Health Care Lost in Translation

Although U.S. authorities might not share C¿rdova's goal of universal health care, they don't deny the universality of the problem.

"From our perspective, there is no border in terms of health anymore," said William Steiger, director of the Office of Global Health Affairs at the U.S. Department of Health and Human Services. "We know that not just immigrants but travelers in this age of globalization can represent a challenge because they can bring diseases and export them as well."

Steiger cited recent measles cases brought to the United States by Japanese boys coming for the Little League World Series.

As part of efforts to protect Americans, Steiger said the department is responsible for the health of refugee populations within the United States and focuses efforts overseas on preventing diseases from reaching U.S. territory. Those efforts, he added, are not unique to the United States. Other countries are just as interested in ensuring that disease does not reach their populations.

"Good health is a positive-sum game for all us," he said.

Steiger and C¿rdova said the United States and Mexico are beginning to explore some innovative ideas, such as a binational health plan that would provide coverage to Americans living in Mexico and Mexicans living in this country.

Aware that there are many more Mexicans here than Americans there, C¿rdova suggested that a plan could fully cover U.S. citizens in Mexico but would offer only primary care to Mexicans here. After all, he said, most Mexican immigrants are young and healthy, and primary health care covers 85 percent of diseases. Those with more serious 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 receive health benefits than the average resident of the United States. This might be a large factor in the rise in the number of the uninsured. In 2003, immigrants represented more than one of every four uninsured individuals in the United States, according to the Employee Benefit Research Institute.

In a 2005 report, the institute said that "immigrants accounted for about one-third of the increase in the uninsured between 1994 and 1998." But after the 1996 welfare reform that restricted access to public assistance programs to immigrants with more than five years of legal residency, "immigrants accounted for 86 percent of the growth in the uninsured between 1998 and 2003," the report said.