Re: future of migrant health

[Guest guest]

Geoff,

Thought this article may lead you to the right conclusions. Also the UFW won a contract for strawberry pickers in California that included free health, dental and life insurance. There was an article going around not too long ago.

Adolfo Mata, Director

Hispanic Health Initiative

Bureau of Primary Health Care

*****************************************************************************

Mexico exploring medical aid for migrants

Workers' options are few in the U.S.

The Dallas Morning News, March 7, 2001

GUANAJUATO, Mexico -- The one and only time he ventured from his home in

central Mexico to work the farm fields of California, Hubaldo Yebra spent a

lot of time worrying about staying healthy so he could make it back home.

" I had no papers, I had no insurance, so where was I going to turn if I got

sick or injured? " asked Mr. Yebra, who now plays guitar for outdoor diners

on Guanajuato's colonial square. " We all go with a prayer to protect us. "

In his first three months as Mexico's president, Vicente Fox has made gains

on a series of prickly matters â? " â? " like narco-trafficking, corruption

and illegal immigration â? " â? " that for years have strained Mexican

relations with the United States.

But health care for hundreds of thousands of Mexican migrant workers in the

United States may become the toughest nut to crack for Mr. Fox.

" I don't think [Mr. Fox] has thoroughly costed out yet what it might take

for Mexico to help cover the health-care costs of its migrants, " said

Warner, a University of Texas at Austin professor and an expert on

binational health-care issues. " It's clear he's trying to be responsible,

and it's good to raise the issue. But how effective the solution is depends

on how much he's willing to pay. "

Providing better health care for migrant workers is part of a pledge Mr.

Fox made to improve the lives of the millions of Mexicans living abroad.

This week, Fox administration officials meet with health-insurance industry

officials from both sides of the border to explore ways to cover medical

expenses of migrant workers in the United States.

The Binational Migrant Health Policy Initiative, a group of academics,

insurance-industry officials and public-health specialists are wrestling

with the issue at a conference in Cuernavaca, south of Mexico City. Task

force members think they can reduce the bill American taxpayers pay to

cover illnesses and accidents among Mexican migrant workers.

Binational coverage " is not only realistic, it's inevitable, " said Pablo

Schneider, part of the binational group and president of Blue Cross-Blue

Shield of Mexico, an offshoot of Blue Cross of Texas.

His company is about to launch an insurance plan in Mexico that will cover

Mexicans when they travel in the United States through the nationwide

network of Blue Cross plans.

Mr. Schneider admits the policies will be initially too expensive for the

average Mexican migrant worker. But he insists that the promise of the Blue

Cross plan is that it breaks the ice.

" Over the long term, it means a new health-care platform in Mexico that has

access to the United States platform of Blue Cross, " said Mr. Schneider,

who has been studying binational insurance problems for decades. " Such a

platform that addresses all the differences in health-care costs and

delivery in the two countries is needed before we can have affordable

binational insurance policies. "

Health care for uninsured immigrants is said to cost American taxpayers

billions of dollars, since a fourth of the 45 million uninsured people in

the United States are immigrants.

Extending Medicare coverage to 7.4 million immigrants, for example, would

cost $30 billion a year, according to a report by the Center for

Immigration Studies.

Health care in Mexico costs a fraction of what it does in the United

States. In Mexico, where citizens enjoy at least rudimentary medical

services from low-cost public hospitals and clinics, the government spends

less than 5 percent of its annual gross domestic production on health care.

By comparison, the United States spends 15 percent, or about $1.4 trillion,

on health care. That's equal to about $3,700 per person But apart from some

labor union coverage, and scattered group health plans like the one some

growers provide farm workers in the West, most migrants in the United

States go without coverage.

Migrant-health clinics exist in the United States, but a survey of farm

workers suggests that the clinics reach only 20 percent of that workforce.

The clinics are underfunded, and most workers do not report injuries or

illnesses because of their undocumented status, said Rick Mines, a

researcher with the California Institute for Rural Studies.

In a report, Mr. Mines said migrant workers' precarious status in American

society makes it difficult to extend health care and insurance to them.

Even legal workers, he said, shy away from disclosing the origins of injury

or illness because they fear retaliation by employers. As a result, health

care is generally the migrant worker's lowest priority.

" It was a miracle we did not get seriously sick because of the way we

lived, all crammed together in one room after working long hours in the

fields, " said Mr. Yebra, who worked on grape and vegetable farms around

Bakersfield, Calif. " We had plenty of mint tea, and some of the men knew of

herbs that could make you feel better. "

Mexican immigrants working near the border regularly cross into Mexico for

low-cost health care. But as immigrants increasingly find work in other

parts of the country, farther from the border, paying for their own health

care becomes more difficult.

That's where the Mexican government can step in, said ,

director of the Fox administration's Office of Migrant Affairs. Mr.

and Foreign Ministry and public health officials will meet with

the binational health group in Mexico City.

" We've been looking at getting [the Mexican Social Security Institute] more

involved with migrant health abroad and linking it with private companies, "

Mr. said, referring to the agency in Mexico that provides health

insurance for workers.

The Mexican government now provides health plans for the families of

migrants working abroad. The Fox administration plans to expand that

coverage, and Mr. wants to add coverage for migrants in the

United States.

" We have not found the perfect link for all that yet, but a lot of

companies have called me, " Mr. said. He predicted that the Fox

administration will find solutions during the president's six-year term.

-----Original Message-----

From: Ironman814@... [mailto:Ironman814@...]

Sent: Tuesday, March 20, 2001 3:34 PM

Subject: [ ] future of migrant health

I am finishing up a senior thesis at town University about the general

topic of migrant health care. My thesis has focused on the history of the a

Migrant/Community Health Clinic in Wenatchee, Washington (Columbia Valley

Community Health). I have discussed the coming of Hispanic agricultural

workers to the Pacific Northwest, some general information about migrant

health and the barriers they face, and governmental and local efforts to

provide health care to the poor population of migrant and seasonal

farmworkers in North Central Washington. Themes addressed include

immigration, health care, government aid for the poor, and local reactions to

an increasing Hispanic presence.

Presently, I am writing the thesis conclusion. In it I will mention what the

Health Center's experience says about the greater American society. I also

want to write some about the future of health care for migrants. For any of

you who feel qualified, I would greatly appreciate a short statement about

what you see in the future of migrant health (i.e. single-payer government

sponsored health care in US, likely changes in government policy and funding,

etc.). Thanks for your help.

Geoff Sonn

[Guest guest]

Geoff,

Wow. What a challenge. Do we write what we'd like to see happen to Migrant

Health or what we think will happen to Migrant Health?

If the former, how about portable Medicaid coverage for mobile migrants as

they move from state to state. This coverage would meet their basic and

then some health care needs. Additional emphasis on migrant health research

including more community-involved research and inclusion of migrant and

seasonal farmworkers into research sponsored and conducted by broader

agents; e.g., CDC, NIH, many of their branches and more universities

throughout the country. Then how can I stop without wishing for additional

funding so the program can really help meet those " 100% access, 0 health

disparities " goals of the government instead of just serving from 10-25% of

the population.

Now, regarding what might happen, how about these scenarios.

Agreements made with the Mexican government to develop an international

health care program for those moving across both countries. Inclusion of

health care requirements in a new guest worker program developed with the

assistance of the Mexican government. Continued underfunding of the Migrant

Health Program. More emphasis on Hispanic health care within the Bureau of

Primary Health Care and increasing ability of Community Health Centers

without Migrant Health funding to serve Hispanic patients. Slowly

increasing inclusion of Hispanics, and thereby migrant and seasonal

farmworkers, into health research. More Hispanic researchers who will take

an interest in these issues.

That's it for my guesses. Anyone else want to try?

Alice C. Larson, Ph.D.

las@...

P.O. Box 801

Vashon Island, WA 98070

206-463-9000 (voice)

206-463-9400 (fax)

----- Original Message -----

From: <Ironman814@...>

< >

Sent: Tuesday, March 20, 2001 12:34 PM

Subject: [ ] future of migrant health

> I am finishing up a senior thesis at town University about the

general

> topic of migrant health care. My thesis has focused on the history of the

a

> Migrant/Community Health Clinic in Wenatchee, Washington (Columbia Valley

> Community Health). I have discussed the coming of Hispanic agricultural

> workers to the Pacific Northwest, some general information about migrant

> health and the barriers they face, and governmental and local efforts to

> provide health care to the poor population of migrant and seasonal

> farmworkers in North Central Washington. Themes addressed include

> immigration, health care, government aid for the poor, and local reactions

to

> an increasing Hispanic presence.

> Presently, I am writing the thesis conclusion. In it I will mention what

the

> Health Center's experience says about the greater American society. I

also

> want to write some about the future of health care for migrants. For any

of

> you who feel qualified, I would greatly appreciate a short statement about

> what you see in the future of migrant health (i.e. single-payer government

> sponsored health care in US, likely changes in government policy and

funding,

> etc.). Thanks for your help.

>

> Geoff Sonn