The American healthcare system is dominated above all by pecuniary concerns, premised on the extreme form of capitalism practiced in America. When canvassing on the issue of the healthcare of immigrants, the finances will, therefore, feature as a major bearing factor. Further, the issue of immigrants in America is compound as it entails documented and undocumented immigrants (Byrd & Clayton, 2015) . The American healthcare system considers these two groups of immigrants very differently. These differences are reflected both on the issue of actual access to health care as well as ability to afford healthcare services. Finally and mainly from a cultural and preference perspective, Americans have been known to have a high affinity for visiting healthcare facilities for emergency purposes and otherwise (Hacker et al, 2015) . This trend has, however, not be deemed to apply to immigrants whose affinity for visiting healthcare facilities is exponentially lower. For undocumented immigrants, this affinity is literally diminished. Therefore, both being an immigrant and one’s immigration status is an important bearing factor upon the access to healthcare in America.
The Cost Perspective
The USA has some of the most advanced healthcare systems globally from academia, research, equipment to pharmacological advancements. However, this is available at exponentially steep prices, some of which have been found to be prohibitive for the poor (Byrd & Clayton, 2015) . Unfortunately, with very few exceptions, immigrants, both documented and otherwise mainly fall within the definition of the poor in America. It is, therefore, almost impossible for the poor to have access to premium health care services. Indeed, even primary health care services are beyond the purview of the pecuniary capacities of most ordinary immigrants in America. This leaves two avenues for them to access healthcare. The first is through insurance, with the second being through avenues specifically put in place to cater for the poor.
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Healthcare Insurance
Insurance kindred to healthcare is one of the largest healthcare based industries in the USA. A majority of citizens and documented immigrants having various varying forms of healthcare insurance covers (Byrd & Clayton, 2015) . The issue of cost is a major bearing factor for health insurance. Indeed, most premium service healthcare insurance is prohibitively expensive for the poor. As indicated herein above, a majority of immigrants in America, do happen to be poor. Fortunately, the Patient Protection and Affordable Care Act is popularly known as Obamacare provides subsidized health insurance for the poor (Hacker et al, 2015) . This subsidization is also available for the documented immigrants, a fact that gives them an edge over their undocumented counterparts. Indeed, to qualify for Obamacare, an immigrant’s status needs to be pristine. Even the recognized immigrants known as ‘dreamers’ who are immune from deportation do not also qualify for Obamacare. However, those who eventually qualify for Obamacare can get useful, albeit not premium health insurance at quite affordable prices. Health insurance has become like a ticket for health care access, a fact that ensures the at least primary health care for insured documented immigrants in America (Hacker et al, 2015) . It must, however, be noted that this insurance is not of a premium nature and the services available still come with some levels of limitations. For undocumented immigrants who can afford it, health insurance can be available but at premium prices. However, only very few of them can be able to afford it. It is worthy of notice that the low affinity of immigrants to visit health care institutions makes them a very lucrative market for health insurers. A general exception to this rule applies to students as they can benefit from school health insurance programs (Zamosky, 2014) . As a matter of policy, immigration status is not a bearing factor for school enrollment in America.
Institutions Established To Cater for the Poor
Based on the analysis above it is clear that a majority of undocumented immigrants, as well as the very poor documented immigrants, have no access to medical insurance. This makes it is almost impossible to be treated in healthcare institutions under normal circumstances. Three general exceptions, however, exists for them (Zamosky, 2014) . The first is the community hospital option. Almost all community hospitals benefit from federal funding. As a rule, therefore, the emergency rooms of this hospitals are bound to accept and treat all patients who are brought in. However, the said treatment is strictly limited to stabilizing the patient, after which the hospital has no legal obligation to continue treatment. The stabilized patient is then obliged to seek further treatment elsewhere. The second option is the community health clinics of which there are about 1400, spread across the USA (Zamosky, 2014) . These clinics provide extremely subsidized services with patients having to pay between US$25 and US$75 for the services. Whereas most of them provide primary health care services, some of them offer advanced medical care. The final option for the poor and undocumented immigrants is the charitable healthcare such as the one provided by medical schools and charitable organizations. There are also non-economic bearing factors that hinder undocumented immigrants from accessing health care such as discrimination and the fear of deportation (Zamosky, 2014) . These issues are, however, being informally handled to ensure that one’s immigration status does not become a death sentence in the case of a medical emergency.
Whereas there may be a few non-economic bearing factors on the subject of immigrants and immigrations, most factors are economic in nature. Healthcare services are expensive in America and only very few immigrants, documented or otherwise, can afford them out of pocket. This brings in the complex issue of health insurance, which is also mainly too expensive for immigrants. However, federal subsidization makes it affordable but only for the documented immigrants. Those who are undocumented have to make do with the extremely expensive commercial options unless they qualify for school programs. The other alternative is community hospitals for emergencies, community clinics for subsidized care, and charitable organizations as and when available.
References
Byrd, W. M., & Clayton, L. A. (2015). An American health dilemma: Race, medicine, and health care in the United States 1900-2000 (Vol. 2). New York: Routledge
Hacker, K., Anies, M. E., Folb, B., & Zallman, L. (2015). Barriers to health care for undocumented immigrants: a literature review. Risk Management and Healthcare Policy, 175-183. doi:10.2147/rmhp.s70173
Zamosky, L. (2014, April 27). Healthcare options for undocumented immigrants . Retrieved July 17, 2017, from http://www.latimes.com/business/la-fi-healthcare-watch-20140420-story.html
