Outline: Health insurance policy and the immigrant U.S. latino working class

Wednesday, October 06, 2004
Medical Anthro Paper Outline
October 6, 2004
Yongho Kim
Medical Anthropology 239

Paper Outline: Health insurance policy and the immigrant U.S. latino working class

During my summer volunteer work at Centro de Derechos Laborales [Workers’ Rights Center], a community program at Minneapolis focused in self-education, organization and mobilization for immigrant latinos’ rights as workers in the United States, I gained a quick glimpse on the state of the health insurance and worker’s compensation among immigrant workers in Minnesota.

Administration of the health insurance program is complex and offers multiple chances for immigrants workers, who often lack english skills and to an increasing ratio are also illiterate, to be abused or left in a procedural limbo while waiting for proper insurance funds to arrive to them. Many are left in a position to choose between hiring a lawyer to claim an uncertain workers’ compensation payment that increasingly is dependent upon the worker’s immigration status, and not taking action and trying to cover the costs from regular income, which may lead to an eventual bankruptcy for the worker and her/his family.

In particular, when workers are injured at the workplace, companies prefer to send them to company doctors, who are paid by the company to keep all costs down, including that of the health care for their workers. These company doctors then refer them to company health professionals to aid them with other administrative work, and try to diagnosticate symptoms to the minimum, occassionally bringing upon a more serious (and more expensive) health hazard. Company health professionals also look for reasons to not provide health insurange funds to the worker, the chief motive being the worker’s often unstable immigration status.

On the other hand, in the context of racist police profiling against immigrants after the crumble of the Twin Towers in New York City, immigrants in the U.S. are increasingly hesitant to report themselves when health crisis situations such as automobile accidents occur.

The first, theoretical, approach of this paper will be to understand this series of hostile circumstances that immigrants are put against with respect to public and private health services as a particular cultural environment in which they need to operate in order to insure survival. Reports from health organizations and researchers will be analyzed with an eye to strategies adopted by immigrant families to cope with the circumstances.

Nationally, because of the strongly mexican and wage labor influx of latino immigrants, a great majority of working class U.S. latinos are uninsured. The second emphasis of this paper will be an assesment of initiatives taken by local clinics, attorneys, Qualified Rehabilitation Consultants (QRCs), and immigrant health advocates at the Twin Cities looking at the uniqueness of the working-class immigrant latino community and its possibilities and dangers. Within this second approach, structural questions will be asked in order to find possibilities for improvement. Is there a greater possibility of a succesful health issues/policies education campaign in the latino immigrant community because of its linguistic cohesiveness and extensive network of non-profits already established through other loosely related issues? What characterizes immigrant U.S. latinos as a target of health care in comparison to other recent immigrant groups in the Twin Cities, such as the Hmong and Somali? Do these differences make the task more or less difficult? Are there any structural incumberances to the current distribution of tasks in the health care industry targetted at latino immigrants?

Throughout these two approaches – a cultural understanding of health survival strategies in the general immigrant population across the U.S. and a structural analysis of local latino health care initiatives – the paper aims to provide an overview of health insurance policy and the U.S. latino immmigrant working class in the context of the Twin Cities.

Outline

• Brief historical outlook on latino immigration and the development of health institutions and policies. (1 page)
• Relationship of immigration policy and social security mechanisms (1/2 page)
• Case Study 1: Emergency rooms, Immigration, and the reaction of the non-profit community (2 page)
• Coping strategies for health care procedures as a form of cultural adaptation. (4 page)
• Latino health and the marketting of a people (4 page)
• Case Study 2: Casa de Esperanza and long-term strategies of social balance (2 page)
• Case Study 3: Insurance companies, QRCs, doctors and the worker’s compensation (3 page)
• Final observations (1 1/2 pag)

Tentative Bibliography
Brodie, Mollyann et all. “Perceptions of Latinos, African Americans, and Whites on Media as a Health Information source” The Howard Journal of Communications, vol. 10 (1999): 147-67
Brown, Richard E. and Yu, Hongjian. “Latino’s access to employment-based health insurance”, In Latinos : remaking America, ed. by Marcelo M. Suárez-Orozco and Mariela M. Páez (Berkeley, CA: 2002): 236-53
Managed Cre Weekly Digest editors. For U.S. Latinos, shared heritage has an impact on health. July 5, 2004
Hayes-Bautista, David E. “Latino health research agenda for the twenty-first century”, In Latinos : remaking America, ed. by Marcelo M. Suárez-Orozco and Mariela M. Páez (Berkeley, CA: 2002): 215-35
National Council of La Raza. The Health of Latino Communities in the South: Challenges and Opportunities: Report on the Findings of the National Council of La Raza Institute for Hispanic Health’s Health in Emerging Latino Communities Project. (2004)
Vargas, Lucila and dePyssler, Bruce J. “U.S. Latino Newspapers as Health Communication Resources: A Content Analysis”, The Howard Journal of Communications, vol. 10 (199): 189-205