Article

Immigrants And The Cost Of Medical Care

RAND Corporation, Santa Monica, California, United States
Health Affairs (Impact Factor: 4.97). 11/2006; 25(6):1700-11. DOI: 10.1377/hlthaff.25.6.1700
Source: PubMed

ABSTRACT

Foreign-born adults in Los Angeles County, California, constituted 45 percent of the county's population ages 18-64 but accounted for 33 percent of health spending in 2000. Similarly, the undocumented constituted 12 percent of the nonelderly adult population but accounted for only 6 percent of spending. Extrapolating to the nation, total spending by the undocumented is 6.4 billion dollars , of which only 17 percent (1.1 billion dollars) is paid for by public sources. The foreign-born (especially the undocumented) use disproportionately fewer medical services and contribute less to health care costs in relation to their population share, likely because of their better relative health and lack of health insurance.

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    • "Generally speaking, undocumented immigrants are not entitled to receive health care and other federally funded, public welfare programs, posing a severe threat to the health of immigrants and the nation as a whole (Goldman et al., 2006; Torres-Cantero, Miguel, Gallardo, & Ippolito, 2007). With the recent economic downturn, further steps have been taken to reduce health care expenditures while continuing to provide adequate coverage for U.S. citizens and legal immigrants. "
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    ABSTRACT: The growth in undocumented immigration in the United States has garnered increasing interest in the arenas of immigration and health care policy reform. Undocumented immigrants are restricted from accessing public health and social service as a result of their immigration status. The Patient Protection and Affordability Care Act restricts undocumented immigrants from participating in state exchange insurance market places, further limiting them from accessing equitable health care services. This commentary calls for comprehensive policy reform that expands access to health care for undocumented immigrants based on an analysis of immigrant health policies and their impact on health care expenditures, public health, and the role of health care providers. The intersectional nature of immigration and health care policy emphasizes the need for nurse policymakers to advocate for comprehensive policy reform aimed at improving the health and well-being of immigrants and the nation as a whole.
    Preview · Article · May 2014 · Policy Politics & Nursing Practice
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    • "As studies [8] [9] [10] [11] [12] confirm, migrants constitute a vulnerable minority with restricted access to health care. The unequal conditions are caused particularly by the socio-economic status [2] [11] [12], by the immigration status [13], by the language barriers [14] or by the marginalization and stigmatization of individual ethnic minorities [1] [15] [16]. The so-called healthy immigrant effect is sometimes mentioned in this context also [17] [18] [19] [20]; that term describes the status when immigrants have better health condition than the majority population after their arrival in the host country. "
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    ABSTRACT: Research studies have shown that the health condition of immigrants is not influenced only by gender differences; significant determinants also include ethnicity, consistency of cultural heritage and social class. In relation to their status, immigrants belong to a vulnerable group with a higher incidence of a number of illnesses [1] and [2]. The submitted article is focused on mapping the influence of four basic factors – ethnicity, degree of acculturation, immigration status and the socio-professional position on the immigrants’ health. The influence was described with the help of a secondary analysis of relevant sources using electronic databases including Scopus, EBSCO, etc. To map the ascertained factors, the conceptual model of basic determinants influencing the immigrants’ health was created, considering health a multidimensional result subject to external and internal determinants with emphasis on key aspects. Those aspects were further analysed and confronted with research projects and conclusions implemented in the Czech Republic and in other countries of the world. Although the mutual influence of the determinants was proved by studies, the European region still sees a priority rather in the social and economic self-sufficiency of the individual. The immigrants’ health has not yet been sufficiently mapped, as is evidenced by the survey of research activities focused on this issue in the Czech Republic.
    Full-text · Article · Mar 2014
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    • "The proportion of medical expenditures paid out-of-pocket was slightly higher among immigrant workers compared to U.S.-born workers, but this difference was not statistically significant. This finding is consistent with previous studies that reported a slightly higher proportion of medical expenditures paid-out-of-pocket among immigrant adults in comparison with U.S.-born adults [19,35]. Another study of immigrant children’s medical care also found that Spanish speakers had 1.5 times the odds of spending $500 or more out-of-pocket medical expenditures per year than English speakers. "
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    ABSTRACT: Background No national study has investigated whether immigrant workers are less likely than U.S.-workers to seek medical treatment after occupational injuries and whether the payment source differs between two groups. Methods Using the 2004–2009 Medical Expenditure Panel Survey (MEPS) data, we estimated the annual incidence rate of nonfatal occupational injuries per 100 workers. Logistic regression models were fitted to test whether injured immigrant workers were less likely than U.S.-born workers to seek professional medical treatment after occupational injuries. We also estimated the average mean medical expenditures per injured worker during the 2 year MEPS reference period using linear regression analysis, adjusting for gender, age, race, marital status, education, poverty level, and insurance. Types of service and sources of payment were compared between U.S.-born and immigrant workers. Results A total of 1,909 injured U.S.-born workers reported 2,176 occupational injury events and 508 injured immigrant workers reported 560 occupational injury events. The annual nonfatal incidence rate per 100 workers was 4.0% (95% CI: 3.8%-4.3%) for U.S.-born workers and 3.0% (95% CI: 2.6%-3.3%) for immigrant workers. Medical treatment was sought after 77.3% (95% CI: 75.1%-79.4%) of the occupational injuries suffered by U.S.-born workers and 75.6% (95% CI: 69.8%-80.7%) of the occupational injuries suffered by immigrant workers. The average medical expenditure per injured worker in the 2 year MEPS reference period was $2357 for the U.S.-born workers and $2,351 for immigrant workers (in 2009 U.S. dollars, P = 0.99). Workers’ compensation paid 57.0% (95% CI: 49.4%-63.6%) of the total expenditures for U.S.-born workers and 43.2% (95% CI: 33.0%-53.7%) for immigrant workers. U.S.-born workers paid 6.7% (95% CI: 5.5%-8.3%) and immigrant workers paid 7.1% (95% CI: 5.2%-9.6%) out-of-pocket. Conclusions Immigrant workers had a statistically significant lower incidence rate of nonfatal occupational injuries than U.S.-born workers. There was no significant difference in seeking medical treatment and in the mean expenditures per injured worker between the two groups. The proportion of total expenditures paid by workers’ compensation was smaller (marginally significant) for immigrant workers than for U.S.-born workers.
    Full-text · Article · Aug 2012 · BMC Public Health
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