By Farooq A. Kperogi
A reader who read my article last week asked to know how Nigerians who come to America to have babies get medical attention from hospitals since I said you need to have health insurance (somewhere between $1,500 and $2,500, that is, between N232,000 and N386,000 in upfront payment to insurance companies every year in addition to what your employer pays the health insurance companies) before you can be admitted and treated in hospitals here.
Well, there are three possibilities. First, it’s entirely conceivable that wives of wealthy Nigerians who come here to have babies have international health insurance coverage that is acceptable in America hospitals. There are several international health insurance carriers for travelers, for families on vacation, etc that hospitals here accept. But certainly not all Nigerians who rush to America to be delivered of babies in hopes of getting American citizenship for their children are rich enough to afford the kind of international health insurance coverage that will be accepted here. So how do they work the system?
I think it’s usually through one of two means. The most common, from my discussions with people here, is outright fraud or, if you like, emotional blackmail. The women wait until they are really due, rush to the emergency rooms of hospitals and compel emergency room doctors into delivering them.
You see, the redeeming feature of the American health-care system is its provision that no one should be denied medical attention in the emergency rooms of hospitals, although the cost of medical treatment in emergency rooms, as you saw from my personal story last week, is more than five times the cost of regular hospitals. But to visit a regular hospital, you not only need insurance; you also need to book an appointment at least a day before you visit.
Well, it had not always been the case that anyone who showed up in the emergency rooms of hospitals got treated. It was in 1986 that the U.S. Congress passed a law called the Federal Emergency Medical Treatment and Active Labor Act (EMTALA), more popularly called the Patient Anti-Dumping Law, which forbids emergency departments of hospitals from refusing to treat patients on account of their inability to pay.
Now, if you’re an American citizen or a legal resident who got treated in an emergency room, you will, of course receive your bill after the treatment, which you must pay within 45 days. If you don’t pay at the specified time, your case will be transferred to a debt collection center, which will continue to harass you wherever you go in the country until you pay your debt in full—or until you declare bankruptcy or offer other reasons why you can’t pay.
And—this is the sad part—whether or not you pay, the fact that there was a need to employ the services of a debt collection center to get back the money you owed is sufficient to ruin your creditworthiness and prevent you from getting loans to buy a car or a house, or even doing something as basic as renting an apartment or owning a cell phone. But if you’re non-American, which means you can’t be traced, you can escape. But that means you will transfer the financial burden of your treatment to American taxpayers.
I suspect that’s why the visa section of the American Embassy in Nigeria takes particular exception to uninsured Nigerians going to America for the sole purpose of having babies. During my various visa interviews, I have seen many Nigerians denied visa on account of evidence that they had in the past gone to have babies in America at the expense of American taxpayers.
To be fair, it’s not only Nigerians that do this. Citizens of many developing countries also come here to give birth to babies because they want such babies to grow up to be American citizens. Some Americans derisively call such children “anchor babies.” They are so called because it is believed that non-Americans use the citizenship status of such children as an “anchor” to return to America and become citizens too. The Immigration and Nationality Act of 1965 has a “family reunification” clause, which allows citizens (and “anchor babies” qualify as citizens even if they were born by illegal immigrants) of the United States to sponsor their relatives—spouses, children, parents, etc— for immigration to the United States.
This “anchor-baby” phenomenon, along with the spate of uninsured (read: poor) Americans who patronize the services of emergency departments that they can never pay for, has imposed a huge financial burden on American healthcare. A 2003 study by the American Medical Association, for instance, showed that American emergency doctors, on average, provide $138,300 (over 21 million naira) worth of uncompensated care on a yearly basis under the auspices of EMTALA.
In the new healthcare bill Obama is pushing in Congress, it will become hard for illegal immigrants or “anchor-baby-seeking mothers” to work the system like before. Proof of citizenship or immigration status will now be demanded before treatment. That proviso to the bill was included at the instance of conservative Republicans.