In the debate over immigration, perhaps no question is more politically-charged than whether immigrants are a burden on society. In health care, the question is even more prickly. A recent study found Latino immigrants use far less health care than other groups.
Walk through Orelia Almanzan's door in downtown Lyons, a small town near Vidalia, and you might think you've entered a pharmacy.
"The something tea is to calm nerves and something at night. The something tea is for babies and some people take it for stomach aches. And we have the something tea and cat claw for kidney problems."
The main street Hispanic grocery has plenty of cures for various ailments, but owner Almanzan is not a doctor. Many immigrants in this onion-growing region come to her extensive herbal section because they use such remedies in Mexico and because they don't want to visit a doctor.
"It sells very well. Since we can't afford to go to the doctor frequently, we try to take care of matters ourselves."
Stores like these are just one small reason why Latino immigrants use less health care than U.S. citizens. A recent Harvard and Columbia University study found they receive 55 percent less the native-born. Report co-author from the University of Southern California, Dr. Sarita Mohanty, says that should lay to rest the myth that immigrants are responsible for the nation's high health costs.
"A lot of the comments made about immigrants burdening the health care system seem to be quite unfounded. There was really no substantial data that supports that the're really overburdening systems on a national level."
Mohanty says some of the reasons immigrants use less health care include cultural differences - like the herbs - but are mostly language and money.
At East Georgia Health Care in Reidsville, money is on the mind of many sitting in the waiting room as the small clinic fills with patients early on the Tuesday after Memorial Day. Among them, Ismael Ruiz complains of stomach pain and fever. He says over the long weekend, his wife urged him to go to the hospital, but he decided to wait it out and come here instead.
"The other time I went to the doctor, it was very, very expensive. I was in a hospital room and it was $500. I had to come to an agreement with the hospital to pay it. I paid it back slowly, but I paid it. I know this clinic is less expensive."
Ruiz says most of the time, he just takes over-the-counter medicine for his ailments. The uninsured construction worker says although he's been sick like this before, this is only his second visit to the doctor in six years. Clinic director Jenny Wren Denmark agrees it's typical for immigrants to delay or do without care.
"They wait until it is debilitating, really. When they can't go in the field anymore, then they come to the doctor. And what we try to encourage is preventative health care."
Denmark says she wants more immigrants to see the doctor and has started programs to go into the fields to make sure they're doing so. She says it costs her organization more to do this, but says it's her job. She gets annoyed at the question, and doesn't want to answer whether immigrants are a burden.
"It costs more to provide a bilingual staff. Sometimes we have to employ someone that their only job is translation. But that's just a mission of serving your population. And that's not something that we hold against anyone. We really avidly look for additional patients, particularly in the migrant population. We need to encourage them that we are not there to report them of their legal status."
At an immigrant health fair in a huge, sweltering gymnasium in Vidalia, many immigrants don't seem as interested in check-ups as they do with getting an identification card from the Mexican consulate. The organizers say they need the IDs to get immigrants near physicians. Josefina, who didn't give her last name, was among those waiting hours in a long line to get official papers.
"I think many people are afraid to go to the doctor and they don't get near them even once a year to get checked. One of the biggest fears is not knowing English and the other is, I don't know, sometimes some of us, Hispanic women, are afraid to go to the doctor, especially if they end up with a male doctor. They get nervous."
Many in the line say it's been years since they've been to the doctor. Others say, they've been told to go, but don't. Still others say, they take over-the-counter medicine until it's really bad, then, they go to the emergency room.
At Meadows Regional Medical Center in Vidalia, the cost of such attitudes falls here, in the ER, where the round-the-clock doctors and state-of-the-art equipment make treatment more expensive. Latino leaders are trying to teach the newly arrived to see the doctor early so they can avoid this place, but ER director Peggy Fountain says the efforts only go so far.
"The bottom line is, it is harder to make those collections. Sometimes people, they don't have a permanent address. If they don't have the funds to pay at the time of service, then you have issues with billing. So, we don't collect a lot of money because of the transition and people moving in and out of the area."
Overall, the study found Latino immigrants have the lowest per-capita use of health care than any other group, a third that of U.S.-born whites. But one immigration critic says the hospital's experience should make anyone doubt whether simply "not seeing the doctor" truly reduces immigrants' impact on the health system. Steven Camarota of the Washington think tank Center for Immigration Studies says, per-capita use doesn't tell the whole story.
"Uninsured immigrants, or uninsured illegal immigrants, use somewhat less in health care at taxpayer expense. However, since the immigrants are many more times likely to be uninsured in the first place, it almost doesn't matter. Or think of it this way: immigrants and their U.S.-born children account for almost three-fifths, or 9,000,000 of the 11,000,000 increase in the number of uninsured people in the United States since 1989."
Camarota supports strict immigration controls. He says illegal immigrants should be sent back to where they came from. Meanwhile, the Reidsville clinic and the Vidalia hospital see more each day. And the physicians and administrators there say unconditionally, "Bring us more. We'll treat them and find the money to do it. That's our job."
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