Of course not. America is a civilized country and we won't let suffering people within our borders go untreated. So, an ambulance rushes him to a hospital emergency room and he spends as many nights in the hospital as it takes to treat him. He pays nothing because he has no money. The roofing contractor doesn't pay either (his motto: privatize profits, socialize costs). The illegal alien's cost is simply added to the bills paid by people with insurance.
No, the big issues about illegal aliens, health care, and amnesty revolve around the indirect effects on the birthrate that nobody is supposed to think about in modern America.
If the roofer eventually goes home to Latin America because there is no construction work anymore in America without fathering any children in the U.S., then the costs he imposes on us are finite. If, however, he fathers a number of anchor babies within the U.S., then the costs become long term and difficult to fully foresee.
Clearly, one reason for Obama's repeated announcements that he's going to push through "comprehensive immigration reform" Real Soon Now is to dissuade unemployed illegal immigrants from going home: Sure, it's cheaper to be unemployed back home in Mexico than in LA, but you'll miss out on the amnesty if you leave now.
Add to that Obama's message to the Congressional Hispanic Caucus Institute on Wednesday that the 12-million (or whatever) illegal aliens he intends to amnesty in 2010 would benefit from his subsidized health insurance, and you have another inducement for them to stay here, or to rush on in, even though there aren't jobs, so they'll be on the amnesty list next year.
A massive question that nobody thinks about other than Democratic political strategists is whether the synergy of Obama health and amnesty plan attracts maternal-minded women from Mexico. Maternal-minded women tend to be more cautious than men about crossing the border illegally and living without health insurance for their children. Plenty of them do sneak in anyway and have babies (according to the Public Policy Institute of California, the 2005 total fertility rate for foreign-born Latinas in California was 3.7 babies per lifetime, versus 1.6 for American-born whites and 1.4 for American-born Asians, and about 2.4 in Mexico itself — the U.S. is attracting Mexican women who can't afford to have as many children as they want in their own country).
But think about what's coming if we have another amnesty and we have subsidized health insurance.
We know that the 1986 illegal alien amnesty, even without health insurance, brought in a flood of women from south of the border, who then had an extraordinary number of children in California over the next eight or so years. Demographer Hans P. Johnson of the Public Policy Institute of California wrote:
”Between 1987 and 1991, total fertility rates for foreign-born Hispanics [in California] increased from 3.2 to 4.4 [expected babies per woman over her lifetime]. ...
”Why did total fertility rates increase so dramatically for Hispanic immigrants? First, the composition of the Hispanic immigrant population in California changed as a result of the Immigration Reform and Control Act (IRCA) of 1986. In California alone, 1.6 million unauthorized immigrants applied for amnesty (legal immigrant status) under this act. The vast majority were young men, and many were agricultural workers who settled permanently in the United States. Previous research indicates that many of those granted amnesty were joined later by spouses and relatives in the United States... As a result, many young adult Hispanic women came to California during the late 1980s. We also know that unauthorized immigrants tend to have less education than other immigrants and that they are more likely to come from rural areas. Both characteristics are associated with high levels of fertility. As a result, changes in the composition of the Hispanic immigration population probably increased fertility rates.
This post 1986 amnesty-induced Latino Baby Boom is one of the sizable events in recent American social history and a major contributor to California's current dire financial straits, yet it simply is off the media map as if it never happened. I've been whooping about it for seven years, but I don't recall anybody else ever mentioning it. The national Baby Boom of 1946-1964 is rehashed endlessly, but this more recent and more relevant Baby Boom is utterly unknown.
When it comes to health insurance by itself, I don't have a strong opinion. The current system of employer-provided insurance, which is a byproduct of a loophole in WWII wage controls, is ridiculous. If this was Finland, with negligible immigration and a broadly skilled and healthy population, I'd probably be fine with the government-dominated health insurance system they have there. But, we're not Finland. As Milton Friedman said at the 1999 World Libertarian Conference: "You cannot simultaneously have free immigration and a welfare state."
Many have commented on the craziness of trying to hold a debate over health insurance, when there are multiple plans floating around, each 800 pages long. Worse, though, we're not supposed to publicly debate (or even think about) the most important impact of these bills: the long-term impact on the population.