Bills Pile Up as Federal Policy Fails

U.S. Rep. Dana Rohrabacher’s proposal to have doctors play Border Patrol agents was pronounced dead on arrival Tuesday in the nation’s capital.

“I’m just trying to start a dialogue,” the Huntington Beach congressman had told me on his front porch last week, explaining why he wanted hospitals to report illegal immigrants to the U.S. Department of Homeland Security.

The “dialogue” didn’t last as long as a cheap cigar. Rohrabacher’s bill got blitzed, 331-88, with many of his GOP colleagues giving it thumbs down.

No surprises there. The bill was impractical, illogical and absurdly timed, just to mention a few of its problems.

Republicans are well aware that if they do anything that might jeopardize President Bush’s hopes of snagging a few Latino votes in November, Karl Rove is going to beat them like birthday pinatas.

Rohrabacher’s true purpose was to rally support against illegal immigration, period. But on the subject of healthcare costs, Rohrabacher was raising a fair question in his own polarizing, conversation-killing way.

When an illegal immigrant gets his foot caught in a lawnmower, burns his hand on a fast-food grill or passes out from heat exhaustion in a strawberry field, who should pay the doctor bill?

Let me put it another way:

The annual budget at L.A. County-USC Medical Center is about $825 million, and an estimated 30% of the patients are illegal immigrants. So who should cover the approximate $250 million tab?

Certainly not the federal government, argues Rohrabacher. His bill was a protest against a provision in last year’s Medicare reform act that appropriated $1 billion over four years to help hospitals cover the cost of treating illegal immigrants.

Let’s think this through.

Federal law requires hospitals to treat anyone who makes it through the doors of an emergency room. But the federal government, which tacitly encourages illegal immigration because of the demand for cheap labor, doesn’t like to pony up when the bill comes due.

We finally get Congress to deliver a meager $250 million a year, which would at least take some of the heat off local taxpayers, and Rohrabacher wants to take it away? As it is, Californians get an insulting 77 cents worth of service for every federal tax dollar paid.

“Border patrol is a federal government issue,” said Jan Emerson of the California Healthcare Assn. “If the federal government is not going to keep people from coming over the border, it has a responsibility for covering the bills incurred by hospitals.”

David Altman, chief medical officer of County-USC, notes that illegal immigrants are among the one in five Californians who have no health insurance. So when they get sick or injured, they end up in emergency rooms.

“You and I, as county taxpayers, are the ones picking up the bill for this,” said Altman.

We have to keep reminding ourselves, I suppose, that healthcare policy is not designed to make sense to anyone, except maybe health insurance executives. Put healthcare policy together with immigration policy, and there’s no hope.

In yet another example of the inept cat-and-mouse game played by the U.S. Immigration and Customs Enforcement agency, 90 illegal immigrants were found Monday when agents raided a Canoga Park “drop house” believed to be used by smugglers.

Agency officials say they’re now switching the focus of their investigations from Arizona to Southern California, and they’re going after the leaders of these smuggling rings.

Wayne Cornelius, a UC San Diego authority on immigration policy, told me there are two things we ought to get straight here in California.

First of all, “there is not a shred of evidence” that Mexican nationals cross into the U.S. illegally to get free public services like healthcare. They come to work, and we keep hiring them.

Secondly, you cannot stop illegal immigration by guarding part of the border part of the time, or by running after those who make it across.

“There are probably hundreds of drop houses all over L.A., and they’re used on a regular basis,” Cornelius said. “The fact of the matter is, workers will get to L.A. one way or another, and if big smuggling rings are disrupted, they will immediately be replaced by others.

“Most smugglers are very small-time operators, anyway. So even if they do take out one or two major rings, there are thousands of small-time competitors around. [Raiding drop houses] is great election-year stuff with clearly symbolic import, but it doesn’t really disrupt the trafficking in migrant labor.”

If we really wanted to end illegal immigration -- and I’m far from convinced that we really do -- what measures would work better?

I’ve already touched on some. I’ll be back with more in the weeks to come.

Steve Lopez writes Sunday, Wednesday and Friday. Reach him at steve.lopez@latimes.com and read previous columns at latimes.com/lopez.