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Author Topic: Can You Be Certain the Baby was Born in the US?
fugu13
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. . . if you're the hospital that delivered it?

The Bush administration has announced a policy that has been denounced by the author of the provision under which it falls and legal scholars, that prevents hospitals from caring for babies born there of possible illegal immigrants until proof of citizenship can be obtained.

Of course, the constitution and the law make the baby a citizen purely by virtue of its being born there, something these hospitals are rather capable of ascertaining given their employees saw it happen!

http://economistsview.typepad.com/economistsview/2006/11/denying_health_.html

The reason given? To save money. :-(

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ClaudiaTherese
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Oh, no. [Frown]

quote:
Dr. Martin C. Michaels, a pediatrician in Dalton, Ga., said that continuous coverage in the first year of life was important because “newborns need care right from the start.” “Some Americans may want to grant amnesty to undocumented immigrants, and others may want to send them home,” Dr. Michaels said. “But the children who are born here had no say in that debate.” ...
...
The new policy “will cost the health care system more in the long run,” Dr. Berkelhamer added, because children of illegal immigrants may go without immunizations, preventive care and treatments needed in the first year of life. ...

Exactly. This is a short-term "fix" (if that), and the long-term costs in financial burden are going to be astronomical -- not to mention the human costs.

The structure of this healthcare system feels to me like a game of Pickup Sticks. Which stick is the one that will bring the pile crashing down all hurly-burly?

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Scott R
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These issues (health care and immigration) are the ones that consistently tip my vote over from the GOP side of the ticket to the Democrats.

Man, we need another political party...

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ClaudiaTherese
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Indeed. This so-called two-party system isn't good enough for the birds. [Frown]
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Storm Saxon
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Democrats aren't exactly jumping over themselves to help illegal immigrants, either. It's really less of a party issue and more of an electorate issue.

If you want to change the parties,you don't need a third party, (general you) you just need to get your facts in order and start talking the hell out of them and bringing people over to your side.

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Scott R
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You're right, SS.
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Dagonee
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I'd like to here more about the documentation required. This:

quote:
to receive care in the hospital the child was born in, the parents must first prove that the child was born there which makes no sense -- if the child was born there, citizenship is not in question
might not be an issue because the documentation is there as well.

I don't agree with withholding care. But this specific criticism doesn't ring true to me.

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Storm Saxon
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quote:

You're right, SS.

[Embarrassed]
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fugu13
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quote:
Under the new policy, an application must be filed for the child, and the parents must provide documents to prove the child’s citizenship. .. Obtaining a birth certificate can take weeks in some states, doctors said. Moreover, they said, illegal immigrant parents may be reluctant to go to a state welfare office to file applications because they fear contact with government agencies that could report their presence to immigration authorities.
It appears what's needed requires an application be filed with the state welfare office, so no, the documentation is not also at the hospital.
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DarkKnight
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quote:
Administration officials said the change was necessary under their reading of a new law, the Deficit Reduction Act, signed by President Bush in February. The law did not mention newborns, but generally tightened documentation requirements because some lawmakers were concerned that immigrants were fraudulently claiming United States citizenship to get Medicaid.
I wonder how much their reading of a new law counts for probable distortions as well?
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ClaudiaTherese
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Dag, I just relogged in to my computer to note that I wasn't abiding by one of my own personal rules: "If it sounds either too good or too outrageous to be true, it probably isn't as portrayed -- and so the facts should be checked."

I'll turnabout halfway and reserve judgment for now.

(Blame it on my current sleepiness and having given just yesterday a lecture that might well have been entitled "Why babies shouldn't be discharged from the hospital before Day 2 of life," subtitled "Scary metabolic diseases, etc." I am riding a biased horse this morning. *smile)

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Dagonee
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quote:
It appears what's needed requires an application be filed with the state welfare office, so no, the documentation is not also at the hospital.
I know what it appears - but no regulation and no administration official was directly quoted as saying this.

It should be noted that even if this characterization of the regulation is true, there are additional possibilities for coverage:

1) the states can issue birth certificates more quickly or authorize hospital-issued temporary birth certificates.

2) hospitals can provide the coverage anyway

3) states can remimburse hospitals for care between birth and birth certificate issuance.

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fugu13
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Some more info here:

quote:
Before federal authorities passed the new requirements for Medicaid -- the health insurance program for low-income patients -- states automatically provided newborn babies of undocumented immigrants with a year of medical care. After that, parents had to apply for benefits on behalf of their American child.

In the past, Medicaid recipients filled out an application that included their financial history, Social Security number and other data, but were not required to produce a birth certificate or passport. U.S. citizens and legal permanent residents in the country for at least five years are eligible.

Under the new law, anyone applying for Medicaid must also provide a passport, birth certificate or other legal document.

http://www.sun-sentinel.com/news/local/broward/sfl-cmedicaidnov03,0,3419773.story?coll=sfla-news-broward

Given that the child is undoubtedly a US citizen, refusing to pay for services that child is entitled to absent documentation unnecessary to verify that status would seem to be rather suspect.

Solution 1 is tolerable, but silly.

Solution 3 is essentially what the states were already doing in the longer term, and what appears to be problematic now -- the states already provide significant portions of Medicaid funds, this, at least as the people implementing it at the state level have interpreted the policy, prevents them from spending even that money on children.

Solution 2 isn't a solution, its ignoring the problem. Hospitals could just go and provide all sorts of care (though relying on that across all hospitals for care that's potentially expensive isn't going to work). That doesn't mean requiring unnecessary documention for children clearly eligible by virtue of their existence in the place in question to participate in a program providing funding for extremely important medical care isn't a very bad thing.

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Dagonee
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quote:
Given that the child is undoubtedly a US citizen, refusing to pay for services that child is entitled to absent documentation unnecessary to verify that status would seem to be rather suspect.
The hospital knowing something does not mean that the government agency knows it. I'm not sure why #1 is silly - if we're to take the hospital's word that the child was born there, what's wrong with requiring that the word be given in a certain format.
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dkw
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quote:
1) the states can issue birth certificates more quickly or authorize hospital-issued temporary birth certificates.
We were told to expect it to take a minimum of four months to receive John's birth certificate. And we filled out the paperwork in the hospital the day he was born.

I think they should allow a copy of the form requesting the birth certificate to count as proper documentation for the first six months.

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fugu13
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1 is silly because newborns were already receiving care under the program before this policy went into effect, and now in order to circumvent the negative effects of the policy states must create an entire new type of birth certificate that can be issued on site.
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Dagonee
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quote:
I think they should allow a copy of the form requesting the birth certificate to count as proper documentation for the first six months.
I agree, and states could do this themselves if they desired, simply by declaring that form to be the birth certificate until a state-version is filed. They can deputize hospital personnel to do so.

quote:
1 is silly because newborns were already receiving care under the program before this policy went into effect, and now in order to circumvent the negative effects of the policy states must create an entire new type of birth certificate that can be issued on site.
That doesn't make it silly. There was no requirement for documentation before. Now there is. The entire documentation requirement might be silly, but once one exists, requiring a particular form is not silly.
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fugu13
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Given the policy requiring documentation for these children is what I am protesting, any solution that involves creating more bureaucracy to create an otherwise virtually identical situation instead of just reverting to the old way of doing things and avoiding the bureaucracy is silly.

For states to declare a form to be a temporary birth certificate will require a change of law in all those states, I think. I'm pretty certain what qualifies as a birth certificate cannot be changed at an agency level.

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Dagonee
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The policy is one that requires documentation.

For years I could get a job without showing a passport, social security card, or birth certificate.

One day I couldn't.

The requirement that I prove my citizenship in order to work might be silly. The requirement that this be of a certain form is not.

If I were to go to work for the doctor that delivered and treated me all those years, I'd still have to show that ID, even though he "knows I'm a citizen."

The point is that the knowledge is required elsewhere, and therefore requiring the conveying of that knowledge in a particular form is not silly, but reasonable.

What if the child is taken to another hospital? Is it silly to require some documentation then?

quote:
For states to declare a form to be a temporary birth certificate will require a change of law in all those states, I think. I'm pretty certain what qualifies as a birth certificate cannot be changed at an agency level.
It's actually silly that there's no birth certificate for 4 months, for a host of reasons. The silliness of requiring any documentation might remove the silliness of lacking such certification for such a long time.
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Will B
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Clicking on the link, I find that there is nothing in there about denying health care to infants.

In fact, it is *illegal* for hospitals to deny emergency care to *anyone* on the basis of not being able to pay. Period. [Edited to add the word "emergency": fugu is right.]

The question is whether the cost of treating those who can't pay comes from Medicaid or from some other source, possibly the hospital itself. This would backfire if hospitals went bankrupt over it, which is surely preventable.

[ November 03, 2006, 04:00 PM: Message edited by: Will B ]

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rivka
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quote:
Originally posted by dkw:
I think they should allow a copy of the form requesting the birth certificate to count as proper documentation for the first six months.

Pretty sure that's true in California.
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fugu13
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Will: It is illegal to deny emergency care to anyone based on ability to pay.

Most infant care, however, is not considered emergency care. Babies need a lot of care during the first few weeks, months, and years to be healthy.

Dagonee: I maintain that a solution which restores the status quo except with additional bureaucracy is silly in comparison with a solution that restores the status quo without the additional bureaucracy. I do not assume the documentation should be necessary at that stage.,

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Dagonee
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Which is fine as long as you're not trying to support your position with "the baby was born there so documentation shouldn't be necessary." In the general case of baby brought to hospital while under 1 year old, they don't know that the baby was born in this country.

(Oh, and it wouldn't restore the status quo, as the temporary certificate would be demonstrating birth in this country, something not present under the status quo.)

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fugu13
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Nope, I just care about cases where the baby has been born in the hospital itself.

Which, given the hospital would be issuing the temporary birth certificate, is exactly as much demonstration of the baby having been born in this country as the temporary birth certificate.

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Dagonee
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I think special exceptions to general rules like that are messy - I far prefer regulations without them. I don't think regulations - even ones that change the status quo - that eliminate such inconsistencies are silly, but a good idea.
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fugu13
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In that case, to minimize the amount of bureaucracy created a far better solution that having each state write a temporary birth certificate law would be to have an affidavit of birth at the hospital count as one of the forms of identification allowed, and a specification that even in lieu of actual approval hospitals could provide care to children under a certain age given the documentation required for the approval (all the articles talk about the birth certificate or similar being required merely to make the application in question, which apparently must be done at the appropriate government office).

Delaying funding for important early medical care for infants prima facie eligible for it is unacceptable. Any documentation rules must be structured to prevent interruption of medical care to wait for documentation when the requirements are met with great obviousness. This rule, as implemented, does not without significant further legal changes (for instance, every state implementing temporary birth certificates).

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Samarkand
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I actually think that the law that being born in the US automatically makes you a US citizen is ridiculous. I would like to see that repealed, and instead require the US citizenship of one or both parents as a prerequisite to citizenship.

That said, I think withholding medical care from anyone, or making access to medical care more difficult, especially in regards to infants is immoral, harmful, and ultimately expensive for society.

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Dagonee
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ANd I haven't defended the rule (although, until I've seen it, I'm not going to rely on second-hand accounts of what someone said the rule means). I've pointed out that, even if the rule is in place as described, states can work around it if they desire.

That's a corrective suggestion, not support for the rule.

BTW, it appears that several states have administratively defined birth certificate rules with only general statutory guidelines (in such manner as prescribed by the State Registrar or some such).

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ketchupqueen
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It takes so long to get a birth certificate here that they provide alternate documentation at the hospital, including an affadavit that a SSN has been filed for and a signed affadavit on hospital letterhead that the child was born in that hospital and a birth certificate has been filed for.
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Belle
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I think it's wrong to assume that infants will always be treated at the hospital they were born in. In fact, thinking back, every time my children have needed hospital care it has never been at the hospital they were born in. I take them to Children's Hospital if they need urgent care, and they were all born in Brookwood medical center.
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fugu13
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I'm not assuming that, I'm saying the hospital they were born in should be able to treat them with at worst a much-relaxed standard of documentation.

Also, I suspect for many illegal immigrants their choice of hospital will be more dictated by locale, leading to more use of the same hospital.

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Dan_raven
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And I wonder if my baby was very ill if I'd remember to get his papers in order before rushing to the hospital.

I doubt I'd remember to get my pants on, not to mention searching for documentation.

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Dagonee
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quote:
actually think that the law that being born in the US automatically makes you a US citizen is ridiculous. I would like to see that repealed, and instead require the US citizenship of one or both parents as a prerequisite to citizenship.
I meant to comment on this earlier. There's a reason the 14th amendment contains the "born here, born citizen" clause. Without it, it'd be possible to create generations of people born here but not citizens.
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Samarkand
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I personally have no problem with people being born here and not automatically becoming citizens if at least one of their parents is not also a US citizen. In fact, I would like that on the books. I don't think we need something as intense as what some countries in Europe have (prove that you're wahtever to four generation back) or Japan (you really do have to be Japanese), but . . . I'm liberal in a lot of ways, but I don't like that when a child is born in the US, whether it's to a visting upper middle class Swedish couple or migrant workers that child gets an American passport. It's so weird.

If the parents wish to pursue citizenship for the whole family or the child later wants to patriate, fine. And I do think there is a moral obligation to provide basic medical care and education to children living the US (not doing so generally comes back and bites you in the hooie, from a pragmatic standpoint). But handing them an American passport and the right to vote because of geography? Interesting use of my tax dollars.

Out of curiosity, are there any other countries where you automatically get citizenship by being born there? Not the right to apply for it, but just get it?

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Dagonee
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Of the 38 countries surveyed for this study, 12 grant automatic citizenship to those born on their soil while 26 do not, as we show in the chart on the following pages.

quote:
For the purposes of this chart, ''birth'' refers only to whether a person is guaranteed citizenship simply by being born in that country, regardless of the status of the parents. However, ''birth'' does not include children of diplomats or other persons performing official duties abroad, as most countries, including the United States, do not give citizenship to the children of foreign nationals in a country on official business of their home government. See the chart below.
It's an eclectic group of nations:

Argentina
Brazil
Cameroon
Canada
India
Jamaica
Mexico
New Zealand
Pakistan
Spain
United States
Venezuela

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fugu13
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I am strongly in favor of our approach to citizenship. Europe is currently undergoing extreme intercultural stress in part because there are large non-citizen communities who maintain ties to other countries out of necessity.

This is America, land of opportunity. Why should only kids born to the right sort of parent get that opportunity? If they're born here, let them compete on at least somewhat equal ground along with all the other kids born here.

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DDDaysh
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I am TOTALLY in favor of the born here/citizen rule, even if people DO abuse it. I was recently looking at the requirements for getting a "legal" greencard to the US. It's insane!!! If you do not have a family member to sponsor you, and you're not educated, then basically you have to depend on being on of 40K that win a lottery, A LOTTERY, just to be able to live here!!! Perhaps it is because I live in a small, rural town in South Texas, but I think it is utterly cruel to make people sit across the border, looking at us, and give them NO hope of attaining what we have for their GRANDCHILDREN unless they do something illegal. Personally I live next door to a family who is here only because of the "born here" rule. It is a single parent family, a mother, a 15-year-old girl, and a seven-year-old boy. The mother has Cerebral Palsy and can barely walk, but she works across the street at the local resturaunt bussing tables six days a week. (The resturaunt is closed on Tuesdays) The 15-year-old has also worked as a waitress since she was 12. This is not a glamorous job, it's a job they have trouble filling, but this mother takes it, and is glad, ad works VERY hard to provide for her children. When she was in labor with her son, her brother hid her and drove her into Laredo so she could give birth in an American hospital, so her son would be a citizen, and could then "sponsor" herself and her daughter for green cards. It's the only way they could get here. They don't abuse the system, in fact, they have a hard time working it at all. They green cards expired earlier this year, and until the school found out about it, the mother had no CLUE how to renew them. The school had to drive them to the office and help fill out the paper work. To most illegal, or barely legal immigrants, all the paperwork is daunting. Many of them cannot speak English, and a decent percentage of them never had the schooling to even read in Spanish. To require paperwork just to get basic medical care is cruel. Luckily, our hospitals do have to treat ANYONE in case of emergency, and luckily BIRTH is an emergency.

Alot is made of illegal immigrants abusing our systems. Maybe this is true, I do not know what things are like in Los Angelos, or other large cities in California, or similar cities in Florida. However, I do know that I have rarely met illegal immigrants in person that do not have a HIGHER ethical obligation to be productive than many US citizens. Maybe my sample is biassed, since I am only talking about people I have met, maybe there are hoards of them hiding somewhere snickering because we pay taxes so their kids can get shots, but I haven't seen it. What I have seen is an immigration system that is highly biassed against ambitious hard working people who are willing to do what it takes to make the world a better place and to give their kids a shot at a future they know they cannot have for themselves. The "born here" rule is one of the few MOSTLY legal means they have of immigrating. Other means are much worse. I have seen 13-year-old girls married off, by their parents, to total strangers (for an under the table fee I'm sure) in order to get green cards. I have seen countless fathers who cross illegally year after year, risking all the hazzards that go with that (and crossing our border IS more dangerous than the media makes it out to be) in order to work, and to scout, so that they can take their earnings home with them to the families they have to leave behind, because, so far, they haven't found a way to bring them safely too. People are desperate to get here, and the harder we make it, the more bloody it will become.

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