Sunday, August 3, 2008

Hospitals Deporting Immigrant Patients?

Yesterday, we blogged abut "criminal aliens," one of the most unpopular immigrant groups in the United States.  Another unpopular groups of immigrants are immigrant public benefit recipients.  California's Proposition 187, an invalidated measure that would have barred undocumented immigrants from attending public elementary and secondarty schools (contrary to Supreme Court precedent), and 1996 welfare reform, which eliminated legal immigrants from eligibility from major federal benefit programs, are two prominent recent examples of the unpopularity of immigrant benefit recipients.

The N.Y. Times has a story today about a poor and injured Guatemalan man who a U.S.  HOSPITAL deported to avoid paying for his care.  I am surprised by little when it comes to immigration law and policy in the United States but this surprised me: It appears that many hospitals are repatriating seriously injured or ill immigrants because nursing homes won’t accept them without insurance.

Martin Memorial in Florida, for example, leased an air ambulance for $30,000 and “forcibly returned [a Guatamalan man who had been seriously injured in an automobile accident with a drunken driver] to his home country.”  This poor man reportedly is getting no medical care in Guatalama and is withering away. And the Times reports that this is apparently a "widespread practice":

"Many American hospitals are taking it upon themselves to repatriate seriously injured or ill immigrants because they cannot find nursing homes willing to accept them without insurance. Medicaid does not cover long-term care for illegal immigrants, or for newly arrived legal immigrants, creating a quandary for hospitals, which are obligated by federal regulation to arrange post-hospital care for patients who need it. . . . Most hospitals say that they do not conduct cross-border transfers until patients are medically stable and that they arrange to deliver them into a physician’s care in their homeland. But the hospitals are operating in a void, without governmental assistance or oversight, leaving ample room for legal and ethical transgressions on both sides of the border."

What ever happened to the Hippocratic Oath?


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"What ever happened to the Hippocratic Oath?"

The Hippocratic Oath pertains to the actions of doctors. Hospitals are either private or public institutions run by administrators, not necessarily doctors. They operate using funds of contributors, on a profit motive or from the public coffers. How much money have you contributed to paying for the health care of these illegal immigrants, professor? Since you like the idea so much, try paying for it from your personal funds. As for me, I'll continue to support a common sense approach.

Many hospitals are going out of business due to the costs of the indigent and illegal aliens. Real citizens taxpayers and citizen indigents are losing their local health care infrastructure due to the unpaid costs of illegal aliens, and you sit there criticizing the deportation of foreign nationals who should be rightly supported by their own countries. The public burden that illegal aliens pose to those hard working and poverty stricken citizens is sadly not part of your calculus, is it? Such cases are precisely why Americans should support the arrest and deportation of illegal immigrants and not grant amensties.

Posted by: Horace | Aug 3, 2008 7:00:00 AM

I am 100 percent in favor of this hospital's decision. Why should the hospital bear the cost of treating someone who has no right to even be in the United States? Professor Johnson, predictably, smears the medical profession ("What ever happened to the Hippocratic Oath?") and champions the illegal immigrant cause. Professor Johnson would, undoubtedly, have the federal government prohibit this discriminatory practice. This is why there are no serious readers of this blog (witness the paucity of comments) and the blog at present is simply an echo-chamber for Johnson, Hing, Aldana and Saucedo (I do not know about Trucos-Haynes because she is not a frequent poster).

Posted by: Carlos Miranda-Fuentes | Aug 3, 2008 7:07:44 AM

The Hippocratic Oath is not a promise to commit financial suicide.

Wherever possible, the burden should be placed on the employer who hired the illegal immigrant. Provide the care, then deliver the bill to the employer.

Above all, seal the borders. That cheap lettuce isn't so cheap once all the costs are factored in.

Posted by: Byron | Aug 3, 2008 7:53:56 AM

Posted by: KJ | Aug 3, 2008 8:54:12 AM

I've seen it done several times down here in Louisiana. Hospital is sympathetic to needs of undocumented immigrant, but just cannot remain indefinitely on the hook for long-term care of person with permanently disabling injuries that will require life-time care.

Posted by: Ken Mayeaux | Aug 3, 2008 9:37:05 AM

Horace, et. al.,

Once again your comments are tinged with the irrational conclusions of those on the anti-immigrant (and generally inhumane) side of the debate.

There is no correlation between the dire financial state of some hospitals and care of "illegal immigrants".

The person described in the article was injured in the United States by what you probably consider a "model" citizen (drunk hick from Florida) and yet our system owes this "illegal" immigrant nothing for it.

Furthermore, your privilege and arrogance denote the extremely close-minded world view you maintain. The developing world doesn't have "long-term" care and even health insurance to rely on.

Posted by: RRP | Aug 4, 2008 6:26:34 AM

I can only hope that hospitals who practice "repatriation" do so reluctantly. It is tempting to think that the Florida hospital that sent the man to his family's home in remote Guatemala would have served him better by putting him up in the broom closet in a hospital corridor. There he would at least have access to medical care and medicine. His elderly mother said the only thing he was receiving at home was "alka-seltzer and prayer." The nurse who had cared for him over a period of years and who accompanied him to Guatemala was stricken by the immediate deterioration in his level of care.

Check out the story in the Arizona Republic on 08-03-08 too (by Daniel Gonzalez). It gives some dramatic background to the practice of international transfers carried out by some Arizona hospitals. Where do the hospitals in El Paso, TX stand on this issue? Do they "repatriate?"

Posted by: Patricia Dabbs | Aug 4, 2008 1:12:48 PM

"Once again your comments are tinged with the irrational conclusions of those on the anti-immigrant (and generally inhumane) side of the debate."

Well RRP, I'm glad to see that you've finally mustered some testosterone to finally respond to your opposition. There really has not been much argument disputing the freebee nature of health care to illegal immigrants, but perhaps it's because it's true that illegal aliens put a burden on our health care infrastructure and are partly the cause of the high premiums middle class citizens pay for insurance premiums. For every failure to pay (as in the case of illegal aliens) the hospitals jack up the costs paid by insurance companies, and consequently we pay thru the nose.

For every illegal alien in chronic long term care, there's a poor citizen who will not receive health care due to a lack of local facilities and shortage of supporting funds. What do you tell those citizens, RRP, that their government cares equally for foreign invaders as it does for the citizen? Why should citizens compete with these people for ever scarce and expensive health care services? Our government and its elected officials exist for the benefit of the citizen, as do the governments and officials of those who enter our country illegally. The latter recognize their duty for their citizens. Why should ours do anything less for us? I suggest that if you and the immigration lawyers in this blog feel so badly about this case, you're free to dip into your own personal savings to help the bloke. I doubt that you'll do so, as liberals generally dip into someone elses pocket, i.e. our general treasury, before resorting to their own wallets.

Humanity? That's just another liberal code word for adopting the problems of the entire world while sacrificing our way of life.

Posted by: Horace | Aug 4, 2008 4:31:09 PM

Note: These people are not immigrants, as defined by our laws, but illegal entrants at best. Most never intend to stay, but return home. That makes them no more immigrants than the millions of U.S. citizens working in foreign lands with the intent on repatriation one day. I've worked in Korea, and I know that the Korean government didn't recognize me as an immigrant, but as a guest worker. I am also certain that if I had became chronically ill, I'd have been sent home, and it wouldn't matter to them if I had health insurance or not. RRP, it's you that are ignorant of the ways of the world, not we who oppose your naive ideas.

Posted by: Horace | Aug 4, 2008 4:41:50 PM

First of all, are we to hold ourselves up to the high and lofty moral standards of Korea? Is that what we are to aspire to? To quote Gov. Mike Huckabee, when challenged by Mitt Romney about his being too soft on immigrants because he dared to offer in-state tuition to high achieving undocumented high school students, "We are a better country than that." We are a better country then to deport sick people that show up at our hospital doors. But let me appeal to your wallet. Guess what? At the end of the day, we have more tax dollars generated by our overall economy because of the 20,000,000 undocumented that are here. The problem is that because the restrictionists have so far managed to block CIR, the money hasn't been properly apportioned to the area's that need the money the most. CIR would actually solve the problem, because even a higher percentage of undocumented would pay taxes, (most already do), and we could find out with some degree of accuracy where to send the tax dollars. Also, more of these undocumented people would be insurable, thus mitigating the problem.

Posted by: Robert Gittelson | Aug 4, 2008 8:34:43 PM

"Guess what? At the end of the day, we have more tax dollars generated by our overall economy because of the 20,000,000 undocumented that are here."

Actually, this is speculative on the part of you anti-citizen illegal alien advocates, a gamble that most Americans do not think they should bother taking. These illegal aliens are net losers for our tax base and anyone with common sense and genuine care for our nation knows it. The poor always take more out of society by their burden on the middle class than they put in. The rest of us make up for it in higher taxes and higher health care costs. Ultimately, 20 million amnestied illegal aliens will barely earn enough Social Security to survive at retirement. And since low income people take more out of SS than they put in, we'll ultimately bankrupt the SS trust fund and have to borrow to pay the shortfall. And it is a fact, as much as your assertions are fact, that illegal aliens given amnesty will ultimately become eligible for social support benefits. Considering that most live on the exploitive wages of such businesses as your garment industry, these people will provoke a transfer of wealth from the middile class to these low income poor. Perhaps if we taxed yor business for such an imposition, you'd change your tune. No country in the world, except the one you would live in, Git, aspires to import illiterate and unskilled people to become citizens. Name one that does Git, and I'll retract my statement, because it would make you the genius that you make yourself out to be. As a matter of fact such proposals are contrary to our unwritten goal to have a well educated and financially independent nation of citizens.

We know your real agenda, Git, keeping your exploitive industry alive by sabotaging any effort to control our borders or immigration policies.

Posted by: Horace | Aug 5, 2008 4:17:11 PM

"To quote Gov. Mike Huckabee, when challenged by Mitt Romney about his being too soft on immigrants because he dared to offer in-state tuition to high achieving undocumented high school students,....

We are no more obligated to subsidize foreigners educations than they are to subsidize our citizen students who reside overseas. Should we give in-state tuition to foreign students who come here under student visas, just because they are brilliant? Right now we're debating the wisdom of allowing illegal aliens to stay, never mind addressing perks while they're here. Illegal aliens should feel lucky that they've evaded capture and deportation and have enjoyed the benefit of our K-12 schools, never mind arrogantly demanding that we not only tolerate their presence, but pay for the honor of doing so. I'm sure there are many deserving citizens that could use such subsidies but aren't getting them as they don't qualify for in-state tuition. Unless you address such inequities you'll get no sympathy here. Perhaps when the last out-of-state citizen who wishes to attend college is given in-state tuition to the college of his/her choice, and if there are left over funds, perhaps we'll give in-state tuition privileges to a legal alien visa holder, but never to illegal aliens. You say that illegal aliens don't put a burden on our society, but then you say that we should accept the burden of subsidizing their collegal education. My friends would call that chutzpah. This very fact makes your group disingenuous. Mr. Gittleson, you and the open borders types really don't understand how ridiculous you sound. In this respect you are tragic figures indeed.

Posted by: Horace | Aug 5, 2008 5:02:55 PM

Mr. Gittleson, barring congressional action on the Dream Act, do you favor private enterprises like yours setting up scholarships for undocumented immigrants? Advocates for the undocumented should be eager to do so, yet we seem to hear nothing on such proposals.

Posted by: Allen | Aug 5, 2008 6:16:43 PM

Horace, Horace, Horace. As Ronald Reagan once said in a Presidential debate, "There you go again." I must say, that in the year or so that I've been reading this blog, I've seen you post, on the average, several comments per day. You are active, I'll give you that, and I don't doubt your passion. However, why is it that out of the several hundred, or more likely thousand or so comments that you've posted, I have yet to see you make even one suggestion as to how we can address the problem of the undocumented in our country, and find a solution? It seems that your primary mission here is to post derogatory comments about the motivations and ideas of people who are honestly concerned with solving this problem, and are devoting a considerably amount of their time and effort in that noble and worthy pursuit. For example, while you and I don't actually know each other, in your first comment of 8/5, you managed to call me, and I quote, "speculative, anti-citizen, (without) common sense, (lacking in) genuine care for our nation, exploitative, (greedy) "Perhaps if we taxed your business for such an imposition, you'd change your tune", and for good measure you accuse me of having the actual agenda of "sabotaging any effort to control our borders or immigration policies." In your second comment, you call me, and I quote, "(possessing) Chutzpah, (being) disingenuous, (being for) open borders, ridiculous, and (a) tragic figure.

As to your own assertion that, "These illegal aliens are net losers for our tax base and anyone with common sense and genuine care for our nation knows it," I suggest that you are not looking at this equation from a "macro" economic perspective. It is not only the direct taxes of the undocumented that affect our tax base. It is, more importantly, the indirect taxes that they generate through the corporate and property taxes of the companies that they work for, the legal co-workers of those companies that pay more taxes due to their usually much larger salaries, the taxes of the owners of the companies that they work for, the taxes of the businesses and employees of tho businesses that the undocumented's companies work with, (such as supermarket chains that buy produce from companies that employ undocumented workers), and last but not least, the multiplicative effect on our economy that the spending of all of these people, undocumented and their co-workers, has on our economy, ( every dollar that these 20,000,000 people spend domestically gets recycled several times throughout our economy, getting taxed at each stop along the way, and dramatically increasing our GDP). As to your assertion that, "since low income people take more out of SS than they put in, we'll ultimately bankrupt the SS trust fund and have to borrow to pay the shortfall," I can only suggest that you read the work of Dowell Myers, (from my alma mater USC), who explains clearly that it is through the much needed immigrants that we will even have a SS system down the road.

As to your assertion that, "You say that illegal aliens don't put a burden on our society, but then you say that we should accept the burden of subsidizing their collegal (sic) education," I can only say that I am for equal opportunity. If the innocent children of undocumented parents demonstrate the capacity for achievement through higher education, then we all lose if they are blocked from having that opportunity. A mind is a terrible thing to waste. So is time, and I suggest that until such time as you can think of something to say that will actually contribute something constructive to this debate, that you please save your time, and more importantly our time, by refraining from posting negative and demeaning comments on this blog. If you are not part of the solution, then you are indeed part of the problem.

Posted by: Robert Gittelson | Aug 6, 2008 9:48:29 AM

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