If you feel attacked I am sorry, I feel that article as mulan posted it has serious bias and is misinforming people - you say you work with immigrants in healthcare and it is accurate. Why do you feel that way? Where do you work with immigrants - are most of them mexican, polish, etc? From where I am sitting in palm beach county the assumptions posted by real mulan in the paragraphs she posted seem very inaccurate to me, perhaps my perspective here in this area is very different to yours because things are simply different here. I will go over it again to try and clarify for you. I apologize if the data and links posted were confusing.
The study - the particular parts of it posted by real mulan - that immigrants are foregoing preventive care and are not contributing to rising health care costs because of that - I believe that is total crap. Clear?
An ounce of prevention is worth a pound of cure, they need preventive care instead of the expensive emergency room care they get - so the cost is very high and what part she posted claimed was a net benefit I think is actually a net negative - spending on preventive care is better than spending on emergency room care. Clear? Do you think preventive care or emergency room care is cheaper?
Mohartys study was based on a 1998 survey - that is old data - you disagree? I think trends since 1998 are very different today especially relating to uninsured immigrants - much worse than 98 numbers showed. Moharty said the survey may have missed undocumented immigrants - casting serious doubt on her own study - the study did admit that emergency room care for immigrant children cost much more than non immigrant children. Three times as much - Why do you think this is so too early?
Steven Camarota poses several refutations of what is lacking in the study - do you disagree with what he said too early?
"The fact that immigrants, when uninsured, might use 27 percent less medical care doesn't change the fact that they're 200 percent more likely to be uninsured in the first place," said Steven Camarota, research director at the Center for Immigration Studies, a Washington think tank that favors strict controls on immigration. "Why have a system that allows in so many people who aren't self-sufficient?"
Immigrants account for 18 percent of the costs associated with the uninsured -- expenses likely to be borne by taxpayers and charities, Camarota said.
Both sides said financial, cultural and language differences all make it hard for immigrants to afford care, understand medical advice or embrace recommendations from American doctors and nurses.
I said political agendas use study's to advance their goals - I have posted several links pointing to the same study where completely different data sets are pulled and give different color to the article. Do you disagree with this? Are certain hispanics perhaps not trying to use this study in ways to misinform the general public to advance political agendas??
ahrq.gov
this is the organization the original study came from - and info about methods of that particular study.
Research on thier site even casts doubt on studys collected - do you agree with their own self doubt of thier own studys?
ahrq.gov
Introduction
One of the greatest difficulties in assessing barriers to access, health disparities, and performance of the safety net in a community is obtaining meaningful data to measure these factors. While it is quite easy to conceptualize indicators that might provide some insights, obtaining the data can be challenging.
Many potential measures involve talking directly to patients to determine whether the patient has a usual source of care, had a doctor visit in the last year, or was unable to obtain needed care. However, population surveys can be costly, difficult to administer effectively (many of the most vulnerable can be hard to reach), and usually provide, at best, data at community-wide levels.1
While some population subgroup analysis is usually possible (How do low-income patients compare to higher income patients? Do the measures differ by gender, age, or race/ethnicity?), targeting problems in a specific geographic area within a community is seldom possible with survey data. Moreover, some of these measures are quite subjective (e.g., "unable to obtain needed care"), and differences in expectations, culture, or health beliefs may mask important differences among population subgroups or generate an appearance of disparity when none exists.
Other data that seem quite straightforward are simply not available. For example, data on immunizations for children can be important potential indicators of how well the local safety net is performing and of possible barriers to accessing needed care. However, short of manual review of patient medical records in physicians' offices (a costly and impracticable task), this information is generally not available. Some communities have attempted to establish immunization registries, but most are incomplete. Schools require evidence of immunization on initial enrollment, but few maintain records on compliance that can be used for assessment, and there is usually no means of distinguishing whether enrolling students received immunizations in accordance with the recommended schedules or simply received immunization just prior to school enrollment.
Now relating specifically to old 1998 highly suspect surveys (what a bad way to collect unbiased info) here is some more info from the people who did the study on emergency room issues: This report is a little newer than 98.
ahrq.gov
There were approximately 39 million uninsured
persons in the United States in 2001 and that
number is continuing to rise (U.S. Department of
Health and Human Services, 2002). Individuals may
be uninsured because they lack access to a group
plan or are unable to afford the cost of health
insurance. The number of immigrants with health
insurance is low (Velianoff, 2002). Many of these
individuals are using and will continue to use
emergency departments for primary care.
The actual number of emergency departments in the
United States has continued to decline (McCaig &
Ly, 2002). Over the 3-year period from 1997 to 2000,
the number of hospital emergency departments
decreased from 4,005 to 3,934. As the demand for
ED services continues to increase, the number of
annual visits to each emergency department has
increased 14 percent on average.
At the same time, the actual number of hospital
beds across the country has decreased. For example,
the American Hospital Association reports that
between 1994 and 1998 the number of inpatient
beds nationwide dropped 8 percent (Shute &
Marcus, 2001). As a result emergency departments
are experiencing difficulty moving admitted patients
into the hospital, at times creating gridlock.
Yet you and mulan would have me believe that a study that says because immigrants use less preventive care (which in essence means they are probably using more emergency care which is way more costly) that they are not contributing to rising healthcare costs - that is total bunkun from where I am sitting and makes people who support that seem either foolish or evil to me.
As I said before, in palm beach a call to the police or a wait in the emergency room used to be measured in minutes, now for both it is measured in hours, this is directly related to the influx of many immigrants. Too much too fast if you ask me. In your neck of the woods non english speaking uneducated unskilled immigrants may be good for the community and response times and emergency room waits - but the way I measure standards of living going from minutes to hours in critical services is a very bad bad thing. Most of the cuban immigrants in this area agree.
Do you think we should open the floodgates and give you lots of new customers for immigrant healthcare services while the emergency room wait times go further into the toilet? Or do you disagree with that study? hehe |
