Bringing Mother to the States

[LIFE'SJOURNEY 970]

Maybe I have live it, my mother was a USC, and she couldn't even get healthcare before she DIED. So until you have lived it, you don't know what the cost is to you. I am not just talking $$$$$. Can you live with that, b/c you don't have healthcase, then there are services she can't get that might have savd her life.

I have experience wehat 5 days in ICU and a surgery cost, $100.000.

Oh , that was the 1st heart attack, the 2nd one happen 7 days later, that was another 50,000. Then the prescriptions that cost $60-$100 per 30 days supplies. But wait the medicine isn't working, so now you have buy a different one. Yea, now she taking 10 differents pills a day.

So now you have to decide between buying food or medicine.

Oh I forgot to add the hospitalization didn't end with the 2nd heart attack, other illness started to developed, and my mother wasn't even 60 years of age.

[sergeman 0]

Maybe I have live it, my mother was a USC, and she couldn't even get healthcare before she DIE. So until you have lived it, you don't know what the cost is to you. I am not just talking $$$$$. Can you live with that, b/c you don't have healthcase, then there are services she can't get that might have savd her life.

I have experience wehat 5 days in ICU and a surgery cost, $100.000.

Oh , that was the 1st heart attack, the 2nd one happen 7 days later, that was another 50,000. Then the prescriptions that cost $60-$100 per 30 days supplies. But wait the medicine isn't working, so now you have buy a different one. Yea, now she taking 10 differents pills a day.

So now you have to decide between buying food or medicine.

Oh I forgot to add the hospitalization didn't end with the 2nd heart attack, other illness started to developed, and my mother wasn't even 60 years of age.

I'm really sorry for your loss. I'm sorry that your mother did not have any insurance and you now in huge debt. But, I'm still willing to care for my mother. In worst case I will live in debt, but with peace in my soul.

[Brother Hesekiel 2,236]

Sergeman,

you don't understand: we don't care if you get into debt or die in a cardboard box. Not at all.

You are an adult and you have every right to make your own decisions. Up to a point, and this point is reached when it becomes apparent that an intending immigrant may need lifelong assistance, which happens if, for example, your mom will most likely not be able to pay at least 10 years of full time work into Social Security, hence, no money back.

Here's the passage that matters:

Age and Health of Prospective Immigrant

Both USCIS and Department of State are required to consider the immigrant's age, health, and ability to support themselves when making the public charge determination. This requirement is based on INA section 212(a)(4)(B):

http://www.uscis.gov...190aRCRD&CH=act

Factors to be taken into account.- (i) In determining whether an alien is excludable under this paragraph, the consular officer or the Attorney General shall at a minimum consider the alien's-

(I) age;

(II) health;

(III) family status;

(IV) assets, resources, and financial status; and

(V) education and skills

Only after considering these things, will DHS or DoS consider the affidavit of support:

(ii) In addition to the factors under clause (i), the consular officer or the Attorney General may also consider any affidavit of support under section 213A for purposes of exclusion under this paragraph.

Both the Adjudicators Field Manual (DHS) and Foreign Affairs Manual (DoS) refer to the "totality of circumstances", and specifically refer to INA 212(a)(4)(B). Some specific references in the Foreign Affairs Manual:

http://www.state.gov...ation/86988.pdf

9 FAM 40.41 N4.3 Family Status

You should consider the marital status of the applicant and, if married, the number of dependents for whom he or she would have financial responsibility.

9 FAM 40.41 N4.4 Applicant's Age

You should consider the age of the applicant. If the applicant is under the age of 16, he or she will need the support of a sponsor. If the applicant is 16 years of age or older, you should consider what skills the applicant has to make him or her employable in the United States.

9 FAM 40.41 N4.5 Education and Work Experience

You should review the applicant's education and work experience to determine if these are compatible with the duties of the applicant's job offer (if any). You should consider the applicant's skills, length of employment, and frequency of job changes. Even if a job offer is not required, you should assess the likelihood of the alien's ability to become or remain self-sufficient, if necessary, within a reasonable time after entry into the United States. (See 9 FAM 40.41 N4.7.)

9 FAM 40.41 N4.6-1 Aliens Subject to INA 212(a)(4)©/(D)

An alien who must have Form I-864, Affidavit of Support Under Section 213(A) of the Act, will generally not need to have extensive personal resources available unless considerations of health, age, skills, etc., suggest that the likelihood of his or her ever becoming self-supporting is marginal at best. In such cases, of course, the degree of support that the applicant will be able and likely to provide becomes more important than in the average case.

This means that an affidavit of support is not simply a backstop in case the immigrant requires support. They may conclude that it's virtually guaranteed that the sponsor is going to have to support the immigrant (and derivative family members), and require proof that the sponsor is capable of doing this for an indefinite amount of time.

With thanks to VJ Member JimVaPhuong who once researched this so thoroughly.

[sergeman 0]

Sergeman,

you don't understand: we don't care if you get into debt or die in a cardboard box. Not at all.

Good to know, thank you

This means that an affidavit of support is not simply a backstop in case the immigrant requires support. They may conclude that it's virtually guaranteed that the sponsor is going to have to support the immigrant (and derivative family members), and require proof that the sponsor is capable of doing this for an indefinite amount of time.

Brother Hesekiel,

Here is my plan. I can afford and I am going to pay for the medical insurance. The only my concern here is an emergency surgery with the cost over $200K. If such event happened, I can negotiate payment plan with hospital and pay off my debt in 2-3 years. In worst case scenario I can back it up with my 401K or my property.

Now question to you. Do you find immoral to let elderly parent die alone far away from family?

[Boiler 45,486]

So you have a situation where the Parent has one child and no other relations.

The child emigrates, presumably as it is on this forum by Marriage with no great concern about leaving the Parent.

4 years ish later they have had a conscience attack and decide to bring their elderly parent to the US, removing them from their friends and the environment they have known and feel comfortable with.

Any savings they have are likely to be blown on health costs and then they risk bankrupting their child and presumably the spouse.

Sounds an odd scenario.

[sergeman 0]

So you have a situation where the Parent has one child and no other relations.

The child emigrates, presumably as it is on this forum by Marriage with no great concern about leaving the Parent.

4 years ish later they have had a conscience attack and decide to bring their elderly parent to the US, removing them from their friends and the environment they have known and feel comfortable with.

Any savings they have are likely to be blown on health costs and then they risk bankrupting their child and presumably the spouse.

Sounds an odd scenario.

I am only child. Mother's last sibling and husband passed away recently, so environment not that friendly anymore.

[Boiler 45,486]

So this was part of your original decision when deciding who moved in which direction, that the surviving parent would follow.

I think it is something that would not appeal to most people.

[ndu26 114]

I'm really sorry for your loss. I'm sorry that your mother did not have any insurance and you now in huge debt. But, I'm still willing to care for my mother. In worst case I will live in debt, but with peace in my soul.

I share your sentiments...

[JimVaPhuong 4,863]

Brother Hesekiel,

Here is my plan. I can afford and I am going to pay for the medical insurance. The only my concern here is an emergency surgery with the cost over $200K. If such event happened, I can negotiate payment plan with hospital and pay off my debt in 2-3 years. In worst case scenario I can back it up with my 401K or my property.

Now question to you. Do you find immoral to let elderly parent die alone far away from family?

At 70 years old your mother will probably be eligible for Medicare, but you'll have to pay the premiums for parts A and B, at the minimum. She won't be eligible for free Medicare, like most seniors in the US, because she never paid into the system. The premiums won't be cheap, but it will be substantially less expensive than a private medical insurance policy. If you make a decent living then you should be able to afford these premiums without having to cash out your 401K or sell your property.

Anyway, that's not really the issue here. They are required to consider her age and health in determining the likelihood she'll become a public charge. If you can overcome that hurdle and get her a visa then you can look into premium based Medicare coverage for her.

[Nikki + Tomislav 7]

Thanks for all of your replies! I was just curious about timing, have no idea if it will actually happen. I can't imagine my Grandma even wanting to leave Poland at this point. And just a note, my parents have spent their whole time in America paying insane costs for healthcare, it just seems so unfair to me how hard they work and despite them being healthy, their insurance is still so crappy and expensive. Anyway thanks again!

[JimVaPhuong 4,863]

Thanks for all of your replies! I was just curious about timing, have no idea if it will actually happen. I can't imagine my Grandma even wanting to leave Poland at this point. And just a note, my parents have spent their whole time in America paying insane costs for healthcare, it just seems so unfair to me how hard they work and despite them being healthy, their insurance is still so crappy and expensive. Anyway thanks again!

Healthcare costs will eventually get better - probably about 20 years or so. In the meantime, it's going to get much much worse. It's going to be a crazy ride. Hang on tight!

[Boiler 45,486]

Why do you think they will get better?

[JimVaPhuong 4,863]

Why do you think they will get better?

We'll eventually have a single payer system, like Canada and most other first world countries. However, the private health insurance industry will be destroyed, and the healthcare industry itself will implode first.

We're in the midst of an expansion bubble in healthcare, as evidenced by the 5% to 15% annual increase in costs for more than two decades. This is what happens when one group of people purchases a product or service using the money of a payer with deep pockets, like private health insurance or the US government. The dot com bust and housing market collapse should have been enough to teach us that no bubble grows forever. As the costs of healthcare continue to rise, so too will the cost of insurance. More and more individuals and companies are going to opt to pay the fine rather than purchase insurance. When prices get completely out of control the public will insist the government take action. Congress will respond by capping insurance prices, which will eventually cause most private insurers to close shop. Many private doctors will quit, and clinics and hospitals will close because they're not being paid. The people will scream for the government to intervene. Congress will have no other option than to institute a single payer system. The only thing that isn't clear to me is whether the healthcare industry itself will survive as a private industry, like in Canada, or if we'll just end up with all healthcare workers being government employees.

I don't know if the people who crafted the Affordable Healthcare Act actually had this scenario in mind, but I can't think of any other outcome given the way the law was designed.

[Boiler 45,486]

The majority of US Health Care is under a single payer scheme.

The rump is likely to continue shrinking that is true.

It will be interesting to see whether there is any attempt to contain costs, certainly tricky in the current environment where providers can buy politicians.

[JimVaPhuong 4,863]

The majority of US Health Care is under a single payer scheme.

The rump is likely to continue shrinking that is true.

It will be interesting to see whether there is any attempt to contain costs, certainly tricky in the current environment where providers can buy politicians.

If you're referring to Medicare and Medicaid, then you're correct - over 60% of the market. To anyone who has heard about the US government paying 50X the actual cost of common items like hand tools, it should be no surprise how this has led to an explosion in health care costs. An individual trying to pay for their own health care is competing for service with a buyer that has very deep pockets.

The problem with containing costs is that the health care industry has grown in proportion to the revenues it receives. There have been a flurry of articles from sources like Money magazine and the Wall Street Journal giving advice on where job seekers should be looking for work, and they all list health care as the #1 growth industry. Unfortunately, the bean counters who write those articles are looking only through the rear view mirror. The health care industry certainly does have a history of explosive growth, but only because that growth has been funded by private insurers and the US government, just as the housing bubble was funded by private lenders and Fannie and Freddie. That bubble is going to burst, and when it does it will put millions of people out of work. The people who thought they were secure pursuing a health care job will be just as pissed off as those who thought they were secure buying a home five years ago.

Yes, the health care industry has a very strong lobby, and they have a lot of money to throw at politicians to get what they want, but politicians can't continue to spend money they don't have indefinitely. The federal government is facing this demon now, and have proposed cutting Medicare payments to health care providers without cutting benefits; i.e., health care providers who accept Medicare will have to provide the same services and receive less money. The American Hospital Association claims that a cut of even 2% of the Medicare budget will cost nearly 200,000 jobs in the industry. This is an early sign of the collapse to come.

Like I said, it's going to be a wild ride!