The red hot topics of immigration across the Mexican border and infectious disease epidemics converged this month when Rep. Phil Gingrey (R-GA), a retired obstetrician-gynecologist, claimed that “illegal migrants carrying deadly diseases such as swine flu, dengue fever, Ebola virus, and tuberculosis” represent a threat to American health and well-being.
It is a new, if very old argument in the immigration wars, but Dr. Gingrey’s suggestion, in a letter to the director of the Centers for Disease Control, is unusually dim-witted. Were I, an infectious disease guy, to write to a federal agency about an obstetrical matter, I at least would run my tractate past a colleague in the OB field. Gingrey, apparently, was in too big a hurry to have a friendly local ID expert point out that swine flu is not in season (indeed, the brief dust-up of a few cases among immigrant children reported a week ago has gone nowhere fast); that dengue fever is not transmitted person to person; and that Ebola has not appeared in the Americas—North, South, or Central—and shows no signs of doing so. OK, so TB is always a threat, sort of, but we know how to screen for it and, from the evidence one can find, are doing so not only at the Mexico entry point but across all immigration points.
After that misstep, though, Gingrey went on to give the world of public health a great deal to cheer about. Unlike his conservative colleagues Michele Bachmann, Ron Paul, and perhaps his lad Rand, Gingrey endorsed mandatory vaccination.
Of course it is not altogether clear that he meant to. Gingrey stepped in it during the great Todd Akin rape-can’t-result-in-pregnancy debate, suggesting that getting pregnant, or not, was somehow under a woman’s control in a mind-over-matter sort of equation. So it is not certain that he has opted to leave the shadows and head toward the bright lights of an evidenced-based belief system.
No matter—in his letter to the CDC, Gingrey also wrote: “Many of the children who are coming across the border also lack basic vaccinations such as those to prevent chicken pox or measles. This makes those Americans that are not vaccinated—and especially young children and the elderly—particularly susceptible.” In other words, vaccines work! And they are necessary! And people, citizens and “migrants” alike, should be required to receive them! Wow.
And the reason? The health of you and me (OK, of employed, all-American guys): “Reports have indicated that several border agents have contracted diseases through contact with the unaccompanied minors. As the unaccompanied children continue to be transported to shelters around the country on commercial airlines and other forms of transportation, I have serious concerns that the diseases carried by these children may begin to spread too rapidly to control.” Hear that? Infectious diseases are (a) infectious and (b) preventable with a simple shot.
But it gets even better. Gingrey, an outspoken critic of the Affordable Care Act, has kicked the legs out from one of the most durable arguments in the anti-ACA repertoire—that everyone in the U.S. actually has health insurance. It’s called the ability to go to an emergency room, a place that, by law, cannot toss you out on the basis of your ability to pay.
That argument might be convincing if not for its total disregard for health-care quality, cost, human decency, waiting times for those with true emergencies, relegation to second-class status for one and all sitting breathlessly in an overcrowded, under-ventilated ER—and this: ERs are just like “commercial airlines.” They are places where people sit cheek to jowl, maybe sneezing, maybe coughing, maybe puking. Actually, the ER is much worse than seat 23A on Delta 317 because the people on the airline are feeling well enough to fly that day, whereas the guy across from you in the ER, sweating and pale, is sitting there because he’s sick.
So in the guise of being an out-of-touch geezer railing in high crank against the CDC and migrants, and all manner of threats, Gingrey has given those interested in public health, health, and health care something new to develop arguments with. He has said, accidentally or not, that the refusal to vaccinate our children and our short-sighted use of ERs as medical homes pose a substantial health threat—surely a greater risk that the appearance on our shores of migrant-mediated Ebola virus.