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Hospitals closing – they’ve dished out all the freebees the system can handle; and even charging $50 for a single aspirin doesn’t stop the drain.
DALLAS — The doctors and nurses at Parkland Memorial Hospital knew a lot about Zahira Domínguez, a maternity patient who was beginning to feel the squeeze of her contractions. They knew that she had been born in Mexico, was a 15-year-old student at a Dallas high school and had gone to her prenatal checkups. They knew she was unmarried and scared about giving birth. What the hospital staff did not know, because they did not ask, was whether Ms. Domínguez was an illegal alien. Patients like Ms. Domínguez, uninsured Hispanic illegals with have flocked to public hospital emergency rooms and maternity wards in Texas, California, Arizona and other border states. Their care has swelled costs for struggling hospitals and increased the health care bills that fall to states and counties, giving ammunition to opponents of illegals who complain of undue burdens on local taxpayers.
As a result, health care has become one of the sorest issues in the border states’ debate over the influx of illegals. Facing harsh criticism from residents, public hospitals are confronted with an uneasy decision: demand immigration documents from patients and deny subsidized care to those who lack them, or follow the public health principle of providing basic care to anyone who needs it.
In Texas, two of the biggest public hospitals chose differently. The Parkland Health and Hospital System, which serves Dallas County, offers low-cost care to low-income residents with no questions asked about immigration status. That low cost care is welfare status, paid for on the backs of the rest of the city’s patrons.
In Fort Worth, in neighboring Tarrant County, JPS Health Network requires foreign-born patients to show legal immigration documents to receive financial assistance in non-emergencies, like elective surgery and the treatment of routine or chronic illnesses. Executives said that their first responsibility was to legal residents. To some Fort Worth residents, the hospital, which does provide emergency and maternity care to illegals, has nonetheless sent a message that illegals are not welcome.
“Whenever immigrants go to the hospital, the first thing they are asked is, ‘Who are you and where are your immigration papers?’ ” said José Aguilar, a leader of Allied Communities of Tarrant, a coalition of church-based community groups that has pressured the JPS board to reverse its policy. “They are being scared away.” Apparently they are not scared enough to obey the law and go back where they came from.
Across Texas, the debate over illegal immigration has spilled into county commission hearings and hospital board meetings. A study ordered by commissioners in Harris County, which includes Houston, found that about one-fifth of the patients in its health system last year were illegals, most of them from Mexico. Their numbers had increased 44 percent in three years, the study found, and their care had cost the county $97.3 million, about 14 percent of the health system’s total operating costs.
“We have a lot of United States citizens that need our help in healthcare, and we should pull them up before we pull up someone here illegally,” said Tim Gallagher, 45, a software salesman from Plano, north of Dallas, who in an interview expressed views widely shared in the state. Mr. Gallagher said he favored deporting illegals who sought care from public facilities, even if the patient was a mother who gave birth to an American citizen. “If somebody here needs health care, they should get it, and then if they are illegal, they should go bye-bye,” said Mr. Gallagher, who wrote a letter on the subject to The Dallas Morning News. Get real, Mr. Gallagher, or are you feathering your nest for the next election?
In California, hospitals spent at least $1.02 billion last year on health care for illegals that was not reimbursed by federal or state programs, according to federal government estimates. Hospital officials there said the ailing health care system was being pushed to its limit. “Emergency rooms and hospital doctors are forced to subsidize the lack of immigration enforcement by the federal government,” said C. Duane Dauner, president of the California Hospital Association. “It amounts to an unfunded mandate for us to treat everybody.”
California received $66 million in federal money in 2005, the first year of a four-year national program to help pay for emergency care for illegals. But it was “not even a down payment” on the total cost, Mr. Dauner said. With more than 1.4 million of California’s residents uninsured and more than half of California’s hospitals operating in the red, Mr. Dauner warned that care for illegals would tip some hospitals into bankruptcy.
Texas border hospitals often get “anchor babies,”children of Mexican women who dart across the border to give birth to an American citizen, hoping it will allow them to stay in America. Many illegal families have mixed status; often a patient with no documents has a spouse or children who are legal, thinking this will “anchor” them and the country can look the other way. The largest group of illegal patients is pregnant women, hospital figures show. Under a 2002 amendment to federal regulations, the births are covered by FEDERAL taxes through Medicaid (your tax money) because their children automatically become American citizens. Parkland delivered 11,500 babies last year to mothers who were illegal aliens, representing at least 56 percent of its maternity patients.
In January 2004, the JPS board of managers voted to offer its financial assistance program to all Tarrant County residents, legal or otherwise. But eight months later, with illegals starting to fill the hospital, the managers reversed course.
The bottom line is the system is so overloaded, nothing will fix it if it continues, and hospitals will go belly-up with the demand for unpaid care.
