Illegal Immigration & Hospitals: 'In Mexico, it's different. There, you have to pay.'

By Jon Feere and Jon Feere on November 23, 2009

Taxpayers will have difficulty finding dialysis treatments due to illegal immigration, reported the New York Times over the weekend. Our open-border immigration policy is resulting in increased costs to taxpayers and medical patients, layoffs of hospital employees, and is simultaneously endangering public health.

Disease is a serious matter and one's instinct obviously is to help those in need to the fullest extent possible. But can the United States be the world's free health care provider, particularly if the result is less care for U.S. citizens?

Mixed throughout the NYT's syrupy, open-border commentary are some troubling anecdotes which represent larger, nationwide trends. Read the full article, but here are excerpts:

To survive, [illegal immigrants at Grady Memorial Hospital in Atlanta] needed dialysis at a cost of about $50,000 a year, which their sporadic work as housekeepers, painters and laborers could not begin to cover.
. . .
Every Tuesday, Thursday and Saturday morning, the 15 or so patients would settle into their recliners, four to a room, and while away the monotonous three-hour treatments by chitchatting in Spanish.

That all changed on Oct. 4, when the strapped public hospital closed its outpatient dialysis clinic, leaving 51 patients — almost all illegal immigrants — in a life-or-death limbo.
. . .
Like other hospitals, particularly public hospitals, Grady has been left to provide costly treatments to nonpaying illegal residents ... American taxpayers and health care consumers have borne the expense.

Over time, the mounting losses have compromised Grady's charitable mission, forcing layoffs, increases in fees and the elimination of services.

"Years and years of providing this free care has led Grady to the breaking point," said Matt Gove, one of the hospital's senior vice presidents. "If we don’t make the gut-wrenching decisions now, there won't be a Grady later. Then, everyone loses."
. . .
Officials at Grady, which will provide more than $300 million in uncompensated care this year, estimate that as many as a fifth of its uninsured patients are illegal immigrants.
. . .
The hospital lost $3.5 million on the dialysis clinic last year… Its 88 dialysis patients accounted for a 10th of total losses at a hospital with more than 800,000 patient visits a year.
. . .
Calling it "a horrible situation," [Grady board chairman] Mr. Correll said that governments at all levels had decided that immigrants were not their problem. "But somehow," he said, "they've become Grady's problem, which seems totally unfair."
. . .
It was evident, given that so many patients were undocumented and uninsured, that the losses would never stop… "It was just financially hopeless," Mr. Correll said. "For every vacancy that opened up, another nonpaying patient would walk in the door, so it was going to last forever."

The Times notes that, unsurprisingly, some illegal immigrants have relocated to states that are more welcoming to illegal immigration. Others have returned home with the incentive of a taxpayer-funded flight:

Some of the Grady dialysis patients have chosen to return to their countries, encouraged by the hospital's offer of free airfare, cash payments, three months of paid dialysis and assistance in seeking insurance or other long-term remedies. Others are trying their luck in states where Medicaid policies may be less restrictive.

But most remain in Atlanta, taking full advantage of a last-minute offer by the hospital, in response to a lawsuit, to pay for three months of dialysis at commercial clinics. They are hopeful that the reprieve will buy time for the lawsuit to progress or for private dialysis providers to take them as charity cases.
. . .
After hearing that the clinic would close, Ms. Perez, 32, set out for Alabama on Sept. 6 because cousins told her they might be able to procure dialysis there. Grady was not yet offering its deal for three months of treatment, and instead gave her $1,300, enough to cover dialysis for a week or two.

Ms. Perez said the money was quickly spent on rent, food and transportation. After going without dialysis for 16 days, she walked into an emergency room near Birmingham, which found that the potassium levels in her blood were high enough to require immediate filtration. Eight days later, she did the same at another Birmingham hospital.
. . .
She went back to the first hospital, where she was dialyzed again, and then found a third hospital that was willing to provide three treatments.
. . .
[S]he returned to Atlanta on Oct. 11, and underwent one more emergency treatment before agreeing to fly home to Mexico with assistance from Grady and a California company, MexCare, that the hospital has hired to help repatriate interested patients.
. . .
The hospital's agreement with MexCare, obtained through a state open records request, calls for Grady to pay $18,000 for every patient relocated — $6,750 in travel expenses and escort fees, a $750 administrative fee, and payment for 30 dialysis treatments at $350 each.

A grateful Adolfo D. Sanchez, 31, explained "No place in Mexico would have offered dialysis for free." His words were echoed by Bertha A. Montelongo who explained, "In Mexico, it's different. There, you have to pay."

But in the United States, we do pay. Over one's life, one pays for these types of treatments through taxation and insurance, regardless of whether or not one actually makes use of them. The goal is to make sure expenditures don't outpace the money coming in. Immigration policy takes this into account by requiring legal immigrants to rely on their sponsor for financial assistance the first five years of their stay. In some sense, this provides five years of paying into the system before the immigrant begins to take from the system.

Illegal immigration, on the other hand, represents a way around this five-year bar. By immigrating illegally, an immigrant could immediately begin making use of taxpayer-subsidized programs that he or she has never paid into. In significant numbers such a system is unsustainable, as evidenced by hospitals reducing services to stay afloat. This is another reason why illegal immigration must not be tolerated.

Federal law requires that states not deny a person emergency medical care, even if they are in the country illegally. But this cost can be reduced through a serious commitment to the enforcement of our immigration laws on the federal, state, and local levels.