De Blasio: Billions For Illegals’ Health Care But Not A Cent For Enforcement!

By Paul Nachman

09/16/2016

Bill De Blasio, New York City’s mayor, is downright enthusiastic about illegal immigration. For example, there’s what he said in a recent radio interview:
[The mayor] cheered a Brooklyn supermarket owner who acknowledged hiring undocumented workers.

“Of course you’re running a business and if someone’s willing to work hard for you, you’re going to hire that person,” de Blasio told the caller, who was identified as Thomas in Brooklyn. “And you’re giving them a job that they get to feed a family on, and I thank you for that.”

The caller told the mayor he owns a supermarket in Brooklyn. … “Just as a businessman I’m caught between having these undocumented workers, which I’m not supposed to employ,” and the benefits of doing so.

De Blasio said neither the business owner nor the employees should be penalized, calling the current rules governing immigration “ridiculous."

[De Blasio thanks businessman for hiring undocumented workers, by Rosa Goldensohn, Crain’s New York Business, September 1, 2016]

So, unsurprisingly, the mayor affably told questioners at the late-April unveiling of his Fiscal Year 2017 Executive Budget that the city’s Health + Hospitals Corporation spends more than $2 billion per year caring for "uninsured" patients, a term De Blasio clearly equates with "undocumented."

You can see the discussion for yourself, starting at about 1:36:00 into the video of the proceedings. Wrapping up the exchange at about 1:38:20, De Blasio cheerfully summarized that "'Over two billion' is your first working number. If you report 'over two billion,' you will be accurate."

Seth Barron, a contributor to City Journal, steered me to the video (private communication). Mr. Barron had recently publicized that financial tidbit about the health-care burden on taxpayers of New York City’s illegal aliens, writing online at the journal

One effective metric for understanding the costs of illegal immigration is health care. Because Medicaid is funded partially by the federal government, it is limited to U.S. citizens or lawful permanent residents. But the city’s Health + Hospitals Corporation, which runs New York’s massive public health infrastructure, takes it as its mission to provide care to anyone who needs it, without regard for immigration status. This policy is a major reason why HHC is on constant verge of financial collapse. During the last fiscal year, HHC needed an emergency allocation of $337 million from the city just to keep its doors open, and the prognosis for the future is even worse. At an April press conference, Dr. Ram Raju, president of HHC, said that caring for illegals consumes about one-third of his $7.6 billion annual budget. Rounding down, that means that $2.5 billion — of which the city is picking up an increasingly large chunk every year, as state and federal aid dries up — goes toward providing health care to illegal aliens in New York.

[Undocumented — and Unmeasured, September 2, 2016]

ramanathan-raju-bio

My cost figure — from viewing the video multiple times — is a bit lower than Mr. Barron’s. That’s being conservative, since there are probably also citizens and legally-present aliens among the uninsured served by the city’s public health-care institutions. But De Blasio, HHC chief Dr. Ramanathan Raju (right) and the questioners in the audience were all obviously thinking "undocumented" when they heard or said "uninsured."

Meanwhile, there’s no uncertainty about the $82-billion size of the total executive (i.e. proposed-by-the-mayor) budget. So "free" health care for illegal aliens will consume 2.4 percent to 3 percent of New York City’s anticipated spending for FY 2017.

The $2-billion figure is especially useful for illegal-immigration opponents because of who uttered it. (But for illegal-immigration booster De Blasio, it amounts to a statement against interest.)

Prior to this, the best estimate for the cost to taxpayers of illegal aliens' health care was probably contained in The Fiscal Burden of Illegal Immigration On United States Taxpayers, [PDF] a massive study for the Federation for American Immigration Reform [FAIR] by Jack Martin and Eric Ruark (now at NumbersUSA) that was completed in February 2011. The report gives both costs to the federal government and outlays at the state and local levels, the latter given for each state. Table 12 (page-number 61) lists health-care costs of about $960 million associated with illegal aliens — including anchor-children and children who are themselves illegal aliens — in all of New York state, less than half the amount acknowledged by New York City alone.

So if the FAIR report is inaccurate, as the "hate"-sleuths at the Southern Poverty Law Center [$PLC] would robotically insist, it’s in the direction of underestimating costs.

(Oddly absent from FAIR’s report is a table of state-by-state illegal-alien populations or estimates. Perhaps authors Martin and Ruark used the figures from the contemporary version of FAIR’s online table How Many Illegal Immigrants?. The version available now, dated December 2011, gives an estimate of 750,000 illegal aliens in all of New York state. Meanwhile, Seth Barron’s article at City Journal puts the illegal-alien population for New York City alone between 500,000 and 800,000. Thus the FAIR report’s underestimate of the state’s health-care costs can’t result from a gross undercount of the illegal-alien population.)

Unlike the city’s illegal aliens, the head of HHC appears to be a bargain. The Indian-born Dr. Raju, a surgeon with an impressive resume, [PDF] returned to New York in early 2014 after several years in Chicago as chief of Cook County Hospitals, where his annual salary had been about $500,000. New York City got him back for about $400,000 per year, which seems like a pittance in the context of a $7.5-billion-per-year enterprise. So perhaps it’s just another case of a job native-born Americans won’t do at the offered wage.

It’s clear, unfortunately, that Dr. Raju will be no help in reducing the burden of illegal aliens on the city: According to an article about the speech he gave [PDF] at the May 28, 2014 graduation ceremony for the New York College of Podiatric Medicine, "Dr. Raju spoke about access to healthcare as a fundamental civil and constitutional right, adding that none of us is free until there is equality of healthcare for all of us." We can hope that his prowess as a medical administrator compensates for his constitutional illiteracy.

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