From Privilege to Right: The Debate Over Medical Care for Immigrants

A camel that manages to get its nose inside a tent, an Arabian proverb warns, will eventually attempt to push the rest of his body in as well. Great Society programs have already managed to change the nature of a medical service from a good to a subsidized public benefit. The next question is whether Americans will now allow further encroachmentnwhether this benefit will become a right for all inhabitants. The 1996 federal Personal Responsibility and Work Opportunity Reconciliation Act (PRWORA), the so-called Welfare Reform Act, attempted to eliminate public benefits, including welfare, medical, and housing services, for certain nonqualified categories. However, the reaction by individual states to the PRWORA highlights where the debate may head in the near future. Thus far, state and federal legislation have maintained that taxpayer-subsidized care provisions constitute a public benefit, in other words, a privilege for qualified individuals. Certain states and municipalities have since countered with a concept of care that would have far-reaching implications for states harboring large numbers of immigrants, legal and otherwise. Literature from the Physicians for a National Health Program unequivocally states, health care is a right, not a privilege. Led by such groups, supporters of the right to care hope to replace the current privilege, or public benefit system, of subsidized disbursal of medical care with a system guaranteeing care for all. Using the societal and economic impact of immigration, as an example, this paper attempts to illuminate the consequences on public policy if Americans pursue a conception of care as a right, as opposed to a good or even a public benefit.