Entitled to Nothing: The Struggle for Immigrant Health Care in the Age of Welfare Reform

5 Fear and Loathing at the Border

115 chapter 5 Fear and Loathing at the Border [W]hat this county as a whole is more concerned about is fraud and fraud prevention than they are in provision of services, so everything they do is geared toward making sure the wrong people don’t get it and if that means that many people who may be eligible don’t get it in the process too, well that’s just the way it goes. —Health care advocate, San Diego Borders are contradictory. They have the potential to both enable and constrict ideas and actions. For this reason, borders are spaces of power. Whether they demarcate literal, physical place or figurative, abstract space, borders are socially constructed entities with the potential for real, lived consequences. Geographer David Sibley explains that boundaries can provide security and comfort as well as provoke risk and fear, depending upon where you stand and with what resources.1 Subsequently, the ability to cross boundaries—or, to move from a familiar to an alien space— can be an anxious experience. In some circumstances it can be fatal. At the Mexico-U.S. border, the deaths of hundreds of Latin American women working in maquiladora factories in Juarez2 are a graphic example. 116 Fear and Loathing at the Border Borders are also powerful locations for defining who is included or excluded , and how. As liminal spaces, they are messy locations in which the contradictions of boundary maintenance are exposed. Legal scholar Robert Chang observes, “The Border is everywhere” and yet can be rendered invisible . “It is through this invisibility that the border gains much of its power.”3 Chang notes that because national borders are imperfect, supplementary mechanisms for exclusion are deployed. As such, welfare and health care policies function to supplement immigration policies in deciphering who belongs and who does not. In doing this, each mechanism roots out the foreign as a threat thereby necessitating systematic observation, control, and potential deportation. Welfare and health policies, then, inconspicuously extend the power of the border far beyond the literal, physical fence. At the same time, the international border in San Diego County has undergone very conspicuous changes during the neoliberal 1990s. In his investigation of the Operation Gatekeeper program, Joseph Nevins writes, “Nowhere along the boundary are integration and boundary policing as pronounced as they are in the San Diego-Tijuana region. . . . In addition, it is the location of the most intense economic and demographic growth of the U.S.Mexico border region—the fastest developing border zone in the Americas, and perhaps the world.”4 With the passage of the North American Free Trade Agreement (NAFTA) in 1994, trade between the United States and Mexico grew from $80 million to $200 billion in 2000.5 This increase in capital was accompanied by an increase in the flow of people. Nevins documents: About 60 million people and 20 million cars per year now enter San Diego from Mexico through the San Ysidro port of entry, making it the busiest land crossing in the world. And an estimated 40,000 people cross the border each day to work, including several thousand who manage and work in maquiladoras (export-oriented assembly plants) in Tijuana, but live in the San Diego area.6 The population of those who live on both sides of the border numbers 12 million.7 This is a relatively new phenomenon. Only since the 1970s has the U.S.-Mexico border region housed large-scale cities. Some urban studies scholars have identified the San Diego-Tijuana region as a new urban ecological space or “transfrontier metropolis.”8 Since its creation in 1848, the two thousand-mile international boundary between the United States and Fear and Loathing at the Border 117 Mexico has run across a sparsely populated, rural edge of two vast nationstates . Beginning in the 1950s, a dramatic transformation occurred in the borderlands region of both nations, turning what was once a dusty frontier into permanent, economically driven cities. The population of cities along the border increased faster than the national average in both countries. Propelling this dramatic urbanization and its accompanying tension at the border is the concentration of global capital and growing demand for cheap labor in the region. Nestor Rodriguez argues that the economic reality of the new transfrontier metropolis soon became incompatible with the existing nation-state boundary. He writes, “the ‘crisis’ of the border is not that ‘illegal aliens...