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Monday, May 15, 2006

Taking Responsibility for Our Immigration Woes

In foreign policy, you have the misguided ``blame America first'' crowd.

And in the immigration debate, there is the equally misguided equivalent: the ``blame Mexico first'' crowd.

For the blame-Mexico bunch, the world is a delightfully simple place. To listen to them, we Americans were just sitting in the backyard, sipping lemonade and minding our own business, when all of a sudden we noticed that our country was being invaded by poor, uneducated Mexican immigrants.

And it's all Mexico's fault. Not the companies who hire illegal immigrants, or the politicians who take contributions from companies that hire illegal immigrants, or Americans who lost their work ethic so that companies feel they have little choice but to hire illegal immigrants.

Putting the blame there would require us Americans to do something that, these days, we are loath to do: take responsibility. That's one of the great things about living in America: No matter what ``it'' is, it is never our fault. Why should we expect the issue of illegal immigration to be any different?

A reader invited me to join the blame game. ``Shout from the hilltops about the corruption in the Mexican government,'' he said. ``Focus on them until they act responsibly toward their citizens.''

The argument goes like this: The United States would not be taking in so many illegal immigrants if Mexico didn't provide so few opportunities. There's truth to that statement. But there's also truth to this one: The United States would not be taking in so many illegal immigrants if employers here didn't provide so many opportunities.

One reason that blaming Mexico is so tempting is because the Mexican government has been and is so inept. The administration of Mexican President Vicente Fox actually is an improvement over what preceded it -- a string of corrupt leaders from the Institutional Revolutionary Party (PRI) that governed the country for decades. But not everything changes overnight. The Mexican government still serves the interests of the few who are rich at the expense of the many who are poor. And it has cynically turned its national embarrassment -- the exodus of millions of its own people -- into nothing less than an economic engine.

Last year, Mexican expatriates in the United States sent home almost $20 billion. Yet, naive Americans want to know when Mexico is going to help the United States control illegal immigration. How does ``never" sound? Think about it... why should they?

And despite the knee-jerk assumption that Mexican-Americans are ancestrally disposed to defend Mexico, the opposite is closer to the truth. Every Mexican-American knows that somewhere in his family tree there's a Mexican immigrant who was cast aside by Mother Mexico and that there's only one nation to which they owe their loyalty and gratitude for all they have accomplished -- the United States of America...if you doubt this simply look at the Congressional Medal of Honor winners and the make up of our Armed Forces.(1Hispanic American Medal of Honor Recipients USA )

That said, as a Hispanic-American, I have little interest in defending Mexico or the Mexican government. But I also have no appetite for the way in which many Americans duck responsibility for a problem they helped create through their addiction to cheap immigrant labor -- illegal labor being among the cheapest varieties.

With demonstrations in the streets, a lot of Americans are demanding to know why, if things are so bad in Mexico, these immigrants don't go home and march there to bring about change in their own country.

Simple: Because they live here now and because their fates rest in the hands of the U.S. Congress, not the Mexican Congress. If they still lived in Mexico, they could indeed take to the streets there -- as some demonstrators have already done in Mexico City in advance of this year's presidential election.

Here's the really troubling part -- that by avoiding responsibility for the problem, ``blame-Mexico-first" Americans surrender the power to find a solution.

It's just like the politics of victimization here in the United States. When a group -- any group -- goes around blaming its plight on the actions of others, what the supposed victims are really saying is that they're powerless to affect change and shape their own destiny. How pathetic.

Is that really the message that America wants to broadcast to the world with regard to illegal immigration -- that this is something that was done to us, and so we can't do anything about it?

Hon. Vinicio E. Madrigal, MD.
Board of Regents Uniformed Services University
Phone: 504-885-3272 Fax: 504-456-8224
EastBank Primary Care Associates
Physicians Choice Hearing Aid Centers
# 3800 Houma Blvd. Suite 250
Metairie, LA 70006

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Neither Preference Nor Prejudice

By Hon. Vinicio E. Madrigal, MD.

There’s a difference between having an “open door” policy and having no doors at all.

The U.S. economy has been strengthened perpetually via its open doors. Free flows of immigration, trade and capital have fueled the wealthiest economy in history. But the continued success of this policy hinges on us knowing who is attempting to come through those doors -- that is, on fostering community as well as growth.

Today America’s exceptional status as a nation of immigrants is being challenged by globalization, a phenomenon that makes both migration and terrorism much easier. The favored approach of recent years -- a policy of benign neglect regarding the immigration problem -- is no longer tenable.

Successful immigration reform must be comprehensive. A lopsided, ideological approach is bound to fail, whether it focuses exclusively on border security while ignoring migrant workers or vice versa.

Just think through the numbers. Illegal immigration has reached massive proportions. The U.S. currently hosts more than 12 million undocumented aliens. When three out of every 100 people in America are undocumented (or documented with faked papers), we have a profound security problem. And that’s the point Congress should focus on. The real problem presented by illegal immigration is security, not a supposed threat to the economy.

Today the percentage of Americans who are foreign-born (12 percent) is the highest in decades. At the same time, the economy is strong, with higher total gross domestic product, higher GDP per person, higher productivity per worker and more Americans working than ever before. Immigration may not have caused this economic boom, but it is folly to blame immigrants for hurting the economy at a time when the economy simply isn’t hurting. Ironically, efforts to curtail the economic influx of migrants actually worsen the security dilemma by driving many migrant workers further underground, thereby encouraging the culture of illegality.

The real problem with accommodating a flood of undocumented workers is that it makes flouting the law the norm. And that makes the job of terrorists and drug traffickers infinitely easier. To solve that problem, we must develop a nationwide system that identifies all foreigners present within the U.S. A non-citizen guest-worker program is critical, meaningful reform is impossible without one.

Incentives for employers and workers to comply should be written into the law, along with strict penalties for non-compliance. Guest-worker status should not be a path to citizenship or convey rights to U.S. social benefits. The guiding rule: Treat migrant workers with neither preference nor prejudice.

This century of globalization will see America either descend into timid isolation or affirm its openness. We can’t afford to wait. Already China’s economic power is ascending with openness, while Western Europe declines into isolation.

Too many voices are saying that immigration reform is politically untenable. That supposes a false choice between openness and law. And it misreads the populist demand for a simple solution that’s both obvious and true to our American heritage.

WAS 2005 REALLY THE HORRIBLE YEAR YOU MIGHT THINK?

Was 2005 really the “ horrible year” you might think if you trusted only certain news publications? If you only looked a what is generally presented by the main streams you are likely to be haunted by such images. In fact the images are so haunting that it takes a mental effort to remember the good things that also happened in 2005.

Picture collections presented in the media show image after image of the devastation of Hurricane Katrina: a mother clutching her child in the rain, a violent scuffle at the New Orleans Superdome; a dead man indecently photographed floating through New Orleans.

After that, we move onto the earth quake in Pakistan and a reminder of the Indian Ocean tsunami (though that disaster actually belonged to 2004, as it happened just days before the end of that year…but why nitpick?). We also get the London bombings, the French car-burning riots, and Israeli troops in violent struggle with a settler being evacuated from the West bank.

Iraq, needless to say, looks overwhelmingly like a tragedy with pictures of an American soldier patrolling terrified Iraqis in Mosul, a crippled soldier back from Iraq, a flag draped coffin returning home – and one small badly displayed photo of a woman returning from voting showing her blue finger.

With this unrelenting display of bad news – and yes, of course, it all has to be acknowledged -- we miss the joys and the progress of 2005. Sometimes, good news arises from the way we deal with the bad.

How about the news that the U.S. economy grew at the highly respectable rate of 4 points in 2005, while unemployment remained low at 5 percent? Maybe a picture of Americans hard at work would be in order?

Or how about some pictures from New Orleans of the U.S. Armed Forces evacuating over 30,000 people, or of churches opening and offering their services as relief and rescue centers when the federal and local governments failed. Or a reminder that American cities throughout the country generously opened their doors and schools for the storm hit refugees. As many as 11,000 still remain in Houston alone. Showing that the spirit of generosity is alive and well in this country, Americans donated some $700 million within days of Katrina’s landfall

If we are to count the Indian Ocean tsunami as part of the news of 2005, consider that in many cases the U.S. military were the first signs of help many people saw. Private Americans donated almost $1 billion in record time. In Pakistan, U.S. help was equally swift, and in both Indonesia and Pakistan, anti-American sentiment took a nose dive as a result. In a poll just released by the group Terror Free Tomorrow, because of the earthquake aid, Pakistani favorable opinion of the United States has doubled from 23 percent in May 2005 to more than 46 percent today. Support for Osama Bin Laden, on the other hand, over the same period dropped from 51 percent to just 33 percent now.

And let us not be shy about celebrating with the Iraqi people their progress towards democracy. Defying terrorist threats, they came out to vote three times in 2005, an estimated 11 million of them in the Dec. 15 election. According to an ABC News poll, 70 percent of Iraqis now feel good about their lives, and 44 percent feel optimistic for their country.

There was more good news in the Middle East as well. Lebanon is free of Syrian troops, owing to a combination of its political Rose revolution, and the unexpected success of international pressure from France and the United States working together.

And, finally, Back here in America , 2005 was the year “some” in Washington found the courage again to call a Christmas tree a Christmas tree.

We need a Dose of Competition in Health Care

Hurricane Katrina has brought to the fore the strengths and weaknesses of America's health care delivery system. Millions of individual Americans, acting on their own initiative, rushed to meet the dire need Katrina created. Those efforts include providers rushing to assist in person, as well as charitable contributions made by those who never left home. In contrast, the response of government has been alarmingly slow and has even thwarted private efforts. According to reports, Wal-Mart not only implemented emergency plans six days before Katrina hit land. It knew from its in-house meteorologists that Katrina had zigged toward New Orleans 12 hours before the National Weather Service issued a similar advisory.

Why the discrepancy? Entrepreneurs and private charities often respond much faster than government because they are more agile and flexible. Another good example is Home Depot, also used to dealing with hurricanes. It had mobilized four days before Katrina hit. It had generators and building supplies pre-positioned to the left and right of Katrina's projected path and had 23 of 33 stores in the hurricane disaster zone open the next day. In this manner they avoided wasting valuable resources, allowing help to go where it's needed the most.

These considerable advantages emerge from the fact that government must follow cumbersome rules, and that individuals are more careful with their own resources than with other people's. There is a lesson here for America's daily struggle with how to make health care more accessible.

In many sectors of the economy, market competition consistently improves quality while reducing costs. Health care is an exception, but not because competition cannot work. In fact, the recent rise in cash-paying patients traveling abroad for medical care shows that market competition makes even urgent, high-cost acute care more affordable.

Rather, health care is an exception because market competition is not allowed to work. Market competition requires three key elements: (1) a large pool of actual and potential producers with new ideas; (2) consumers who are free to choose different products; and (3) consumers who weigh the costs and benefits of those products. At every turn, government tax, spending, and regulatory policies thwart these necessary conditions of a free market.

To mention just one example, heavy government subsidies (through programs such as Medicare and Medicaid) and tax penalties (for workers who do not let an employer purchase their health care) discourage patients from weighing costs against benefits. As a result, Americans pay for more of their medical care through third parties (86 percent) than patients in 17 other advanced countries, including Canada.

Time and again, free markets have proven an effective framework for making products of ever-increasing quality available to an ever-increasing number of consumers. To make high-quality care available to more Americans, we need reform that will allow markets to work in health care.

More flexible health savings accounts( HSAs).
Though promising, this new health insurance option is too restrictive. Congress should create large HSAs that are more flexible and give workers ownership of all their health care dollars and decisions.
Injecting choice, competition, and ownership into Medicare.
This federal program for the elderly engenders enormous waste and will soon impose a crushing tax burden unless we act soon. Congress should give seniors greater choice of health plans, and allow workers to save their Medicare taxes in personal accounts for their health care needs in retirement.
Reforming Medicaid as Congress reformed welfare.
This federal-state program for the poor creates the same harmful incentives as the welfare system Congress reformed in 1996. Those reforms should be applied to Medicaid.
Health insurance deregulation.
Costly state regulations make health insurance too expensive for many, and each state prohibits the purchase of coverage licensed in other states. Congress should tear down those barriers.
Letting patients and providers negotiate malpractice protections.
Patients can choose different levels of malpractice protection by going abroad for care. They should be able to have the same choice at home.

Though not comprehensive, these reforms would go a long way toward improving the quality and convenience of medical services, while making care more accessible.

People are suffering in the wake of Katrina. But others suffer every day because our health care system is not what it should be. The gains are there to be had. We must build the will.

Hon. Vinicio E. Madrigal, MD.
Phone: 504-885-3272 Fax: 504-456-8224
EastBank Primary Care Associates
Physicians Choice Hearing Aid Centers
# 3800 Houma Blvd. Suite 250
Metairie, LA 70006

Monday Morning Reading… Katrina’s first casualty

By: Dr. Vinicio Madrigal

The first casualty of Hurricane Katrina appears to have been the truth. Many of the other casualties were products not of armed gangs but of overheated imaginations. The reality of the devastation and misery in New Orleans was bad enough, or should have been. But when the rumors started to fly, we were all taken in.

Now that the deluge of water and journalists looking for a dramatic story have both receded, reporters at the New Orleans Times-Picayune have been separating the tall tales from the true stories. Their findings are startling and instructive.

At the Superdome, for example, there were not hundreds of corpses but six. One person had overdosed, four had died of natural causes, and the one suspicious death, a fall, may have been an accident or suicide. One shooting has been confirmed: A Louisiana Guardsman was attacked by someone with a metal rod, and he accidentally shot himself in the leg with his own gun during the struggle.

The hundreds of bodies stacked inside the Ernest N. Morial Convention Center never materialized either; just four were recovered and only one appeared to be a murder victim. In fact, the parish's district attorney (Eddie Jordan) said only four murders have been confirmed in the hurricane's aftermath, which makes that week no more deadly than what used to be the norm in New Orleans prior to Katrina. There was plenty of looting and some guns, but a Convention Center official said he saw no violent crimes.

While the news media spread the fables, they were not the only ones. Instant urban myths were passed between reporters, evacuees and even city officials -- and they grew more lurid and inflated with each telling. I got an e-mail from J. R. a New Orleans attorney telling of the gun battle at Charity Hospital (that never happened). It was the New Orleans police chief who told of gunfire on police, soldiers and doctors. The mayor told Oprah Winfrey that armies of gun-toting gang members were on a rampage in the Superdome. But the piles of dead never turned up.

Aside from being irresponsible, the gossip-mongering hurt response to real problems, as help was sent where it wasn't needed. A thousand soldiers and police in battle gear went to the Convention Center to quell the storied mayhem, but they met no resistance, found no evidence of assaults or murders and were in control in 20 minutes, according to their commander.

I can attest to the fact that the bad conditions in our hospital became worst when the bits of information we were able to receive made the perception of things be seen as reality. When we heard of doctors and nurses fighting gangs at Charity Hospital and of drug seekers vandalizing other health care facilities, our team became afraid of their own safety. There were calls from the members of our staff to leave the Hospital while we still could. As history will tell, we were able to persuade our cohorts that we needed to stay and stand our ground; in so doing we all helped write another chapter in the proud 35 year history of community service at East Jefferson General Hospital.

Hon. Vinicio E. Madrigal, MD.

NOTE: Doctor Vinicio E. Madrigal, one of the founders of the Hispanic Chamber of Commerce of Louisiana was reappointed by President Bush and was confirmed by the Senate of United States for another term as a Member of the Board of Regents of the Uniformed Services University.

The Board of Regents of the Uniformed Services University of the Health Sciences provides advice and guidance to the Secretary of Defense through the Assistant Secretary of Defense for Health Affairs for the operation of the Uniformed Services University of the Health Sciences. The Board consists of nine persons outstanding in the fields of health and health education who shall be appointed from civilian life by the President of the United States, by and with the advice and consent of the Senate.

Any views or opinions presented in this article are solely those of the author and do not necessarily represent those of the Pregones Publishing Corporation.

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