Dr. Manny: American citizenship should not be for sale

I know that immigrants built this country, and that today our society is the product of many different cultural influences coming together to create the American way of life. Nearly every aspect of our country has been enriched by the beautiful beliefs and customs that our immigrant ancestors brought to America with them.

Today, politicians on all levels are weighing in on immigration policies and ways to protect our borders. Nearly everyone has an opinion when it comes to finding a way to ensure that people coming to this country are doing so for the right reasons and will respect what our country stands for. This topic continues to dominate the news cycle because unfortunately not everyone coming to the country is entering for the right reasons— or necessarily by the right means.

Back in March I weighed in on the topic of birth tourism and voiced my opinion as a practicing OB-GYN. I wrote about my experience seeing women arrive at our New York airports almost ready to give birth, and how dangerous these situations can be because we have no knowledge of their previous medical history, or whether the patient had been receiving proper prenatal care. What prompted me to weigh in on the topic was a report detailing a raid in Southern California, where federal officials found “Chinese birthing houses,” or “maternity hotels,” in which wealthy Chinese couples were paying up to $80,000 to stay to have their child born in the United States, thus guaranteeing the child’s American citizenship.

I was hoping that birth tourism would be a fleeting trend, and that the Southern California incident would be isolated because, as I stated then, this is not the right way to grow our country. However, what I am seeing now is that the trend has become a booming business opportunity for some institutions, and that these groups are employing American citizenship as a genuine marketing strategy to entice foreign women to come to the U.S. and deliver their children for a substantial fee.

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Just yesterday FoxNews.com published a story on AmeriMama, a program at Meadowlands Hospital Medical Center in New Jersey, which charges Russian mothers anywhere from $8,500 to $27,500 and promises to secure citizenship papers, passports and travel visas for the baby. The company operates under the slogan “Childbirth in New York is the best investment in the future of your family!”

My first question after hearing about this program was, is it illegal? From a medical perspective, I can’t find a reason to say that it is. From what I understand, the law is only broken if a pregnant patient doesn’t not disclose the purpose of her trip to the U.S. Once she enters the country, nothing stops her from entering a hospital and delivering a child who will then receive an American birth certificate.

My second question was, is it unethical? Ha, let me count the ways. To traffic health care for profit— while knowing perfectly well that delivering a child without the doctor’s full comprehension of the mother’s health history could harm both the baby and mother— is, to me, completely unethical. Second, when a woman buys into a gimmick like this, she doesn’t necessarily know anything about the quality of the doctor who she will be under the care of in the U.S., nor will she be familiar with the quality of the hospital providing the delivery services.

Moreover, what happens if a complication does arise? Any mild-to-moderate complication for a mother or her newborn could place tremendous financial risk on not only the individual, but also on the state. Most of the medical bills stemming from the patient’s case will become bad debt, and such deficits from the hospitals typically trickle down to affect the taxpayer. Still, with all of this risk involved, programs such as AmeriMama and “birthing houses” largely contribute to the estimated 40,000 babies born to couples vising the U.S. each year.

The federal government, along with states and medical licensing boards must step in and crack down on these practices. According to the report on AmeriMama, this is the first instance of an American for-profit hospital openly marketing U.S. citizenship, but it isn’t necessarily punishable by law. Going forward, there must be some legislation that forbids hospitals and medical centers from participating in such practices. Our medical community should not be affiliated with any independent groups that operate with such a careless attitude for the health of our country. American citizenship should not be for sale, and if we want to maintain our health care at its current level, representing a major pinnacle of our culture, we should require it stick to what it knows best— which is providing medical care.