No Quick, Cheap Fixes for Healthcare

We all know the reason six Los Angeles County emergency rooms have shut down in the last year and even more are expected to go belly up as well.

Illegal immigrants.

Whether the story is about low test scores, teeming prisons or the healthcare crisis, my colleagues and I often field the same raft of angry e-mails and phone calls, which often begin something like this:

“Why don’t you and the rest of the liars in your dirtball business have the decency to report the truth? If we booted all the illegals out of this country and didn’t have to pay their bills, we wouldn’t be in this mess.”

Occasionally I am invited to return to my homeland, although I’m not sure what would be accomplished by my moving to the San Francisco Bay Area.

So it’s the truth you want?

Yes, the cost of treating illegal immigrants runs into the hundreds of millions of dollars, and it’s one reason emergency rooms are in trouble.

Earlier this year, when I ended up at County-USC Medical Center after a bike injury, 151 other people were waiting in the ER. On average, about one-third of the patients there are undocumented.

But there’s a far bigger problem at County-USC than the number of noncitizens who come through the door. One-third of the patients may be here illegally, but 95% have no private health insurance.

And those without?

“They’re the nanny and the gardener and the furniture maker and the supermarket workers,” says E. Richard Brown, director of UCLA’s Center for Health Policy Research.

Brown estimates that California has 6.3 million uninsured, and he says somewhere between 15% and 20% of them are illegal immigrants. It’s a sizable chunk, but not quite the root of all evil.

Meantime, despite years of gum-flapping by one politician after another, the ranks of the uninsured just keep growing and are now at about 40 million nationally. As healthcare and prescription drug prices soar, employers are squeezing out more workers. Roughly 80% of the nation’s uninsured have jobs.

“We ought to be providing coverage to everybody who is residing legitimately in this country, at least,” says Brown. “And that means working people and their families.”

Unfortunately, all you have to do is say the words “national healthcare” and the usual suspects go into full Hillary Clinton panic mode.

By contrast, Jeff McCombs, a conservative USC professor, has been pitching me the idea of a payroll tax to fund federal healthcare vouchers that can be used to shop for a health insurance plan.

“If you go to an ER, the ER is going to get paid,” McCombs says. “But HMOs will try to avoid that by giving you a 1-800 nurse you can call and urgent-care centers you can walk into. They’ll want to keep you out of the ER” except for real emergencies.

This still leaves the question of who would pay the medical bills of illegal immigrants. As readers suggest, maybe we should go ahead and boot them out of the country.

Then again, in the form of cheap labor, they make life easier and cheaper for millions of Southern Californians. So far, I can’t find anybody who can prove whether the costs outweigh the benefits.

The nanny is cheaper.

The housekeeper is cheaper.

The guy fixing the roof is cheaper.

The gardener is cheaper.

You asked to see their papers, right?

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Steve Lopez can be reached at steve.lopez@latimes.com.