The myth of undocumented immigrants using American health care

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I hear it all the time: “All these illegals are coming over here and they don’t pay taxes, but they get all these government handouts and they’re clogging up our health care system …”

I often point out that many undocumented immigrants actually do obtain a taxpayer identification number for the express purpose of paying taxes in hopes that if a path to citizenship ever becomes a reality for the undocumented in this country, they will have a record of their contributions into the system. I don’t think people believe me when I tell them this. But perhaps they’ll pay attention to the information from a recently published study by Dejun Su and colleagues.

The study, “Cross-Border Utilization of Health Care: Evidence from a Population-Based Study in South Texas” appears in the latest issue of Health Services Research. While many of the people whose social circles overlap my own are of the opinion that all the immigrants are crossing over into the U.S. to take advantage of all our “widely available free care”–you know, the ER variety–this study showed the opposite: people are headed from the U.S. to Mexico for care.

Of course, that’s not the case generally. The study looked only at border towns, and specifically, found that those who were uninsured and/or in poor health were the most likely to head to Mexico for care. But the point is that about 50% of the residents of border towns do actually go to Mexico for care. Some of these are undocumented immigrants heading back to their homeland for care, but others are U.S. citizens who are finding it more cost-effective to head to a Mexican physician or pharmacy.

This study actually speaks volumes. Opponents of health reform claim that the U.S. has the best health care system in the world, and that the uninsured can get health care whenever they want it, by going to an emergency room. If this were truly the case, the flow of cross-border health care seeking behavior would be unidirectional, with everyone pouring into the U.S., but it isn’t. Instead, many people find it better to go to Mexico, where care is far more affordable, and I expect, absent improvements in our health care system, more and more people will choose to do so and will make the journey from farther away.

After all, medical tourism is already a booming business far beyond Mexico. I just wonder if the people of Juarez are as disgusted with those of us crossing into Mexico to see their doctors as we are about them coming here. Something tells me they’re not.

Brad Wright is a health policy doctoral student who blogs at Wright on Health.

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