I wanted to take a pass on this story. It’s gut wrenching from a personal perspective and reflects the difficulties of being humane in an era of very stretched medical budgets. But taking passes isn’t what SHS is all about, so here goes.
The NYT had a front page story yesterday describing the plight of an illegal/undocumented alien whose brother wants to donate a kidney for transplant. He can obtain kidney dialysis, but due to his illegal/undocumented status, no doctor or hospital will perform the surgery. From “For Illegal Immigrant, Line is Drawn at Transplant:”
For nearly two years, the brothers and their supporters have been hunting for a way to make the transplant happen. Their journey has taken them through a maze of conflicting laws, private insurance conundrums and ethical quandaries, back to the national impasse between health care and immigration policies. The waiter’s boss sought private insurance, she and the brothers said, speaking on the condition that their names be withheld for fear of provoking immigration authorities. The Catch-22: for the first year, the waiter, called Angel, would get no coverage for his “pre-existing condition,” nor would he receive the dialysis that keeps him alive and able to work four days a week.
Obamacare doesn’t cover illegal immigrants, so that would not change even if the law goes into full effect. Which makes sense from a policy perspective. Talk about a magnet for people to enter the country without permission.
This, to me, was the kicker:
Doctors sought a transplant center that would take him. Hospitals in the city receive millions of taxpayer dollars to help offset care for illegal immigrants and other uninsured patients. But at one hospital, administrators apparently overruled surgeons willing to waive their fees. At another, Angel was told to come back when he had legal status or $200,000. A last resort is a return to Mexico, where the operation costs about $40,000. But to pay off the necessary loans, Angel and his brother, a deli worker, would have to sneak back in through the desert. If they failed, they would be cut off from their children in Brooklyn, who are United States citizens.
Why should a return home for needed treatment be a “last resort?” It should be a first resort. People who enter the country illegally have to be aware that there are potential consequences, including if they sire or give birth to children, the prospect of having to leave the country. When those consequences bite, we can’t just say “never mind” to one who happens to garner a sympathetic NYT story. There must be tens of thousands of other similarly human wrenching stories that could be told.
Here is how things stand:
The waiter now shuttles between a basement dialysis center [treatment paid], the restaurant [where he works] and his family’s cramped but well-kept walk-up. There, as their children clustered nearby, his brother, 26, said they would not give up. “He’s more than my brother, he’s like my father,” he said. “If I can give him life, I have to.”
The brother can. In Mexico. By refusing to return home for optimal care, Angel is putting his own life in jeopardy. We are not putting him at risk.
That doesn’t mean we should do nothing. I would stipulate that we should pay the cost of the man’s ride home as a matter of humane care, and help arrange needed surgery, with money that his friends can raise to supplement loans he must take. But it is not our responsibility thereafter to support his continued treatment or to let him back in the USA. Nor is it our fault that he would have to “sneak” back into the country to be reunited with his children. Indeed, he brought this conundrum upon himself and his family by the choices he made—which, let’s face it, most of us would probably make too if we were living in poverty in another country.
Hard cases such as this are why, when it creating public policy about issues legal involving illegal/undocumented aliens, promoting the common good for the USA must override our natural sympathy in difficult individual cases. It would be wonderful if we could carry the world. But we can’t. We aren’t Atlas. It’s that simple—and terrible.
