U.S. immigration reform and illegal immigration came up again and again during President Bush's tour of South and Central America. Some 12 million illegal immigrants live in the United States, many from Latin America. A large number of immigrants, including legal immigrants, have little or no access to health care, except in emergencies. VOA's Carol Pearson takes a look at what kind of medical care is available for these immigrants.

For some 46 million Americans, health insurance is out of reach: it is too expensive. Non-Americans living in the U.S., both legal and illegal, face the same problem.

Dr. Dubard speaking with a patient

Dr. Dubard found, with respect to health care, some recent immigrants are in the same situation as many American citizens.

"These are working families. They are often working in jobs where their employers are not providing health insurance benefits, and they aren't earning wages sufficient to purchase their own coverage," she says.

Dr. Dubard tallied emergency Medicaid spending in the southern U.S. state of North Carolina for four years to see who was getting emergency aid. Her findings: less money goes to emergency health care for immigrants than most Americans think.

Recent legal and undocumented immigrants accounted for only a small portion of the total Medicaid budget. And of those immigrants, certain groups stood out.

"Nine out of ten [people] were pregnant women receiving care for labor and delivery or for emergency complications of their pregnancies," says the doctor.

Many women in the study had no access to prenatal care and nowhere else to go but a hospital emergency room. Dr. Dubard also found emergency care spending for elderly and disabled immigrants increased during the study. "We are spending at the wrong end of care. We could stretch the health care dollar further by emphasizing preventive care."

Dr. Dubard says the study shows that as the government makes plans to reform American health care it should consider the health care needs of immigrants. The study has been published in the Journal of the American Medical Association.

Video courtesy of Journal of the American Medical Association