It’s Not the Immigrants, Mr. President

Op-Ed:  July 1, President Barack Obama spoke of the immigrants who helped build our country—such as my great-grandparents.  They passed through public health screening, obeyed the law, worked hard, and never got welfare benefits.  They learned the English language and American history.  Some even carried the Constitution of their beloved adopted homeland in their pocket throughout their lives. They asked only for the opportunity to contribute.

Should we, as Obama suggested, break down the bureaucratic barriers that hinder such people?  Absolutely.  That is not what the controversy is about. 

The issue is illegal immigration—lawbreaking. Controversy is inflamed by marches of angry people, aggressively waving a foreign flag, insulting Americans in a foreign language, and demanding to “take back” the property and earnings of Americans.

Illegals circumvent public health screening, bringing once banished foreign organisms with them. The most serious one is probably multi-drug resistant tuberculosis, which one can catch on a bus. Head lice are far more common than previously in schools. Dengue has reached the continental U.S. and the parasite that causes Chagas disease now infests more than 40 percent of the kissing bugs found near Tucson, compared with only 4 percent in 1964.

Then there’s property and environmental destruction in the Arizona desert. Ranchers’ land is trampled, and strewn with tones of garbage and human excrement.

Worse, there are guns—including military assault rifles. Americans are warned to stay out of the Buenos Aires National Wildlife Refuge because it is occupied by heavily armed invaders, who smuggle drugs and humans.  Phoenix, Arizona, is perhaps the kidnapping capital of the world, with heavily armed contingents invading homes and carrying off people for ransom.

While proclaiming that we are “a nation of laws,” Obama didn’t mention how the U.S. federal government encourages lawlessness.  One way is by forcing the private sector to care for illegals free of charge, through the Emergency Medical Treatment and Active Labor Act (EMTALA).  Physicians on a hospital staff are required to serve these patients immediately—even if they have scheduled surgeries or an office full of waiting patients.

When hospitals in border states complained that this unfunded mandate could cause them to close (as many actually have), the federal government offered some reimbursement for services provided under EMTALA to illegals.  Hospitals, however, could not inquire about immigration status—they had to somehow divine it without asking, and file a claim without telling.

Doctors owe a duty of confidentiality to their patients.  The Oath of Hippocrates states:  “All that may come to my knowledge in the exercise of my profession or outside of my profession or in daily commerce with men, which ought not to be spread abroad, I will keep secret and never reveal.”

Some things, however, ought to be revealed, and by law physicians must report them.  These include certain infectious diseases, gunshot wounds, suspected abuse, and evidence of an impending crime.  While the government demands access to more and more sensitive information about citizens from their health records, including illegal drug use, sexual preference, psychiatric history, and gun ownership, one is not allowed to ask basic questions about immigration status. This is a double standard.

Doctors are not law enforcement agents.  Their duty is simply to treat patients—even known enemy combatants or criminals.  They may not, however, help people evade the law.

Federal law may actually encourage them to do so. According to anonymous reports, “community health centers,” which are generously funded by federal tax dollars, not only provide treatment to illegals but also may help them obtain many other welfare benefits to which they are not entitled. Bending or violating the law might keep enrollments expanding and the federal dollars flowing and the staff paid. Immigration officials look the other way, and anyone who dared to raise questions would likely be branded as a “racist.” (“ObamaCare,” by the way, will expand the reach of such centers from about 5 percent to 10 percent of the population.)

In contrast to Obama’s examples, like Jews fleeing Eastern Europe, this time we’re not facing just a migration, but an influx having many hallmarks of a foreign invasion.  Individual illegal residents may be oppressed refugees or simply, as President Obama says, people seeking a better life.  Sympathy for individuals—some of whom might even be hostages or human shields— must not, however, blind us to the threat to our country from harboring at least 11 million “entrants” who have defied our laws.

The system is set up to distribute benefits of lawbreaking.  Not just to President Obama’s “unscrupulous businesses” but also to politicians who expect to get the immigrant vote, and to bureaucrats, medical professionals, and other citizens who draw taxpayers’ money from the welfare state.

If the United States cannot or does not enforce its laws, Lady Liberty’s lamp will no longer beckon to the people throughout the world who are “yearning to breathe free.”


About the author:
Jane M. Orient, M.D., Executive Director of Association of American Physicians and Surgeons, has been in solo practice of general internal medicine since 1981 and is a clinical lecturer in medicine at the University of Arizona College of Medicine. She received her undergraduate degrees in chemistry and mathematics from the University of Arizona, and her M.D. from Columbia University College of Physicians and Surgeons. She is the author of Sapira’s Art and Science of Bedside Diagnosis; the fourth edition has just been published by Lippincott, Williams & Wilkins. She also authored YOUR Doctor Is Not In: Healthy Skepticism about National Health Care, published by Crown. She is the executive director of the Association of American Physicians and Surgeons, a voice for patients’ and physicians’ independence since 1943. Complete curriculum vitae posted at Additional information on health-related issues: and
Dr. Orient’s position on Obama’s healthcare reform:  “The Obama plan will increase individual health insurance costs, and if the federal government puts price controls on the premiums, the companies will simply have to go out of business. Obama makes promises, but the Plan will deliver higher costs, more hassles, fewer choices, less innovation, and less patient care.”
Doctor Orient resides in Tucson, AZ and can be reached at  (520) 323-3110 or