Two issues still remain unresolved in healthcare reform—abortion and illegal immigrants.  Before discussing these two items, I would like to take just one second and remind my readers of the obvious.  Healthcare reform is necessary because of skyrocketing costs.  I would like to discuss these issues in that context.

Abortion, first and before any other consideration, Is a legal right in this country and, as such, should be covered by ANY healthcare coverage.  We do not get to pick and choose how the government spends our tax dollars.  We only get to pick and choose (albeit, in a limited way) our representation in Congress.

Second, disallowing healthcare coverage of approved abortion procedures does not prohibit abortions in our country.  It simply disallows aseptic, safe abortions.  The problem here is that there are not a lot of people around who remember the septic abortions using coat hangers.  While abortions may not necessarily be inexpensive, the cost of repairing a botched, unsanitary abortion is both exorbitant and unnecessary.

With respect to treating illegal immigrants, the same logic applies.  Illegal immigrants, requiring medical treatment in our country will get it, it is simply a matter of when and how expensive will it be when it is ultimately provided.

Almost twenty-five years ago I sat on a board which oversaw the cost and quality of care that our local hospital provided.  One of the things we identified as a problem area was Hispanic women showing up at our local emergency room, about to give birth, without ever having had any pre-natal care.  At least there was no documented pre-natal care.  As a result, the birth was immediately categorized as “high risk.”  All of the mother’s labs had to be run “stat.”  In effect, all the bases that would have been covered over the preceding nine months had to be done in whatever time remained between her showing up at the ER and her infant’s subsequent delivery.  Additionally, the infant was probably going to require admission into the neonatal intensive care unit.

The lack of prenatal care for the Hispanic women in the community ended up costing the hospital hundreds of thousands of un-reimbursable dollars.  Oh, and one more thing, while the mother may have been illegal, the infant is, in fact, a U.S. citizen.

We identified the main reasons that Hispanic women were not getting prenatal care was that they had no insurance and their fear of deportation.  To remedy the situation, we contacted the general practitioners and Ob-Gyn docs in the community and offered to underwrite the prenatal care of the local Hispanic women.  We gave the women a no questions asked “public option” as it were.  It worked and we saved the hospital hundreds of thousands of dollars.  The doctors either wrote off the cost of the patient’s care or accepted Medi-Cal rates.

Suffice it to say, it makes no sense to deny care to anyone.  It will only end up costing us more in the end.