A terrifying medical threat that bears on this election

As a doctor, it has been incredible to see the eradication or minimization of so many infectious diseases over the course of my lifetime. Unfortunately, some of those diseases are being re-introduced to America through our immigration system. I worry this will jeopardize the health and well-being of the American people in the years ahead.

Tuberculosis was previously a fatal disease that until recently had become well controlled in the U.S. It is now making a comeback, and much of this rests on the shoulders of our present immigration policy. Recent data indicates that tuberculosis cases rose last year for the first time in 23 years.
 
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The health of the nation is something that should concern each and every one of us. But lost in the arguments for and against immigration is the threat that TB and other “controlled” diseases pose and the amazing financial burden they place on all of us. Each individual with drug-sensitive TB must receive 6-9 months of treatment and costs the citizens of this country roughly $17,000 dollars. This is not taking into account the exposure risk of individuals who may not know they carry the disease.
 
Even worse is the renewed occurrence in the United States of two entities namely Multi Drug Resistant (MDR) TB and the even worse Extensively Drug Resistant (XDR) TB. These two entities require much more costly and lengthy care, and in some cases may not even be curable. The exposure of Americans is not localized to a few communities. Six refugees in Wisconsin were diagnosed with MDR-TB in 2014 and 2015. California reported 22 cases in 2015. Massachusetts reported 7 cases of MDR TB in 2015. These are only a few examples.
 
This doesn’t account for the massive cost the taxpayers of this country are asked to foot to deal with these cases – to say nothing of the cost of potential widespread outbreaks. These are dollars we sorely need to could go to the health and care of our own citizens who have paid into the system through their hard work and tax dollars. 
 
The cost to treat an MDR TB patient is $150,000 and treatment takes between 20 and 26 months. The cost of treating each XDR TB patient is $482,000 dollars and the duration of treatment is 32 months. To add to the burden, 73% of these patients will require hospitalization and 37% will require isolation.
 
There is also the sad fact that Americans could be exposed to these strains of tuberculosis without ever knowing it. They could develop an incurable disease by going about their daily lives.
 
Four percent of the citizens of the U.S. have latent tuberculosis which is not infectious and does not have symptoms. It is estimated that 10% of these individuals may develop active TB. Studies have shown that about 20% of immigrants to the U.S. have latent TB, which means at least 2% may develop active TB and become contagious. This means a disease which few Americans currently worry about could become a major healthcare crisis.
 
No wonder the immigration issue has been so critical in this election. On the one hand, we have a candidate, Donald TrumpDonald John TrumpTrump faces high stakes in meeting with Erdoğan amid impeachment drama Democrats worry they don't have right candidate to beat Trump Trump threatening to fire Mulvaney: report MORE, who is concerned not only about the security risks posed by a broken immigration system but also understands that failure to reform it increases the resultant health risks of once-eradicated diseases. On the other hand, we have Hillary ClintonHillary Diane Rodham ClintonDemocrats worry they don't have right candidate to beat Trump Krystal Ball credits Gabbard's upswing in 2020 race to 'feckless' Democratic establishment Outsider candidates outpoll insider candidates MORE, who wants to protect the current policy and even expand immigration.
 
The number one job of our government is to protect our citizens from threats foreign and domestic. The health of United States is at risk. As a physician, I am concerned for my patients. As an American, I am concerned for my country.

Reed Wilson, MD, is the CEO of Private Practice Doctors, LLC, and a practicing Cardiologist and Internist in Beverly Hills.