With a comprehensive immigration overhaul now perhaps years away,Latin American governments concerned with the well-being of theirnationals living in this country are taking on an equally thornyissue: the U.S. health-care system.
In Washington, some foreign consulates are providing eye examsand medical tests in addition to the traditional passport renewalsand marriage registrations.
The Salvadoran consulate, which serves the largest immigrantgroup in the Washington area, began offering 'Estaciones de Salud'(Health Stations) two years ago. The Mexican consulate followed suitlast year, offering similar health services that it hopes to expandto its 47 consulates throughout the United States by year's end.
'My health is important,' said Luz de Maria Mejia, 34, a nannyand restaurant worker who came to the United States four years agowithout papers. She found navigating the health-care system'extremely complicated' and has turned to the Salvadoran consulatefor help.
Jose Rigoberto Martinez, a burly, 48-year-old carpenter with atemporary work permit, said he believes that immigrants tend toneglect their health.
'If we have a headache but there is work, we work,' he said.
While waiting to get his blood pressure checked, Martinez said hehas never received medical treatment, other than a few visits to achiropractor. He stopped seeing the chiropractor because gettingtime off work and justifying $45 a visit proved prohibitive.
Seventy-five percent of the more than 3,600 Salvadorans andMexicans who received medical attention at their consulates inWashington this year had not had a medical checkup in the past threeyears, said German Valbuena, director of the local HispanicInstitute for Blindness Prevention, the lead agency running bothconsulates' health programs.
Salvadoran Consul General Ana Margarita Chavez said that soonafter arriving in Washington, she fell ill and realized howexpensive health care is in the United States. On average, 50 peoplea week received health services last year at the consulate. Thoseservices normally include a referral to a health center or clinicthat offers care regardless of the patient's economic or immigrationstatus.
Mexico's secretary of health, Jose Angel Cordova, said in atelephone interview that his government wants Mexican nationals inthis country to have the 'peace of mind of having access to basichealth services.'
As part of his government's goal of providing universal healthcare by 2010, Cordova said he hopes to provide 'health care to allMexicans regardless of where they are.'
'The migratory phenomenon has been growing [around the world],and it is something we will be grappling with for some time. Ibelieve there should be agreements among countries to guarantee abasic service such as health,' Cordova said.
Although U.S. authorities might not share Cordova's goal ofuniversal health care, they don't deny the universality of theproblem.
'From our perspective, there is no border in terms of healthanymore,' said William Steiger, director of the Office of GlobalHealth Affairs at the U.S. Department of Health and Human Services.'We know that not just immigrants but travelers in this age ofglobalization can represent a challenge because they can bringdiseases and export them as well.'
Steiger cited recent measles cases brought to the United Statesby Japanese boys coming for the Little League World Series.
As part of efforts to protect Americans, Steiger said thedepartment is responsible for the health of refugee populationswithin the United States and focuses efforts overseas on preventingdiseases from reaching U.S. territory. Those efforts, he added, arenot unique to the United States. Other countries are just asinterested in ensuring that disease does not reach theirpopulations.
'Good health is a positive-sum game for all us,' he said.
Steiger and Cordova said the United States and Mexico arebeginning to explore some innovative ideas, such as a binationalhealth plan that would provide coverage to Americans living inMexico and Mexicans living in this country.
Aware that there are many more Mexicans here than Americansthere, Cordova suggested that a plan could fully cover U.S. citizensin Mexico but would offer only primary care to Mexicans here. Afterall, he said, most Mexican immigrants are young and healthy, andprimary health care covers 85 percent of diseases. Those with moreserious problems could be sent to Mexico for treatment, he said.
Often employed in low-wage jobs in small service- or trade-sector firms, Latin American immigrants are less likely to receivehealth benefits than the average resident of the United States. Thismight be a large factor in the rise in the number of the uninsured.In 2003, immigrants represented more than one of every fouruninsured individuals in the United States, according to theEmployee Benefit Research Institute.
In a 2005 report, the institute said that 'immigrants accountedfor about one-third of the increase in the uninsured between 1994and 1998.' But after the 1996 welfare reform that restricted accessto public assistance programs to immigrants with more than fiveyears of legal residency, 'immigrants accounted for 86 percent ofthe growth in the uninsured between 1998 and 2003,' the report said.
