Immigrants lacking health insurance access the health care system through the emergency departments of non-profit hospitals. Because these persons lack health insurance, continued care can pose challenges to those institutions. I analyze the values of our health care institutions, utilizing a Walzerian approach that describes its appropriate sphere of justice. This particular sphere is dominated by a caring response to need. I suggest that the logic of this sphere would be best preserved by providing increased access to health insurance to this population. This access would marry the rights of these members of our community to access care to our responsibility to contribute to financing of the system. I close with some considerations on what it means to be a member of the community. © 2011 Springer Science+Business Media B.V.

Affordable Care Act Care medical ethics Michael Walzer EMTALA Amitai Etzioni Communitarian Immigration justice

social justice economics health care policy health insurance human ethics health service Patient Rights patient right Insurance, Health Health Services Needs and Demand human rights United States Humans Emigrants and Immigrants Patient Protection and Affordable Care Act Article migration legal aspect standard Delivery of Health Care Social Responsibility Health Services Accessibility social behavior health care delivery