“Mexican immigration over the border is a good thing,” the late Nobel Prize winning economist Milton Friedman said in a famous 1978 lecture, before stipulating, “but it’s only good so long as it’s illegal.”
Friedman, a libertarian icon and champion of the economic benefits of free immigration, had very little in common with today’s Trumpists on this issue. But he explained a paradox of illegal immigration this way: “as long as it’s illegal the people who come in do not qualify for welfare, they don’t qualify for Social Security, they don’t qualify for all the other myriads of benefits that we pour out from our left pocket into our right pocket, and so, as long as they don’t qualify, they migrate to jobs. They take jobs that most residents of this country are unwilling to take, they provide employers with workers of a kind they cannot get — they’re hard workers, they’re good workers — and they are clearly better off.”
As their 2020 bidding war heats up, Democrats are putting a new twist on immigration and social welfare policy. Asked in the second Democratic debate whether they would support decriminalizing illegal entry into the United States, eight of the candidates raised their hands. On the same stage that night, all 10 of the candidates said their government healthcare plan “would provide coverage for undocumented immigrants.” Joe Biden, the supposed moderate in the race, said yes to both questions.
Simultaneously increasing the incentive to enter the country by offering generous public benefits while removing a deterrent to entry would be a recipe for disaster, putting a further strain on both our immigration and healthcare systems.
South Bend, Indiana, Mayor Pete Buttigieg declared, “our country is healthier when everybody is healthier.” Biden concurred, saying, “you cannot let, as the mayor said, you cannot let people who are sick, no matter where they come from, no matter what their status, go uncovered. You can’t do that. It’s just going to be taken care of, period. You have to. It’s the humane thing to do.”
It’s true that, though they don’t have fully fleshed out proposals, Biden and Buttigieg support some sort of optional government-run healthcare that could involve a buy-in option that would require some form of payment. Yet that is not the case for Sens. Bernie Sanders and Kamala Harris, who both support putting everybody on a single government-run plan.
It is one thing to argue that in the case of emergencies, and instances in which people are carrying transmittable diseases, that they should be treated by hospitals. It’s another thing to argue in favor of giving everybody who enters the country access to a full healthcare plan that offers a wide range of nonurgent medical benefits.
In addition to hospital and emergency care, the plan authored by Sanders and supported by Harris promises to cover: ambulatory services; primary and preventive services; prescription drugs, medical devices and biologic products; mental health and substance abuse treatment; lab tests and other diagnostic services; “comprehensive” maternity, reproductive, and newborn care; pediatrics; dentistry; vision care; rehabilitation services; long-term care; and home care assistance.
At the same time, the plan calls for no cost-sharing — meaning no deductibles or co-payments for any services, beyond certain limited exceptions for prescription drugs and biological products.
As things stand, such a plan is expected to cost $32 trillion over a decade. And figuring out a way to deliver virtually unlimited free healthcare to over 300 million people while keeping down payments to doctors and hospitals without emperiling access is already a significant challenge for any proponent of such a system. Yet by offering free coverage to anybody in the world who enters the country, to pay for everything from a routine dental check up, to contact lenses, to more serious surgery, will crush the healthcare system.
That’s why other nations, which liberals often point to as bastions of humanity compared to the harsh U.S., place limits on who can qualify for care. The Commonwealth Fund notes that in Japan, “undocumented immigrants and visitors are not covered” and that even in the Canadian system, “Temporary legal visitors, undocumented immigrants, those who stay in Canada beyond the duration of a legal permit, and those who enter the country ‘illegally,’ are not covered by any federal or provincial program, although provinces and territories provide some limited services.”
In 2017, Britian’s cherished National Health Service, to combat health tourism, started requiring proof of residence for free care and upfront payment from overseas patients. Britain also requires payment of a “healthcare surcharge” when filling out an immigration application. The government’s immigration website says that people can start using the NHS once they’ve paid the surcharge and their “visa or immigration application is granted.”
At the fear of being on the wrong side of a debate stage handraising exercise, Democrats really did not think through the implications of their new positions.
