Open borders types like Max Boot wax rhapsodic about the all-positive implications and effects of illegal immigration.

Obviously it is wrong for anyone to break the law, but the desire of foreigners to come here to work seems like the most benign sort of lawbreaking imaginable. Lots of other laws are broken routinely — prostitution laws, speeding laws, tax laws — and yet they are not the subject of heated exchanges at presidential debates.

What makes illegal immigration so bad? There is no question that an influx of illegals puts pressure on public services, especially in the border states, and that issue needs to be addressed, perhaps with greater assistance from Washington. But it is hardly unmanageable, especially because illegal immigrants, while making use of some government services, also contribute a lot to society via sales taxes and other means without collecting Social Security, unemployment or other benefits available to legal residents. Studies of the net economic effect of illegal immigration show mixed results.

There is quite a bit wrong with that passage and the article as a whole, notably a conservative arguing for “greater assistance from Washington” to deal with the pressure that illegal aliens put on government services. Where, Mr. Boot, will that “greater assistance from Washington” actually come from? The law-abiding taxpayer, of course! And Boot, who usually writes tough articles about war and security, never gets around to the argument that tends to supersede the economic and cultural arguments against illegal immigration; namely, that if day laborers and coyotes and drug smugglers can cross back and forth with impunity, so can terrorists. To paraphrase an old political saw, it’s the security, stupid.

Additionally, in border states, illegal aliens often cross in not to work, but to take advantage of US government services. They’re not actually contributing anything on this side of the border, but they are costing us millions of dollars every year. When you don’t pay into a system but do take benefits out of it, you’re a net loss on that system.

But back to the economics. It’s fashionable to characterize illegal immigration as an essentially victimless crime. Tell that to the poor American citizens in Galveston whose hospital is being strained to the breaking point by illegals who take advantage of US generosity to obtain long-term care that they have no intention of paying for.

The University of Texas Medical Branch in Galveston may soon close its doors to poor illegal immigrants who need cancer care, a move that could increase the patient load in Harris County.

The medical school, unable to meet the demand for cancer care by indigent patients with limited state funds, is considering a policy that would require patients to prove they’re here legally to qualify for financial assistance. That would save the hospital system money but contradict its mission of providing care for the poor.

“Everyday, very difficult decisions have to be made because there are too few resources for the demand,” said Karen Sexton, vice president and CEO of hospitals and clinics at the medical branch.

The policy decision, which has been under consideration for months by the medical branch’s Cancer Patients Acceptance Committee, is expected to be made by January and any changes would be effective immediately, Sexton said.

Again, we’re talking about long-term care here, where one patient can easily rack up millions of dollars in expenses that the hospital won’t get reimbursed by insurance or anyone else for. The problem introduced by this is very simple, and can be rendered by the phrase “Money doesn’t grow on trees.” The money to care for illegal aliens has to come from somewhere. State hospitals like UTMB don’t get reimbursed by anyone — not the state government, not Washington and certainly not the illegals’ countries of origin — for the care that they give to illegal aliens who can’t pay for it. So the hospital faces a choice: Continue to eat the cost of illegal alien care at the expense of its own budget, or cut care to illegals off so that it can better care for US citizens and legal residents that it’s supposed to serve. Many hospitals have faced the same choice, chosen to continue caring for illegal aliens, and have ended up having to shut down entirely. If you’re looking for illegal immigration’s victims, the citizens and legal residents who would have been cared for but now won’t be because their hospital went broke caring for illegals are among your victims. UTMB is evidently trying to prevent that outcome, and will make its decision in January. If it cuts long-term care for illegal aliens off, they’ll head to Houston, where presumably they’ll just stress more hospitals by receiving care at US taxpayer expense.

Citizenship is not considered by the Harris County Hospital District — and it shouldn’t be since it receives state funding for indigent care, said King Hillier, vice president of public policy and government relations of the district, which operates Ben Taub General, Houston’s largest public hospital.

“We do not question citizenship status,” he told the Galveston County Daily News. “If they live in Harris County and can prove residency, then they are paying taxes. If they’re paying rent, then their landlord is paying property taxes to the hospital district.”

They’ll begin to question citizenship status if the expenses reach a pain threshold.

Open borders types like Mr. Boot ought not put hospitals in the position of having to make choices like this. A secure border and cutting off sanctuary policies would go a long way to alleviating the very real negative effects of illegal immigration that evidently escape the open borders crowd’s notice.