San Diego companies should support charities that tackle the health care crisis at the U.S.-Mexico border, or the health problems could soon be their own, according to a recent report by an international public charity.
Some local business leaders admit border health care is not a priority for them. But others said corporate San Diego just needs a push.
Health care advocates say these issues are already San Diego’s problem. The increasingly large number of uninsured in the county — around 600,000, according to the San Diego County Medical Society — amounts to more seriously ill immigrants and others in the emergency room. Already-struggling hospitals have said it costs them millions of dollars annually, and experts say it eventually causes higher insurance rates.
But the report, published by the San Diego-based International Community Foundation, also encourages companies here to help address the more deadly issue of spreading disease.
Substandard living conditions in Tijuana and among the estimated 10,000 migrant workers living in San Diego County — without electricity, sewers or running water — makes the region a breeding ground for HIV and tuberculosis, and a ticking bomb for the avian flu, the report says.
“There’s many corporations that could be taking a greater role — either philanthropic or otherwise — but they just aren’t there,” said co-author of the report Richard Kiy, the chief executive officer of ICF, which supports nonprofits that do humanitarian work in the United States, Mexico and Asia. According to ICF, 70 percent of its recent donations have benefited projects in Baja California.
Kiy wrote the report, which can be found at www.icfdn.org, with Dr. Robert Bach, a faculty member at the Naval Postgraduate School’s Center for Homeland Defense and Security in Monterey. It came as a result of a round-table among several nonprofits that do health care work at the border.
The report, which took about three months to prepare, cost $25,000 to produce and was paid for by the California Endowment. The ICF released the report late last month.
Binational Health Care
The consensus, nonprofit leaders found, was that corporations were the largest missing piece of the puzzle in developing a binational health care agenda. ICF wants to host a cross-border health summit in 2007 to include stakeholders from both sides of the border, including public and private entities. The report suggests more public/private partnerships and says corporations have an “obligation” to “carve out new mechanisms of system delivery that governments are ill-equipped to even attempt.”
Scott Alevy, the vice president of public policy at the San Diego Regional Chamber of Commerce, said local companies are already “philanthropically active.”
“There’s only so much money in the pot,” said Alevy, who had not read the 40-page report. “If a corporation is committed to giving money to charity, whose right is it to tell them where that money should be? It’s a value judgment.”
Jessie J. Knight Jr., the outgoing chief executive officer of the Chamber of Commerce, sits on ICF’s board of governors.
Local biotechnology firm Genway Biotech Inc., with 22 employees, said, if asked, it may be open to supporting some kind of border health project — perhaps donating materials for research on diseases prevalent in the border region, said Chief Financial Officer Robert Gans.
Gans has spent more than a decade in San Diego’s corporate scene.
“I have not heard any discussion about that issue,” Gans said. “But these are caring, wholesome people. A big reason why they are in biotech is because they want to make the world a better place.”
He said at least one member of his company participates in a group called the Flying Samaritans, which conducts free medical clinics in Mexico. The employee has posted signs about the efforts of the group at Genway, and employees have collected supplies for missions.
“Corporations need to find more avenues for community involvement to balance their aim toward making a profit,” Gans said.
Science Applications International Corp. declined to comment for this story, and Qualcomm Inc. — two of San Diego’s largest firms — did not return phone calls and e-mails before press time.
Cross-Border Risks
The ICF report says Tijuana’s HIV rate is nearly three times as high as the average HIV rate for Mexico, and tuberculosis is still a looming problem there. Kiy and local health care leaders have said the uninsured and poor often go untreated, and therefore San Diego could be susceptible to the spread of these diseases.
The report calls pandemic flu the most “plausible, catastrophic cross-border risk,” saying that the region has the busiest port of entry in the world, two international airports, commercial and military seaports, and a cross-border rail system.
Urban slums and “squatter communities,” which make up about 40 percent of Tijuana’s residential areas, according to the report, have no electricity or running water.
These conditions are not just in Tijuana. The report says that 10,000 migrant workers live in camps in San Diego without the same necessities. It also points out that San Diego’s high housing costs force many families to double or triple up in apartments, and that some Mexican families on both sides of the border live near chickens, raising them for food or cockfights.
“These sub-standard living conditions are potential bird flu incubators,” the report says.
Pressure to reopen borders and resume commerce as soon as possible will make closing ports of entry minimally effective in the event of a bird flu outbreak, according to Kiy and Bach.
While Bach worked for several years as a college professor and also in the immigration service at the U.S. Department of Justice, Kiy is a Harvard University graduate and a former vice president at SAIC who worked on business development overseas. Kiy has held posts at the U.S. Department of Energy, the U.S. Embassy in Mexico and the U.S. Environmental Protection Agency.
Kiy said San Diego tends to have a “cul-de-sac” mentality that could prove dangerous.
“We need to get policy-makers to look more holistically at these issues,” Kiy said.
The report says 200,000 American retirees live in Mexico, and it proposes extending Medicare benefits to them.
It also proposes that more companies increase access to health care by offering workers a binational health plan option. There are now three companies in the region offering them — Blue Shield, Health Net and Mexico-based Sistemas Medicos Nacionales, or Simnsa. The details of the plans vary, but advantages include health care costs in Mexico that are 30 percent to 50 percent less than U.S. rates and the opportunity for immigrants or legal workers to communicate about their health in their native language.
Establishing Priorities
The chamber’s Alevy, who generally regarded the report as a ploy for donations, said, “Everyone gets hit up for every cause — Little League, health care, soccer, you name it.
“There’s a thousand nonprofits. Corporations are challenged by requests constantly for their philanthropy, and they have to make priorities.
“If the report feels that those are not what they should be, it’s every corporations’ right to put their funds where they should go.”
But the ICF strongly suggests that health care should be a top priority for corporate giving. And Kiy says that statistics are difficult to dispute.
His research shows that the pandemic flu could kill hundreds of thousands and cause 40 percent of the area’s work force to remain at home.
Also, in 2005, sprains and strains of migrant workers cost the U.S. agriculture industry an estimated $1.3 billion from lower productivity and lost hours of work.
“The goal ultimately is to try to catalyze more partnership,” Kiy said. “We’re not fooling ourselves. We know we’ve got a lot of work to do.”
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