There is plenty of debate in the United States on the exclusion of the illegal immigrants from the healthcare insurance. There is plenty of argument from the white legislators that are in support of this. Their rationale is to first of all reduce the number of illegal immigrants in the United States. FAIR and CIS are two institutions that have been quite vocal on the media on the issue. They believe that the debate on health care insurance for the illegal immigrants is closely interwoven with the migration debate (Galarneau, 2011). FAIR believes that this is a debate that is more economical.
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They are of the opinion that removing the undocumented immigrants from the insurance list saves the American taxpayers some dollars whereas including in the healthcare insurance only increases the amounts of deficits for the taxpayer. It also means increased number of patients reducing accessibility to health care. It is the opinions of such institutions that have forced the hands of numerous presidents. They led the then president, Barrack Obama, to come up with a healthcare proposition called the Patient Protection and Affordability Care Act (Galarneau, 2011). A proposition that came into law when he signed it in. In the proposition he said that it would not be extended to cover illegal immigrants and true enough it did not. The bill did not even allow the illegal immigrants to purchase independent medical insurance. The only forms of insurance that the illegal immigrants and their families got was Medicaid.
However, some got medical insurance because of their employers. This is not expected because illegal immigrants most often get small jobs that are unable to cover for medical insurance. Others, however, argue that the government should grant the illegal immigrants the type of medical insurance coverage they can afford. Their reasons are mainly based on moral grounds. The people arguing for inclusion of the illegal immigrants include church groups, Latino groups as well as healthcare institutions. On moral grounds they argue that the illegal immigrants are human beings as well and deserve to be treated as such. They argue that getting health care is a basic right instead of a privilege. It is the right of every single human being to acquire proper medical care. The groups also add that all the people that are in need should get access to the best quality medical care that they can afford and it should not matter what group they belong to or their original parentage.
Some argue that simply entering the United States void of permission does not grant the government the powers to deny the person the basic human rights that they are entitled to. The groups also argue from an economic perspective. These groups also argue that the illegal immigrants contribute to the economy by participating in the workforce as well as paying taxes. As a result they should be entitled to medical care. They contribute about $1.5 billion to Medicare and about $7 billion to Social Security. They are able to contribute such heavy amounts despite them not receiving the benefits of the same (Galarneau, 2011). World Health Organization places patient autonomy and patient choice at the very forefront of the medical world.
The modern theories of autonomy are mainly based on self-realization and self-actualization. It is a method that especially favors a treatment that is centered on the person and one that is holistic. It is believed that the patient should be involved in his own treatment. This can be achieved through giving the patient all the information that regards their condition then asking them to make the choice. This is a method of respecting the self-determination and the self-governance of the particular individual. The proposition is that a more open dialogue between the doctor and the patients could help the patients choose their best type of medication. To support the patient’s autonomy and choice requires the particular patient to be rational at the moment of making the decision.
The fact that the patient has to be rational at the time of receiving the information presents a problem for nurses. A feature of health care is known as informed consent. It dictates that the nurse must uphold the right of the patient to have full involvement in their treatment by making decisions about their healthcare. Nurses, on the other hand, realize the practical side of doing so is quite different. Giving this information is not as straightforward as it would appear and the capability of the patient making the wrong decision is quite high. In the dissemination of information, for example, there are ethical issues. One of them is to inflict no harm to the patient. This presents the problem of translation (Galarneau, 2011).
The statement could mean different things in the layman’s language and in the medical field. The nurse might, in a bid to inflict no harm, prefer to give the information in the form of an analogy. However, analogies are easy to distort and the information could potentially become misunderstood. Something that makes it even more difficult is the conversation surrounding death. How do you start the conversation to a patient about their death? How does the nurse begin this conversation and when is it best to do so? Some experts seem to believe that death should become a topic if the patient has only 12 months left to live. But the time left to live is hard to determine in a cancerous situation.
There is a severe form of discrimination against the illegal immigrants in America. However, denying them of medical care is not only unfair, but a breach of fundamental rights. On the other hand, nurses are facing the problems of juggling between discretion and patient autonomy.
Galarneau, C. (2011, May). Still Missing: Undocumented Immigrants in Health Care Reform. Journal of Health Care for the Poor and Underserved, 22 (2): 422“428. https://ai2-s2-pdfs.s3.amazonaws.com/a08d/11f85b45f54593b41402d005cc9ea2db784f.pdf
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