ask because you *appear* to be saying
(1) the price is unacceptable because the number of excluded people will be high;
(2) the price is unacceptable because the number of excluded people will be low but the individual cost will be high; and/or
(3) this price is unacceptable because any non-zero number of excluded people is unacceptable.
Can you clarify your position? What exactly are you disagreeing with, and what is the basis of your disagreement?
My definition of “significant” came up after I asked, “Is there a significant problem for poor elderly people (whom I imagine are in the overlapping category for having ID issues) to receive the Medicare and SS benefits to which they are entitled?” If you’re OK with the Medicare/ SS requirements for establishing identity and don’t know of their posing difficulties for people who are entitled to those benefits, then I honestly don’t know what your gripe with my argument is.
If subsidies are available only to citizens or participation in the exchanges are available only to citizens, your list of documents from the requirements to get a SS card will not be adequate.
And once again, there’s no reason to think that subsidies and participation in the exchanges would be available only to citizens rather than to citizens and legal residents.
As for why Republicans haven’t gone after SS and Medicare, I think it’s too politically sensitive.
They’ve only become the “third rail” in the last few decades. Ronald Reagan won landslide elections even after declaring that Medicare would constitute the death of freedom in this country. If there were a significant problem of illegal immigrants obtaining those benefits, we’ve had 20 years of Republican administrations that would have tried to make political hay of that fact in order to tighten ID requirements for new enrollees (which today would be the baby boomer generation — not likely to be lacking for ID).
I’m not sure why you’re so convinced we’ll end up with Medicare-like requirements. As I’m sure you’re aware, “what PG thinks is reasonable” is not the standard by which our laws are made.
True, but it’s unusual to have Democrats come up with something that I’d consider excessively stringent in this area. My original comment on this subject @4 was complaining about Hullabaloo’s resistance to having any documentation requirements at all.
It’s not really a matter of deserving or not deserving for me. They’re here. If they’re sick with an infectious disease and don’t get treated, that hurts me. If they’re using the ER for primary care, that hurts me when I need the ER for an emergency. And if they’re not paying that hospital bill, which they probably aren’t, I’m paying for it every time I pay a medical bill or in my insurance premiums. It’s about not cutting off my nose to spite my face.
(1) What infectious disease are you worried about going untreated? People keep talking about swine flu, but that’s a virus — there’s not really much to treat. I was one of the 1 in 10 New Yorkers who had swine flu during the spring (almost certainly caught it from a co-worker who insisted on coming to the office while he was ill), and I got better after taking a few days off work so I could sleep as much as I wanted. Most immunizations already are offered free regardless of immigration status; giving people insurance won’t make a big difference there. (I think I’ve commented here before on studies that have shown the income gap on immunization isn’t changed simply by providing insurance; it’s a more fundamental issue of access that’s tied to wealth and education.)
(2) People aren’t supposed to use the ER for primary care. The federal law requiring hospital ERs to treat all comers only covers medical emergencies, defined as “a condition manifesting itself by acute symptoms of sufficient severity (including severe pain) such that the absence of immediate medical attention could reasonably be expected to result in placing the individual’s health in serious jeopardy, serious impairment to bodily functions, or serious dysfunction of bodily organs.” If someone shows up to the ER for primary care — a checkup, a pap smear, whatever you think is less important than your actual emergency — then that person is abusing the law. The easy solution is to have hospitals abide by the law as written, not to give free/ subsidized insurance to people who have broken the law.
(3) Hospitals pursue people for quite a while trying to get them to pay bills. When I interned at Legal Aid, a large amount of the work was just negotiating with health care providers to convince them to forgive bills for indigent people. If someone has the money, the hospital will try to get it out of them. If she doesn’t have the money, then you’d have to pay for her care anyway, so where do the cost savings come in?
Sailorman,
(2) the price is unacceptable because the number of excluded people will be low but the individual cost will be high; and/or
This one. I think the individual cost is high enough that we should not craft our policy as if these people did not exist, even if they are small in number.
I didn’t see your comment @25 until after I’d posted @26, but basically, I agree that the number of people affected will keep getting smaller, and I agree that we’re simply coming at this from different angles. We’re giving different weights to the various costs and benefits and coming to different conclusions.
PG,
They’ve only become the “third rail” in the last few decades. Ronald Reagan won landslide elections even after declaring that Medicare would constitute the death of freedom in this country.
Politics change. And while Reagan certainly wasn’t held back by his dire predictions about Medicare, neither he did he run on a platform of doing everything possible to dismantle Medicare. I’d also note that illegal immigration did not become a significant political issue until the mid-1980s, and it died down quite a bit in the late 1990s and has only resurfaced as a nuclear issue in the past five or six years.
If there were a significant problem of illegal immigrants obtaining those benefits, we’ve had 20 years of Republican administrations that would have tried to make political hay of that fact in order to tighten ID requirements for new enrollees (which today would be the baby boomer generation — not likely to be lacking for ID).
I think we’ve agreed repeatedly that illegal immigrants obtaining SS and Medicare benefits is not a significant problem.
True, but it’s unusual to have Democrats come up with something that I’d consider excessively stringent in this area.
And I’m concerned that the level of freaking out about this bill potentially doing anything for even a single illegal immigrant, even on accident, that we’re seeing from the right, coupled with explosive nature of the issue politically for any politician in all but the most liberal districts, will cause the Democrats to go beyond where I and even you think they should.
I’m addressing why I think covering illegal immigrants would be good policy separately because it’s not really related to my concerns about ID requirements. It’s not 100 percent unrelated in that it factors into my not being really worried about a few people slipping through the cracks of the enforcement system, but neither is “a few people can slip through the cracks” a coherent policy.
(1) What infectious disease are you worried about going untreated?
All of them? When I said “hurts me,” I meant that rather figuratively, as in the general community, not as in I literally live in fear of infectious diseases transmitted by illegal immigrants. Name a disease. Strep throat. Tuberculosis. AIDS. Whatever. I’d rather have people who are ill get treatment and learn about their illness and what they can do to not infect others than have them continue to be sick and infect other people, even if, technically, they shouldn’t be in my community in the first place. Even though I am unlikely to get tuberculosis myself, being a healthy adult with a decent immune system, someone else in my community doesn’t fall into that category. Maybe the person with tuberculosis is their caregiver, but their job as a home health care worker doesn’t provide insurance. So I’d like them to get treatment, even though it’s expensive and technically speaking they should go back where they came from and be sick there instead.
(2) People aren’t supposed to use the ER for primary care.
I saw that you put this in the other thread. I don’t really know what to say except that everyone I know who works in a hospital or who has been to the ER in the last 10 years has an experience that contradicts what you say the law is. Though all the examples you used for primary care were preventative. I’m pretty sure ERs are not overwhelmed with people looking for free pap smears and check-ups. They do, though, get a lot of babies with bad colds whose mothers worry they have pneumonia. The kind of stuff that an experienced doctor can be pretty sure is not an emergency, but they still have to do an evaluation to make sure. And that costs time and money.
Hospitals talk a lot about how uncompensated care, especially through the ER, is a huge burden on them. If all this time, all they had to do to relieve that burden was turn away the hordes of pap smear-seekers, I think they would have done it already.
This is, of course, not caused only by illegal immigrants. It’s caused by all kinds of people without insurance. But if illegal immigrants aren’t covered, we’re not going to see as much cost savings on this front.
(3) Hospitals pursue people for quite a while trying to get them to pay bills.
They can pursue all they want, but they won’t get very far when the person has provided a fake name and address because they know they can’t pay and they’re scared of being found out.
If she doesn’t have the money, then you’d have to pay for her care anyway, so where do the cost savings come in?
Because I’d pay for it at insurance reimbursement rates instead of at joe public rates. And because more people would get treated by regular doctors while their conditions were less serious and costly to treat. And because more people wouldn’t get seriously ill at all. I’d much rather pay $4,000 for a full complement of prenatal visits and a term, vaginal birth in which mother and baby go home the next day, than pay more than a million dollars for a woman with no prenatal care who comes into the ER in premature labor and gives birth to a baby who spends a month in the NICU.
It seems like it would be relatively simple to design a program which would prevent the high cost to improperly denied folks.
For example, you could have an appeals process with two characteristics:
1) Instant during-appeal provisional approval. This would make the cost of improper denial very very small.
2) Relatively high penalties for attempts to defraud through an appeal, and/or an investigative level which would make it obvious that attempts to defraud wouldn’t work.
Good news for once:
The Haliburton employee who got raped, and who was going to be forced into arbitration, just recently won an appeal at the fifth circuit (federal appeals court). As it stands now she’ll be entitled to a trial unless Haliburton overturns it at the USSC–very unlikely, I think.
She may not win, but she’ll get a day in court.
http://blogs.wsj.com/law/2009/09/16/fifth-circuit-halliburton-rape-case-will-head-to-court/
Here’s the opinion from the court:
http://online.wsj.com/public/resources/documents/091509halliburton.pdf