Immigrants trying to negotiate the US medical system give testi- mony to the truth in Virchow’s famous declaration, “All medicine is politics.” Viewing immigrants as outsiders who are simultaneously insiders, the larger society often questions their use of medical and other social services. The issue of medical services for immigrants and citizens alike, at least in the United States, is open to such debate because there is no guaranteed “right” to medical care. Even though citizens may feel an entitlement to medical care, many are unwilling to grant this to immigrants. As a consequence, immigrants seeking med- ical care face restrictive policies, financial tests, and citizenship require- ments. Moreover, immigrants often enter the labor force at the bottom, where low incomes, lack of medical insurance, and little available time present obstacles to their use of medical services. In short, immigrants are disadvantageously embedded in a political economy of health care characterized by pervasive structural inequalities (Farmer 1999; Morsey 1996; Whiteford 1996). It is a challenge for anthropologists, particu- larly those taking a critical approach (Lock and Scheper-Hughes 1996), to explore the influence of culture on immigrants’ use of US medical 197 7 Immigration and Medical Anthropology Leo R. Chavez 197 Copyrighted Material www.sarpress.org