Tuesday, August 25, 2009

Paying The Price For Illegal Care

(emphasis added - rfh)

Re-posted from http://Investors.com, "Issues and Insights", Mo.08/21/2009, p.A15



Health Care: Democrats are right that uncompensated emergency care for the uninsured is driving up costs.   What they don't say is it's illegal immigrants who are bankrupting ERs, and the federal government is encouraging them.

Last decade, the Clinton administration added teeth to a little-known Health and Human Services Department regulation mandating that hospitals provide emergency treatment even to illegals.

Under the Emergency Medical Treatment and Active Labor Act, or EMTALA, hospitals can't even ask for a patient's immigration status or ability to pay prior to delivering treatment.  They also can't keep such uninsured patients waiting, even if their problem isn't an emergency.  Nor can they discharge them until they're fully stabilized and have safe transportation.

More, hospitals must post EMTALA signs in Spanish and English.  The law isn't limited to ERs.  Hospitals must accept illegals at any facility on campus — including outpatient clinics and doctor's offices — located within 250 yards of the main buildings.

Hospitals end up treating uninsured illegals for the sniffles and other nonurgent care, and pass that exorbitant cost on to the insured, the Government Accountability Office has found. Resulting overcrowding leads to delays in "care for patients with true emergency needs."

This unfunded federal mandate has placed a heavy and unfair financial burden on more than 1,500 hospitals across the country, according to HHS data, costing billions in unpaid bills by some estimates.  Many eat losses and eventually go out of business like they're doing in droves in California, which has seen 85 hospital closures in the last decade. An additional 55 facilities have shut down ERs. The state ranks last in the country in access to emergency care and last in ERs per capita, making it woefully unprepared to respond to a major earthquake or terror attack.

Border hospitals are the hardest-hit. By law, they have to treat even illegals injured while crossing the border. Each year, hundreds of them pour into the ER at El Centro Regional Medical Center near San Diego with fractures sustained while climbing the fence or eluding border patrols in high-speed car chases. Others suffer from multiple organ failures from dehydration.

Many abuse the system with encouragement from groups like Maldef and La Raza, which have spread the word about EMTALA. In Texas, hospitals are flooded with walk-in mothers in labor showing up in the ER to have their anchor babies.

Some 80% of the births at Houston's Ben Taub General Hospital and Lyndon B. Johnson General Hospital are to illegal immigrants. In Fort Worth, it's about 70%.

At a recent town hall meeting, President Obama shot down tort reform because, as he argued, Texas has tort reform and one of its cities — McAllen — still has "the highest health care costs in the country."
McAllen also is one of the most heavily trafficked border areas in the country, a little fact Obama failed to mention. The border patrol nabs 75,000 illegals there a year. They're the ones caught; others flood McAllen hospitals.

Overutilization of ER services by illegals is crippling the area's major hospital system, including McAllen Medical Center and Edinburg Regional Medical Center. The South Texas Health System eats $140 million a year in free care, and 60%-70% of those unpaid costs are in the ER.

Some 40% of the babies born at McAllen Medical last year were to illegals. That's nearly 2,400 babies who were given instant citizenship. And their mothers instantly qualified for U.S. welfare. Many of them, McAllen Medical CEO Joe Riley says, were "mothers about to give birth that walk up to the hospital still wet from swimming across the river and in actual labor."

Actually, Miami boasts the highest medical costs in the country. McAllen is No. 2. Like McAllen, Miami hospitals are overrun by illegal Hispanic immigrants.

Thanks to EMTALA, one hospital near Miami was forced to eat $1.5 million in unreimbursed care for an illegal alien from Guatemala. After three years of treatment, Martin Memorial Medical Center paid $30,000 to charter a jet to take Luis Jimenez to a medical facility in his home country. His family in turn sued the hospital.

Any health care overhaul should start with rewriting EMTALA. No one wants to refuse emergency care to indigent Mexicans who truly need it. But when you consider that they wire an average of $300 a month in remittances back to Mexico, that money could go a long way toward purchasing medical insurance.

At a minimum, the government could impose a fee on remittances to Mexico, and use the revenues to offset costs that border hospitals incur for the care of illegal immigrants.

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