ILLEGAL IMMIGRANTS LESS OF A HEALTH BURDEN.

Byline: RACHEL URANGA Staff Writer

Addressing an issue at the center of the immigration debate, a study released Tuesday found that illegal immigrants place a lesser burden proportionally on the nation's troubled health-care system than U.S.-born and naturalized citizens.

The report, conducted by the Rand Corp., found that illegal-immigrant adults make up 12 percent of Los Angeles' population but account for only 6 percent of its public health-care costs.

U.S.-born patients make up 55 percent of the population but represent 72 percent of public health care cost. And legal immigrants make up about 32 percent of the population and account for 22 percent of public medical costs.

``The major message is that the health-care cost of the foreign-born population in general is lower than you would expect. We are not spending a lot of taxpayer dollars on health care for undocumented migrants,'' said James P. Smith, a Rand economist and one of three co-authors of the study.

``There are a lot of anecdotes and stories but if you add it up, this is not where the big money is.''

The study was conducted in 2000, based on a survey of about 2,500 Los Angeles residents, ages 18-64. Based on their findings, the researchers estimated that national health-care costs for illegal immigrant adults totaled $1.1 billion, or about 1.2 percent of the $88 billion spent annually on taxpayer-funded health care.

Published in the November/December issue of the Journal of Health Affairs, the Rand study did not include the cost of treating children and senior citizens.

But it measured a population hospitals and doctors can't: illegal immigrants. Under federal rules emergency room doctors are not allowed to ask patients their immigration status.

Not the silver bullet 

``We have long said that while this is an important problem for hospitals that are required to see anybody regardless of residency, it is not the most significant part of our uninsured problem,'' said Jim Lott, executive vice-president of the Hospital Association of Southern California.

``Even if we were to solve the illegal immigration problem tomorrow, we would still have a huge problem with the uninsured and cost of care provided by hospitals for treating them. This is significant but it's not the silver bullet bringing down the system.''

Separate from the Rand study, Lott estimated that the state's estimated 3 million illegal immigrants cost California taxpayers $1.2 billion, with the federal government covering $71 million of the cost.

And the Los Angeles Department of Health Services estimates that in 2003 it spent $340 million of its $3.3 billion budget to provide health care for illegal immigrants.

The Rand study also said that migrants who come to the United States tend to be healthier than the general population -- a condition researchers term the ``selection effect'' after Darwin's theory of natural selection -- so visit doctors and hospitals less frequently.

But they also use hospitals less frequently because of language barriers, fear and misunderstanding of the system, researchers said.

When they do arrive at the doctor's office, they are more likely to be uninsured.

The study found that in Los Angeles, 68 percent of undocumented immigrants were uninsured compared with 17 percent of U.S. born-citizens.

Critics say such stark differences illustrate how illegal immigrants overburden the public health-care system.

Figures not right?

Some health-care professionals and opponents of illegal immigration say they believe the study's figures are under-reported.

``The numbers seem grossly implausible,'' said Steven Camarota, director of Research at the Center for Immigration Studies, a think tank supporting stricter border controls. ``It doesn't seem possible, no matter what assumptions you make, even if you assume that illegals use dramatically less health care.''

Camarota criticized the Rand study for omitting the cost of caring for the children of illegal immigrants and for its reliance on patients self-reporting their immigration status.

He puts the price tag for caring for all undocumented immigrants at $2.2 billion, with an additional $3.5 billion spent treating their U.S.-born children.

Care sought less

But, the study does confirm what many researchers have long maintained: Illegal-immigrant men seek medical care less often than their female counterparts.

For instance, in Los Angeles County, 58 percent of illegal immigrants visited a doctor in the past year and 11 percent have been hospitalized in the past two years. But among undocumented men, just 2 percent had been hospitalized in the past year.

``Yes, an uninsured illegal uses less in public health care than an uninsured native but since illegals are six times more likely to be uninsured in the first place, the costs they create are disproportionate to the numbers,'' Camarota said.

In Southern California -- where emergency-room waits can average about seven hours, and 10 emergency rooms closed in the last five years -- many say caring for illegal immigrants overtaxes the health-care system.

``Undocumented residents put strain on an overburdened system, but so do rising numbers of uninsured, so it's just one piece of the health-care crisis,'' said Michael Wilson, a spokesman for the Los Angeles County Department of Health Services.

``The challenge is to treat these individuals as much as possible in a primary care setting before they present to the ER, which is the costliest care.''

rachel.uranga(at)dailynews.com

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