Several readers have made comments—some more lucid than others—in response to my earlier post about illegal immigration and health care. The gist of the more understandable disagreements: There's no system in place to verify citizenship, so illegal immigrants will be lining up to get MRIs and prostate exams and whatnot.

As usual, the truth is more complicated, as an effort to block illegal immigrants from using Medicare has shown. The New York Times reports:

Democrats are reluctant to expand those requirements to everyone seeking insurance under a health care overhaul, because several studies on the impact on Medicaid have found that citizenship verification increased administrative costs for states and made it difficult for some American citizens to join the program.

Many of those left out were elderly patients, who did not have originals of identity documents that the 2005 law demands.

“Many states view the proof of citizenship as very onerous on American families,” said Diane Rowland, executive director of the Commission on Medicaid and the Uninsured at the Henry J. Kaiser Family Foundation, speaking of the Medicaid requirements.

In six states that were reviewed in 2007 by the House Committee on Oversight and Government Reform, verification increased federal costs by $8.3 million, but only eight illegal immigrants were detected on the Medicaid rolls of the states.

So on the one hand, opponents of reform complain that government wastes too much money. On the other hand, they think it's worthwhile to spend $8.3 million to root out eight illegal immigrants. And, in the process, deny care to some elderly Americans who don't have the right paperwork. Sounds like some folks are just fine with death panels that decide your fate based on whether you held onto your birth certificate for eight decades.

The whole story is worth a read, but this is an important point:

Some of the concerns raised at public meetings about the health care bills seem to be grounded in misleading information in the news media and on the Internet from conservative opponents of the overhaul. In one example broadcast last week on Fox News, the conservative host Sean Hannity said

that a Congressional Research Service report had concluded that the current plan before the House of Representatives “does not contain any restrictions on noncitizens,” whether or not they had lawful immigration status.

In fact, the report issued Aug. 25 by the research service, a nonpartisan arm of the Library of Congress, states that “unauthorized aliens would be barred” from receiving any federal subsidies under the measure.

And this detail:

Public health researchers say that it could be counterproductive to bar illegal immigrants entirely from public care. “They’re here, and they get sick,” said Ms. Rowland of the Kaiser Foundation.

Citing the current swine flu pandemic, she said, “The H1N1 flu doesn’t know about immigration status when it attacks.”