After retiring from internal medicine in Santa Monica, I volunteered at a free clinic in Palm Coast, Florida. I cared for patients working full-time jobs who still couldn’t afford their medications. Parents choosing between rent and doctor visits. People delaying care until their only option was an emergency room visit they had no way to pay for.
When I later became medical director of the Flagler County Health Department and took over its HIV clinic, the broader failure came into focus. During the pandemic, I watched political talking points collide with the realities of poverty and illness. The gap between what people needed and what our systems provided widened by the day. I eventually helped found a nonprofit to address the social determinants of health that traditional medicine consistently ignores.
I now live in Memphis, where federal task forces are detaining immigrants every day, and the same patterns I saw in Florida have intensified in ways that are evident everywhere.
So, when I watch ICE raids unfold in Memphis neighborhoods, I’m reacting as someone who has treated families just like them, who has taken their medical histories, who has delivered food to their doors. And I’m stunned by the dishonesty driving the debate.
The public framing of immigration centers on legality, economics, and security. But the engine underneath it is scapegoating. And it’s working.
For decades, we maintained a deliberate double standard: allow millions to enter and work, deny them protections or a path to legal status, and extract enormous economic value from their labor. Then, when politically convenient, condemn them for existing in the shadows we forced them into.
The rhetoric about “illegality” may be technically correct, but it is morally empty. A rational verification system — one that either authorizes workers or holds employers accountable — would be easy to build. We haven’t done it because too many benefit from a labor force with no leverage, no security, and no recourse.
The economic arguments collapse just as quickly. Study after study shows that immigrants contribute more to the economy than they take out, and their crime rates are lower than those of native-born citizens. In a nation with declining birth rates and an aging workforce, their demographic contribution is a lifeline.
But rather than level with Americans about the structural problems undermining their economic stability, political leaders have offered them a villain.
Recent economic analyses show that the official poverty line — $31,200 for a family of four — has no relationship to reality. Updated using the same methodology used when it was created in 1963, the true threshold for basic stability is closer to $140,000. This mismatch has created what analysts call a “Valley of Death”: families earning $40,000 qualify for subsidized childcare, food assistance, and healthcare, while families earning $100,000 receive none of it and are crushed by the full market costs.
The family at $100,000 often ends up in worse shape than the family at $40,000, despite working longer hours and carrying greater financial risk.
The frustration this produces is real. It is rational. People feel abandoned. They see neighbors receiving benefits while they themselves fall deeper into debt. The resentment that follows is predictable.
But blaming immigrants for this is like blaming fellow passengers when the ship is sinking. They did not create the Valley of Death. They did not set the price of childcare at $32,000 or push healthcare costs past affordability. They are navigating the same broken system with even fewer protections.
These are the individuals who harvest our produce, prepare our food, care for our children, and support the industries most of us rely on every day. Turning them into targets of public-enforcement spectacles is blatant political performance, designed to signal that a problem is being “handled” while ignoring its true causes.
I know families like these. I have treated them and met their children. They are disciplined, community-centered, and deeply committed to building stable lives. They embody the very qualities we claim to value in American society.
Some will argue that drawing parallels to historical injustices is too extreme. But intentionally frightening families, separating parents from children, and deploying public displays of force against defenseless people inflicts trauma on entire communities and corrodes the moral fabric of the nation.
Here is what needs to happen now:
- First, an immediate moratorium on ICE raids and family separations. These actions are economically damaging and morally indefensible. They destabilize neighborhoods, erode trust in public institutions, and have no measurable benefit to national security.
- Second, an honest, bipartisan immigration framework that recognizes reality: we have built an economy that depends on immigrant labor. If political leaders want to reduce or halt new immigration, that is a policy choice open to debate. But the millions of people already living, working, and contributing here deserve resolution—either a pathway to citizenship or a documented status with meaningful rights and protections.
This should not require months of theatrics. The outline for comprehensive reform has existed for years. It came close to passing with broad support, only to be deliberately derailed for political advantage. The public is far closer to consensus than elected officials admit.
What we lack is political courage.
Our leaders need to set aside self-preservation and do the job they were elected to do: create policy that strengthens the nation, protects the people who live in it, and aligns with our stated values. If they cannot manage that basic responsibility, then we need leaders who can.
Every day we continue this performative cruelty, we diminish ourselves. Not as a “nation of laws” — we compromised that principle long ago through selective enforcement — but as a society capable of fairness, rationality, and decency.
We created this crisis through policy choices. We can solve it the same way.
The question is whether we have the integrity to try.
