Readers React: Two doctors with opposing views on expanding Medi-Cal to immigrants here illegally

To the editor: We can all agree that in a civilized society, access to quality healthcare should be a right. Far more complicated is determining how to pay for it.

The analysis in your stellar editorial, “Now Is Not the Time to Expand Medi-Cal to Undocumented Adults,” points out that offering “free” healthcare to adults present in our country illegally will cost the citizens of California $3 billion each year. This would be a 13% annual increase to the Medi-Cal budget.

However, you do not connect increasing hospital costs for the insured population to the poor rates paid to providers by Medi-Cal. Putting 1.3 million undocumented immigrants on the Medi-Cal roles would not just cost the taxpayers $3 billion, but because of the hospital cost shift, premiums would be about 5% higher.

Offering free care would also encourage undocumented immigrants to move to California. Those in Sacramento advocating for this Medi-Cal expansion have not properly analyzed the impacts on the healthcare system, housing, water, schools or roadways. Giving things away free is not cheap.

Dr. Howard C. Mandel, Los Angeles

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To the editor: Immigration status and healthcare are two completely separate issues that are often conflated. Our immigration system is broken, and Congress has been unable to agree on how to fix it.

However, the decision “who gets to live here” must be made independently from the decision “who gets healthcare.” Because the answer to the latter needs to be “everyone.”

Public health is best served when we all have access to healthcare. Everyone needs their flu shot. Tuberculosis and other communicable diseases must be treated or we are all at risk. Since we aren’t yet accustomed to seeing people die on the streets for lack of treatment, folks without insurance access care at emergency departments, where the cost is exorbitant and the care is not adequate for chronic conditions.

Taxpayers and the insured already pick up the bill for this inefficient, costly care. It makes far more sense to give all poorer folks Medi-Cal and keep them healthy. It is also the right thing to do.

Dr. William Yturri Skeen, Santa Barbara

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