Access to Health Care for Immigrants in NYC
In contrast to most industrially developed countries, American private-public health care system is far from being universal. However, health care system makes a difference in whether and when people get necessary medical care, where they get their care, and ultimately, how healthy people are. Research has repeatedly shown that the lack of insurance ultimately compromises a persons’ health because they are less likely to receive preventive care, are less able to afford prescription drugs, are more likely to be hospitalized for avoidable health problems, are more likely to be diagnosed in the late-stages of disease and once diagnosed tend to receive less therapeutic care (1). Despite general agreement that equity is a part of the United States political culture, there is a little consensus on what is meant by equity in health care in US. There is a variation in health status by location, race/ethnicity, gender, and poverty level. This variation highlights the inequality in the health of the US population, a reflection on insufficient access to care and health insurance coverage for such a big group of population as immigrants (1). •
Who are immigrants and why they have difficulties to assess health care system Each year the U.S. government generously admits immigrants into the country to live, work, reunite with their families, and pursue the American dream. Some have parents, children, or spouses in the United States who sponsored them. Others have been admitted to fill jobs. Still others arrive as refugees or asylees, fleeing persecution in their home country. According to Non-Citizen Benefit Eligibility Chart (2), qualified immigrants (who are lawful residents) are qualified for the public health benefits after five years of admitting the country. Unqualified immigrants (who are undocumented aliens) reminded ineligible for the most services (excluding emergency care service). Even though lawful non-citizens are entitled to the public health care services (after 5 years barrier), low-income immigrants are much more likely to lack health insurance than similarly poor native-born citizens. This happens because of immigrants shortfalls in their access to both public insurance and private job-based health insurance. There are some barriers immigrants face that are preventing them from access to the health care. First, immigrants are less likely to offered job-based insurance because they often work in sectors- such as agriculture, food service, and construction - that have low insurance coverage. Language barriers limit access. If patients know they will have difficulty explaining their medical needs or problems to a doctor or nurse, they are less willing to seek care. About 30% of the foreign-born do not speak English or do not speak it well. Cultural differences also play a role. The medical care system is organized differently in the United States than in immigrants’ home countries, and managed care can be particularly difficult to navigate. Immigrants may have different perceptions of the need and appropriateness of medical care. For example, the need of preventive care may be less familiar or, in many countries, seeking help for mental health problems is stigmatized. Finally, legal status can be a concern. Unauthorized immigrants often worry that seeking care, particularly at a public facility, may lead to exposure of their unauthorized status and increase the risk of deportation. Even legal immigrants may worry that using benefits could jeopardize their legal status and perhaps make it harder to gain citizenship or permanent residency (1) •
Health Care Reform and its implementation in NYS and NYC The 1996 Health Insurance Portability and Accountability Act restricted access for recent lawful permanent residents for public insurance (*). Prospects are improving, however. A 2009 United States National Health Care Act allows states to eliminate the five-year waiting...
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