OF ALL the secrets of Hillary Rodham Clinton's "stealth" health-care program, one is so crucial that it could unravel the American economy. Yet this explosive issue is not even being publicly addressed.
It is the question of whether the program will cover uncounted illegal aliens and at least 5 million undocumented workers already living in the United States.
So far, the jury is out, although the fight seems to be coming down to the highly ideological Donna Shalala, secretary of health and human services, favoring extending benefits to everyone -- while Mrs. Clinton is against that idea.
Meanwhile, if we really need to know any more about the financial and moral costs of giving health care to everyone who hops across our borders, we need only look at a recent series in the San Diego Union-Tribune, "Medi-Cal, the New Gold Rush."
The paper outlines how "health-care pilgrims" have made their way to the United States from countries as disparate as Armenia (for liver transplants), Syria (for cancer care) and Hong Kong and Mexico (for heart operations and bone-marrow transplants).
The paper calls California's program not "Medi-Cal," which is the local term for government-sponsored Medicaid, but "Medi-World." It says that there is now so much fraud in health care that the statewide cost of the special program for undocumented California immigrants topped $700 million last year, up from only $190 million in 1989, its first year. This year it will reach $1 billion, and if the borders stay open . . .
Meanwhile, one respected research organization, the Center for Immigration Studies, estimates that undocumented immigrants cost the U.S. government $5.4 billion in health care, housing and energy assistance, education, welfare and prison expenses in 1990.
Moreover, it isn't only poor Mexicans who are burdening the California health-care plan. (Nearly 2,700 cases of health fraud were uncovered officially in the Golden State last year, and that's a tiny percentage of the whole.)
The San Diego series documents the case of a wealthy woman from the extremely rich Bustamante family, which owns the 23-story Fiesta Americana hotel-office complex in Tijuana. She got free care in California with bills of $635,000 -- all paid for by the California taxpayer. In still another case, a foreigner received a heart transplant while American citizens were waiting desperately for the same operation.
Since the U.S. government has been so pusillanimous about controlling immigration (and has done little to keep terrorist refugees out of the country), all choices concerning a national health-care program and illegal aliens involve extraordinary bureaucratic and moral complications.
The fact is that every other developed nation on Earth with some form of national health care has taken steps to ensure that access is limited to its own citizens or legal residents. Such rights and/or privileges quite simply are the rights and privileges of people who have made a commitment to our nation and to its health -- in short, citizens or "will-be" citizens of the United States.
"Not only have we no ethical responsibility to pay for the health care of people who have no legal right to be in our country," says Dan Stein, head of the Federation for American Immigration Reform, "we have a moral responsibility to ensure that the system does not become so overwhelmed that it can no longer adequately meet the needs of the American people."
The illegal immigration mess has been with us a long time, mostly because Americans do not like to make unpopular decisions that cause them to look less than consummately humanitarian. This has resulted in an overwhelming of public services and is contributing to the destruction of great cities such as Los Angeles and New York.
While we bankrupt our own country, we make con artists of the world's people, who know they can lie to come here to get what they don't deserve. And at the same time, we overload our own citizens and threaten the unity of America.
Georgie Anne Geyer is a syndicated columnist.