About seven years ago, we sat in on a parents’ meeting at the Lycee Francais Albert Camus in Conakry, Guinea, a country in West Africa. It was more out of curiosity than need, to observe how the French run these things, and the French parents were very nice and inclusive, so who could say no? There was just one item on the agenda that day, the discussion of a scholarship for a student, a Guinean girl. The scholarship had been stalled at the French Embassy for approval; the Embassy questioned whether the family qualified.

The father was there to plead his case. He had a right to French tuition assistance for his daughter because he held a dual French-Guinea citizenship. The head of the Parents Association, a French woman, noted that he’d received a loan from the United Nations Development Program (UNDP) to start a theatre business in a city a few hours from the capital. The man said he hadn’t been able to pay back the loan as the business had failed – too many videos and DVDs available. We listened as they went on to note his current income and so forth. The father argued very persuasively that he qualified.

They then noted that they found it hard to believe he didn’t have means because he’d written down his youngest son had born recently in the USA and was listed on the application forms as a US citizen. It was quite common to meet families in those places with kids born in various countries, a different passport for each kid, so that wasn’t surprising. But the French ladies persisted with their coup de grace, if he didn’t have the means, how did he afford paying airfare and US medical bills for his wife’s delivery in the USA, in an expensive US hospital?

The man sat up and exclaimed, “It didn’t cost us ANYTHING in America for the delivery. It’s FREE!” He spread his hands and absolutely beamed with genuine, delighted awe, “It was wonderful! Beautiful hospital, nurses, doctors, clean, and it was all free! American hospitals are superb and they are all so nice to you!”

To say the flabbergasted looks on the two French women were priceless is an understatement. Rendered speechless, their deer in the headlights eyes met ours … the American in the room … and it took nearly superhuman effort to not burst out laughing at them, lean across the table, high-five and shake the man’s hand, so awesome was this demolishing of the totality of the French conceit of their stereotyped opinions of American health care. It was a good thing though we restrained ourselves, because we would have clasped his hand with delight the one second, and then punched him the next moment.

We have six children, and they were all born in the USA. They weren’t “free.” We pay insurance and co-pay and the hospitals billed us, and quite creatively. We learned early on that 50-cent hospital pacifier was about $10, the “complimentary bag” of mostly manufacturers’ samples was about $100 and so forth. But the bottom line was, the hospital billed us and by extension our insurance company, not just for our children’s births, but for this Guinean man’s son’s birth, too. He scraped the money for an almost two-thousand dollar round-trip air ticket; his wife waddled into a US hospital emergency room and gave birth on our dime. At least we hope she waddled in on her own steam, and didn’t call 911 so the EMTs bought her in … at additional unreimbursed taxpayer expense.

Their son also got a crisp state of the art blue US passport as a US citizen. Mom and baby US citizen flew back to Guinea where he has been raised as a Guinean Susu-Francophone bi-lingual African who doesn’t speak English. But if any emergency which requires the United States Embassy to have to evacuate all US citizens out of Guinea, this boy is on the evacuation list, and would of course, while he’s young, require a family member accompany him. All paid for by the US taxpayer. There are more than hundreds of thousands of US citizens growing up in other countries who were born in the USA, but have no language or cultural ties or affinity for it, they are their families’ emergency exit tickets. International flights have women sitting awkwardly in tight airline seats, late in their third trimesters, claiming they aren’t, headed for the USA every day to give birth.

Frankly, who can blame them? Guinea’s per capita GNP is abysmal – under $500 per year – parking it squarely in the World Bank’s Low Income nations grouping, the world’s poorest nations. Compare that to Mexico’s Middle Income status at about $6,000 per year, and Mexico is what many Americans think of when they think “underdeveloped.” Guinea’s infant mortality runs in the 140 per 1000 live births range while America’s infant mortality runs closer to 5 per 1000 live births – which include the incredibly delicate premature babies. So, if we were Guinean, we’d beg, borrow and steal the air ticket money together and fly to the USA, for the world’s best health care for free, too.

It’s legal, but it isn’t free to provide. Hospitals buy supplies, buy medicines, pay nurses, technicians, janitors, pay electricity, water, heating, cooling, invest in state of the art scanners, x-rays, labs … the costs are numerous. Our bills went up with each child. But the hospitals were scrambling to cover mounting expenses they’d incurred by treating zero-pay walk-ins. No one wants to turn away anyone in need, but when more money goes out than in, hospitals go bankrupt and close, and everyone suffers, so ignoring this is not viable.

This is exactly the sort of problem that Americans expect to be fixed with any “health-care reform,” but there is nothing that addresses this untenable situation, in fact it stands to get worse, a strained and ultimately abusive give-away for foreigners, at the expense of nationals.

Congress is quite capable of crafting a logical and sensible guest-worker program for foreigners who want to work in the USA, which includes a simple requirement for any guest worker to buy and provide proof of a basic healthcare insurance coverage while in the USA. This would provide a huge relief for hospitals with large Mexican and Central American walk-in patient demands, and private insurers would have plenty of new clients to compete for instead of paying out for. Under this, any children born of foreigners in the USA would not be automatically citizens, but have a certificate of birth that requires them to have a set number of years of residency requirement by age 18 before being eligible for permanent US citizenship. Likewise, foreign nationals who make the effort to fly to the USA should be required to have insurance coverage that will pay for any medical costs incurred in the USA during their proposed sojourn. If a Third World woman is on an airplane, chances are she’s got some reasonable means to pay a short-term insurance policy, at a minimum. The poorest people of these nations never get on the plane in the first place, so this current arrangement enables a subsidy to the Middle and Upper Class of the home nations who have simply availed themselves of a golden opportunity on the backs of Americans who buy their own private coverage and take care of their own bills responsibly.