About the Book
Probes the relationship between the immigration and health care systems in the United States.
For the roughly ten million undocumented immigrants living in the United States, federal health care coverage is out of reach. Barred from Medicare, Medicaid, and the Affordable Care Act, most rely on hospital emergency rooms when they get sick, or clinics that don't inquire about immigration status. Further obstacles to health care, including discrimination and the fear of deportation, mean that immigrants, undocumented or not, seek and receive less medical attention than any other population in the country. Yet immigrants haven't always been ostracized from health care in the United States—providers and activists have for over a century worked to make medical services available to newcomers and migrants, including, at times, the undocumented.
Drawing together stories from diverse communities from the mid-nineteenth century to the present, Borders of Care examines how health care in the United States has both included and excluded immigrants. Beatrix Hoffman analyzes both the health and immigration systems, adding to our understanding of why these structures, and the policies that support them, have resisted reform. Moreover, she shows that immigrants, often scapegoated as burdens on the health-care system, have strengthened it through their responses to systemic exclusion. By creating hospitals and clinics, serving as practitioners, fighting for safer workplaces, filing lawsuits, organizing and protesting, immigrants and migrants have improved medical access for everybody and advanced the idea of health care as a universal right. As accessible as it is authoritative, Hoffman's survey could not be more timely.
Table of Contents:
Introduction: Two Broken Systems
1. Immigrant Health Threats, Immigrant Health Action
2. Health Care in the Era of Restriction and Expulsion
3. Insuring, Exploiting, and Caring for Migrants
4. From Access to Rights
5. Health Politics as Immigration Politics
6. Violence against Health
7. Undocumented, Uninsured, Unafraid
Epilogue: From Pandemic to Power
Acknowledgments
Archives Consulted
Notes
Index
About the Author :
Beatrix Hoffman is professor of history at Northern Illinois University. She is the author of Health Care for Some: Rights and Rationing in the United States since 1930 and The Wages of Sickness: The Politics of Health Insurance in Progressive America.
Review :
“This complex, somber book about US health care exposes how foreign nationals provide the United States with many health workers, even when they have no official right to receive that care. Historian of medicine Beatrix Hoffman notes that the many politicians who portray foreign nationals as a burden on medical resources ignore the fact that ‘both the health care system and the immigration system are fundamentally broken.’ Of US nurses who died of COVID-19, 20–30% were Filipino Americans and Philippine migrants.”
“Hoffman's wide-ranging study of the immigration and health care systems’ connected inequalities offers an important scholarly contribution on its own, and her analysis of immigrant and migrant responses to such restrictions and exclusions profoundly enhances the significance of this book. . . . Borders of Care is a critically important work for scholars interested in immigration and medical history.”
“A rich history of the struggle for medical care in the United States of not just migrant and immigrants but of the general United States population. . . . Borders of Care, with its impressively extensive bibliography, offers a methodically documented history of how immigration and healthcare access have been rhetorically linked in the United States. As Hoffman argues, by placing unwarranted blame on a vulnerable population, politicians managed to (and still continue to) obscure systemic flaws in how healthcare is delivered/accessed by American citizens. This book is a great reference for anyone interested in cultural studies, public health, rhetoric, and/or political science.”
“A fascinating analysis of the American immigration and health care systems, asserting that both are broken and fail to meet immigrant needs for health care access or the needs of the US economy for a steady supply of immigrant labor. . . . Essential.”
“Hoffman is not only one of this nation’s leading historians of medicine, but with Borders of Care she’s also proven to be a leading historian, period. She has bravely taken on our two most screwed up realms, the border and health care, and shown how intertwined they are. Every page features a telling story, an under-reported fact, a trenchant analysis.”
“In this deeply researched book, Hoffman chronicles the tangled histories of immigration and health care in the United States. She exposes a long-running conflict between our idealized values of universal care and the persistent fact of exclusionary policies. Through individual stories, collective campaigns, and analyses of larger structures of political economy, this history shows how the denial of basic rights has had immediate and mortal consequences. Hoffman also shows how people have organized in the face of tremendous opposition to make decent medical care a reality. This affecting and incisive work is essential reading for scholars, advocates, and policymakers.”
“Borders of Care presents a sweeping and wide-ranging history of migrants’ treatment in the American healthcare system. Hoffman’s vivid and engaging narratives offer fresh insights into migrants’ varied experiences of inclusion and exclusion, as well as how their activism helped establish new rights for all American residents. Timely and deeply illuminating, this book ultimately reminds us of the profound dysfunctions of America’s immigration and health care systems.”
“Borders of Care provides a twentieth-century history of medical access, as seen through the experiences and campaigns of migrant communities, their advocates and their neighbors. By centering the century-long experience of immigrant communities, Borders of Care provides a guide to understanding the future of medical care in our multi-ethnic, transnationally connected United States. This is a model of inclusive, empathetic historical analysis.”
