"Nixon, D." <ABC@att.net> wrote in message
news:MvKdnYgmNcpxBCrfRVn-gg@comcast.com..
> Group, and others . . . . .
>
> It is a long article but it tells of the harsh reality of what is really
> happening along our Southern border and is destined to be the same
> throughout our nation unless the Bush "Effective Amnesty" policy is
somehow
> reversed.
>
> Our politicians are, literally, "throwing our nation away".   Vincente Fox
> is laughing as we take on the responsibility of the sick, the poor, the
> ignorant, of his nation and other nations .....    How, oh how, can we
> be so dismally stupid ???
>
> McDave
>
>                         Catastrophe in Health Care
>
> Hospitals are being crippled by the costs of treating migrants--and that
> could be just the start of an immigrant-related health crisis
>
> PUBLISHED ON JUNE 2, 2005:
>
> By LEO W. BANKS
>
> If you drive along Southern Arizona's border with Mexico long enough, you
> might see a lone illegal wandering the desert. Or maybe he's hunched at
the
> roadside sipping water from his milk jug. What's he doing there, and where
> are his compatriots, the people he broke into the country with?
>
> The uninformed might ask those questions, but those who live with the
daily
> invasion across our open borders can make a pretty good guess what's
> happening. The fellow got bounced from his group by the coyote-guide. Two
> transgressions will get an illegal cut loose with certainty: Either he
can't
> pay, or he shows signs of tuberculosis.
>
> You think these coyotes are fools? They don't want some hollow-eyed lunger
> hacking and coughing blood on them. So it's adios, pal, and now you're
> America's problem. But they know that already. Every illegal realizes that
> if he makes it to an emergency room in Southern Arizona, or anywhere
around
> the country for that matter, he can get treatment, free of charge.
>
> It's federal law, and has been for 20 years. In its evolution, the policy
> has become a kind of federal health insurance program for illegals, and
its
> rising costs are eating up resources that could otherwise go to poor and
> uninsured American citizens. It has created a financial nightmare for
border
> hospitals and contributed to cutbacks in services at Tucson hospitals.
>
> Is this an outrage? A scandal? Some think it's both. But going back to our
> active TB sufferer, here's something even worse: The guy can't get
treatment
> anywhere, goes underground and takes a job at a restaurant in Tucson or
> L.A., and coughs his way to infecting scores of others.
>
> Talk about a Hobson's choice. But as with everything in the ongoing crisis
> of illegal immigration, the hard choices would largely evaporate if the
> federal government fulfilled its constitutional duty and took control of
our
> border.
>
> The threat illegal immigration poses to American public health plays out
> every day at Arizona's hospitals. Until recently, the issue remained only
> marginally public, a problem medical people batted around among
themselves,
> not with the media. Even today, several hospitals contacted for this story
> declined comment.
>
> The Copper Queen Hospital in Bisbee, one of the hardest hit, helped break
> that barrier when CEO Jim Dickson began returning reporters' calls, even
> though the subject, as he puts it, has become "like the third rail. You
> don't want to touch it."
>
> But his problem had grown severe. Dickson's uncompensated costs for
treating
> illegals rose from $35,000 in 1999 to $450,000 in 2004. His total
shortfall
> now sits at about $1.4 million, a hefty deficit for a 14-bed hospital. To
> make ends meet, he had to close, in June 2000, the Copper Queen's
long-term
> care facility, and cut back on staff and hours, forcing some employees to
> take second jobs to survive.
>
> The hospital has seen a ray of light, however. In the first months of
2005,
> the Copper Queen has gone back into surplus, in part because more illegals
> are in Border Patrol custody when brought in to the hospital. That means
the
> Border Patrol must reimburse the Queen for the cost. In the past, agents
> would drop injured illegals not in their custody at the ER and take off,
> sticking the hospital with bills that never got paid.
>
> Another reason for the decrease, says Dickson: the Minuteman Project.
>
> "It's been terrific for us in April," he says, cutting down on the number
of
> people coming across and therefore the number requiring ER treatment.
> Dickson says the hospital wrote off about $6,000 in losses in April this
> year, compared to about $35,000 in April 2004.
>
> The central issue, though, remains in place--the hospital has had to scale
> back health services to American citizens to treat illegals. Bisbee isn't
> alone.
>
> The most comprehensive study on the subject found that 24 counties in four
> states bordering Mexico wracked up $190 million in unpaid emergency
medical
> bills caring for illegals in the year 2000. The study, commissioned by the
> U.S.-Mexico Border Counties Coalition, found that California spent $79
> million of that; Texas, $74 million; Arizona, $31 million; and New Mexico,
> $6 million.
>
> Bear in mind that these numbers, the best available, are from 2000. We can
> assume, with increasing rates of crossings since then, the costs are
> considerably higher today. Nor do the above figures take into account
> non-border counties. Treating illegals in Maricopa County costs as much as
> $50 million a year, according to an estimate used by Republican Sen. Jon
> Kyl. Nationally, American hospitals lose $1.45 billion a year.
>
> The Medicare reform bill passed in 2003 allocated $1 billion to reimburse
> states for federally mandated ER care given to illegals--about $45 million
a
> year of that to come to Arizona over four years. But even that, some
> hospital staffers say, is little more than a Band-Aid on a huge problem.
>
> Ruth Kish, director of patient care services at Copper Queen, expects that
> under the repayment formula, her hospital will receive only 10 cents of
> every dollar they spend on illegals. "But every bit helps," says Kish.
>
> Another factor: The counties in the above-mentioned study spent an
> additional $13 million in 2000 on emergency transportation, such as
> helicopters and ambulances, to pick up illegals injured after sneaking
> across the line.
>
> The Bisbee Fire Department's ambulance responds to about one of these
calls
> a day during the summer, says Chief Jack Earnest. Asked how many of these
> patients pay up, Earnest wasn't sure, and recommended contacting the
billing
> office in Sierra Vista. The billing office knew exactly how often illegals
> pay their ambulance bills--never.
>
> But there's another category--Mexicans injured in Mexico who call American
> ambulances for help. By federal law, they have to respond, which makes
> Bisbee's Copper Queen the trauma center of choice for Sonora's northern
> frontier.
>
> The calls come from Naco, Sonora, the town across the line just south of
> Bisbee, where, in spite of widespread poverty, cell phones are popular,
and
> everybody knows the Americans are bound by law to treat them.
>
> "When we get a call we go, and we don't ask where the person's from," says
> Earnest. Naco residents needing care go to the port of entry and declare
an
> emergency to American officials. When they're waved through, they're
> transported to the Copper Queen's ER in Bisbee's ambulance, or they drive
> themselves in private cars.
>
> The policy is called Compassionate Entry, and it applies to hospitals up
and
> down the line. The Copper Queen averages about five such cases a month.
Some
> abuse the privilege, says ER Manager Josie Mincher.
>
> She's seen Compassionate Entries with bad sore throats and others who
aren't
> sick at all. One pregnant girl landed in the ER recently complaining of
> morning sickness.
>
> Most are seriously sick, though, and the staff rushes to help, "because
> that's what we do," says Mincher. But it doesn't take much to blow the
> budget. "Just walking in the door is $400," says Mincher. "It's not
unusual
> to have one UDA (undocumented alien) cost $5,000, and we know we're not
> going to get that back. We're playing with monopoly money here."
>
> Here's an example of how one patient can wrack up a huge bill:
>
> A young Mexican man had a bad auto accident across the line and was taken
to
> Douglas' Southeast Arizona Medical Center with severe neurological
problems.
> After being stabilized there, he was transferred to Barrow's Neurological
> Center in Phoenix.
>
> He spent a costly month there, courtesy of the Center, and was
> transferred--with a tracheotomy tube in his throat and supplies to clean
it,
> also provided gratis by Barrow's--to a hospital in Hermosillo. That
facility
> kept him less than a day before releasing him to his home in Naco. But for
> reasons no one can explain, the Hermosillo hospital kept his trach kit and
> cleaning supplies.
>
> As a result, he became septic--a bad infection--and came through the Naco
> port under Compassionate Entry to the Copper Queen. He spent three days
> there, then the staff sent him off, with more free supplies, to a clinic
in
> Agua Prieta for continued care.
>
> How much did this fellow cost the American health care system? A figure of
a
> quarter-million dollars would surprise no one. Cost to the Copper Queen?
> Almost $6,000, and they got none of it back.
>
> Northern Cochise Community Hospital is in Willcox, far enough from the
> border that it doesn't get patients crossing the line for health care. But
> that doesn't mean it escapes the invasion.
>
> CEO Chris Cronberg loses about $100,000 a year caring for illegals, mostly
> those injured in traffic accidents when their loaded vehicle flips while
> speeding north. "It's not make or break for us," says Cronberg. "But as a
> small hospital, we depend on cash, and those are dollars that aren't
coming
> in, so it has an impact."
>
> The same is true at Sierra Vista Regional Health Center, according to Vice
> President Marie Wurth. She expects the hospital to lose $250,000 this year
> treating those who jump the line, get hurt doing it and don't pay their
> bills.
>
> The big squeeze is on in Tucson, too. Tucson Medical Center loses an
> estimated $4 million every year treating illegals.
>
> The corresponding figure at UMC, which includes some foreign nationals,
was
> $3.5 million for fiscal 2004, a $2 million increase from the previous
year.
> Part of that is attributable to UMC, in July 2003, becoming Tucson's only
> Level One trauma center, meaning it saw the most serious cases.
>
> Chief Financial Officer Kevin Burns says the hospital's re-payment rate
for
> treating illegals is about 5 cents on the dollar. "It's very expensive for
> us and continues to grow," says Burns, who says many illegals, as well as
> uninsured Americans, use his ER like a primary care physician. "We hear
> anecdotally that people come here from across the border because they know
> they can get cared for, and if they present at the ER, they can get that
> care at no cost."
>
> The federal law that put the hospitals on the hook for the medical bills
of
> illegals goes by the acronym EMTALA--Emergency Medical Treatment and
Active
> Labor Act. It says that anybody who shows up in an ER must get screened,
> treated and stabilized, regardless of citizenship or ability to pay.
>
> But since its passage in 1985, the definition of emergency has evolved to
> include just about anything, and because Congress didn't fund the
> requirement, hospitals have had to eat the costs as word has spread that
the
> federal goodie wagon is parked at the ER door.
>
> In cities with huge illegal populations, such as Los Angeles, the effects
> have been disastrous. In its spring 2005 issue, the Journal of American
> Physicians and Surgeons reported that between 1993 and 2003, 60 California
> hospitals closed because, for several reasons including EMTALA, half of
> their services became unpaid.
>
> Another 24 are near closing, says author Madeleine Pelner Cosman. She also
> writes that in 1983, before EMTALA, L.A. County put together a trauma
> network that was "one of America's finest emergency med response
> organizations."
>
> A mere 22 years later--again, in part because of EMTALA--Cosman says the
> system is coming apart, with most trauma hospitals having left the
network,
> along with physicians, surgeons and others.
>
> The law has caused a similar situation in Tucson, on a smaller scale.
"With
> EMTALA, the government created an unfunded national health insurance
> program, and it has caused real problems in this community," says Dr. Herb
> McReynolds, who works for a company that manages the ER department for St.
> Mary's Hospital, which treats a large number of illegals.
>
> Lawmakers wrote the legislation to prevent patient dumping--in which one
> hospital refuses to accept, say, an uninsured woman in labor, telling
> ambulance personnel to take her to the county hospital instead.
>
> It stopped that practice. But it has caused a big increase in the amount
of
> un-reimbursed care that hospitals provide, and in McReynolds' words, "made
> physicians rethink their careers and lifestyles."
>
> "The price of it has come over time, because after so much uncompensated
> care, it forces physicians off our call list," says McReynolds.
"Physicians
> have a practice to go to the next day and a family, and ask themselves, do
I
> really want to be up at 2 a.m. providing care when I won't get comp, and I
> can still get sued?"
>
> Some docs have removed themselves from on-call lists by going to work at
> outpatient surgical centers not affiliated with a hospital. Others stay on
> call, but limit the amount of time they're available. A neurosurgeon might
> take call one day a week, and that satisfies the law. EMTALA says that you
> must provide a reasonable amount of coverage, without being strict or
> specific about how much that is.
>
> McReynolds says that EMTALA--in tandem with the malpractice crisis--has
> caused the loss of medical coverage at many hospitals around the country
and
> in Tucson, including St. Mary's.
>
> "Several years ago we had five neurosurgeons on staff here, and now we
have
> two," he says. "We had hand surgery coverage every day, and now we have it
> one week a month. We used to have full ob-gyn coverage, and now they've
left
> and gone to TMC. We have no ob-gyn and one gynecologist on staff covering
> emergencies one day a week."
>
> With docs all over Tucson running for cover, trying to stay off call and
> away from ERs, the variety of emergency health care available to Tucsonans
> has seriously diminished. And here's the most maddening irony of all: The
> feds now reimburse American hospitals for treating non-paying illegals,
but
> not for treating American citizens. Exception: Those eligible for care
under
> Federal Emergency Services, a fairly restrictive program.
>
> For a year and a half now, UMC has approached non-paying illegals in a
novel
> way--it actually reports them to immigration officials.
>
> "Some people find that cold, but we have a responsibility to protect this
> charitable asset (hospital)," says CFO Burns, adding that UMC's status as
a
> public entity requires a different approach. "Our belief is that to the
> extent people have ability to pay, we expect them to."
>
> After triaging and stabilizing an ER patient, the hospital sets out to
learn
> who that patient is, and how he or she plans to pay. To those who are
> uninsured and underinsured, the hospital offers the option of applying for
> its innovative Charity Care program. Under it, the hospital charges the
> patient the same rate it would receive for that service from Medicare, a
> possible reduction of up to 70 percent.
>
> Patients unable to pay at that discounted rate are eligible for further
> discounts that can tear up the bill entirely. To apply for Charity Care,
the
> patient need only return to the hospital with a W-2 or other documents.
> Those who cooperate and return with the required documents don't get
> reported to the feds.
>
> But the hospital does report those who take the medical care and run. How
> many illegals cooperate with this generous offer? Ten percent.
>
> Burns says UMC began reporting the 90 percent who don't pay in November of
> 2003. So far, they've reported 565 persons. Why start reporting?
>
> "Maybe a bit of it was born of frustration because people use our
resources
> and make no effort to work with us and pay," he says. "Even if part of the
> population doesn't pay, I still have to hire new people and buy and
upgrade
> equipment, which costs $15-$20 million a year. When you have these strains
> on resources, from foreign citizens and as well as Medicaid patients, you
> have to manage cash flow very carefully."
>
> As with most issues related to the illegal invasion, those who live along
> the Mexican border, the scene of the crime, have the best view. Where
health
> issues are concerned, it's not a pretty sight.
>
> Residents say they've come across ground dotted with discarded pills,
> syringes containing nobody knows what, and used needles. Some report
riding
> horses along creek beds, popular pull-up areas for groups heading north,
and
> finding 70 or 80 piles of human feces, some of it blackened and running
with
> blood.
>
> It's as disgraceful as it is disgusting--and it raises a question: What
> happens when rain washes all this into the water supply? Is it a threat to
> spread diseases such as hepatitis? Some believe it might be.
>
> What happens when cows drink from these contaminated creeks? And what
> happens when this constant flow of Third World humanity goes north,
fanning
> out all across Arizona and the country? What kind of diseases do they
bring
> with them?
>
> ER workers like Mincher live with that question every day. "We protect
> ourselves best we can," she says, "but if somebody comes in with a
> contagious disease, I might as well buy the farm, because I don't know
what
> it is. A lot of times, they don't know what they have either. If they came
> off a ranch in southern Mexico, they've had no immunizations, no health
> care, nothing."
>
> Most of what she sees at Copper Queen--around 75 percent--is orthopedic,
> falls suffered while jumping fences, for instance. Dehydration, too. Some
of
> these are pregnant women nine months along, who, in Mincher's words, "are
so
> desperate to have their babies born in the U.S., they'll do whatever it
> takes."
>
> She sees cardiac-related cases among illegals who've been given crack,
> methamphetamine or speed by their coyote so they can keep walking. But
she's
> also treated illegals with active chicken pox, tuberculosis, all varieties
> of hepatitis and AIDS.
>
> The Web and print media are full of stories about the diseases illegals
> carry, and their effect on American health. But some writers make alarming
> claims with sketchy evidence at best. In the cases of two diseases,
> however--Chagas and tuberculosis--the evidence is clearer that they're
> indeed coming across our border.
>
> Chagas, a potentially fatal illness spread by contact with the feces of
the
> reduviid bug, called the "kissing bug," is prevalent in South and Central
> America. Fifteen million people in that region are infected with the
> parasite, and 50,000 die of it every year, according to the World Health
> Organization. A person can be infected for 10 or 20 years or more before
> showing symptoms, making it particularly insidious. At its most severe,
the
> disease can cause the heart to fail, and literally explode.
>
> In the United States? Louis Kirchhoff, of the university of Iowa Medical
> School, estimates that between 80,000 and 120,000 Latin Americans with
> Chagas live here. Matching prevalence studies and immigration numbers,
> Kirchhoff figures about 10 Chagas-infected persons entered every day from
> Mexico alone in the 1990s.
>
> The disease can be transmitted four ways, but for Americans, the most
> worrisome is the blood supply. In the United States overall, the chance of
> contracting Chagas from a blood transfusion is small, one in 25,000,
> according to David Leiby, a research scientist at the American Red Cross
in
> Washington.
>
> But in cities with high populations from Latin America, the numbers fall
to
> much riskier levels. In Miami, for example, the chance is one on 9,000. In
> L.A., 1 in 5,400.
>
> Researchers have confirmed seven cases of people contracting Chagas
through
> blood transfusions--five in the U.S., two in Canada--and they say the
number
> of unknown cases is probably much higher.
>
> "A rate of one in 5,400 is something we're concerned about," says Leiby,
> adding that the FDA is still a few years away from a useable
blood-screening
> test. "Chagas is overlooked by the health care system in the United
States.
> Our physicians aren't aware of it and wouldn't recognize it in most
cases."
>
> Tuberculosis, which also shows up in high rates in Mexico, is migrating
> north as well. Many assume a place like Cochise County, right on the
border
> and overrun by illegals, would have a high incidence of TB. But it
doesn't,
> says Edith Sampson, of the Cochise County Health Department. "The
immigrants
> only pass through here on the way to Atlanta, or whatever city they're
going
> to," she says.
>
> Exactly the problem--which is a big reason why 53 percent of the TB in the
> United States in 2003 was among foreign-born persons, up from 29 percent
in
> 1993, according to the Centers for Disease Control. In L.A., again because
> of its huge illegal population, the figure is closer to 80 percent.
>
> Only 15,000 Americans suffer from active TB, the only dangerous kind
because
> it can be passed to someone else, usually by coughing and expelling the
> bacteria from the throat or lungs. That's a small number, but the New York
> Academy of Sciences estimates that each victim will "infect 10 or 20 or
more
> people--in whom the disease will likely remain latent, creating the
> potential time-bomb effect."
>
> The State Health Department says that Arizona had 295 reported cases of
> active TB in 2003, a jump from the previous year. Why the increase? More
of
> the disease was found among kids under 5 years old and prisoners. The
latter
> were mostly Immigration and Customs Enforcement detainees--in other words,
> illegals.
>
> Sixty-eight percent of Arizona's foreign-born TB cases are from Mexico,
says
> state health. Will TB return to the United States in a big way?
>
> It hasn't yet, says Lee Reichman, executive director of the New Jersey
> Medical School's National Tuberculosis Center. But he adds that with
> globalization--the ability to get around the world in 20 hours--and
because
> "we can't stop people from getting in to this country, no matter how hard
we
> try," the potential exists for a new epidemic.
>
> His particular concern is with multi-drug-resistant TB, fatal in 60
percent
> of cases. This strain requires a long regimen of costly drugs that
illegals
> are unlikely to take, or have access to. Arizona has a small number of
> MDR-TB cases, and all of them in the past five years have been among
> foreign-born persons.
>
> "The reason you haven't heard about TB here is that good public health is
> working," says Reichman. "People who are symptomatic go to physicians, and
> the physicians don't ask questions. As soon as you have to ID yourself, or
> say we're going to send you back to Mexico, these people go into hiding
and
> spread more TB. Any physician who cares about being a physician isn't
going
> to ask those questions, because he took an oath to treat sick people."
>
> The Copper Queen's Rush Kish says that under Medicare reimbursement
guides,
> her hospital cannot ask patients if they are in the country illegally. But
> how do you bill the feds to get money back for treating illegals if you
> can't ask if someone is illegal?
>
> Well, you play a little Orwellian word game, probing around the issue with
a
> list of government-approved questions, then make educated assumptions. But
> the illegal holds the trump card, because he can refuse to answer every
> question. "We don't know yet what evidence Medicare will accept when we
> apply for reimbursement," says Kish. "But at least we can begin
documenting
> the enormity of this problem."
>
> The question isn't whether those with genuine emergencies should get
> treatment. Of course they should. In Naco, residents have no access to ER
> care and many would die if they didn't get to the Copper Queen. The real
> question is: Who pays?
>
> Rev. Tom Buechele, pastor at St. John's Episcopal Church in Bisbee, thinks
> it's appropriate for the federal government to keep ponying up, as long as
> American companies "maintain their illegal trafficking in human labor."
>
> "Until we have comprehensive immigration reform, we need to bear the
> health-care costs for undocumented workers, whatever those costs are,"
says
> Buechele, who, for almost a year now, has been running a free monthly
clinic
> in Naco, Arizona, catering to the poor and uninsured on both sides of the
> line.
>
> Although they talk a different language, politicians, even Republicans,
> promote policies that further Buechele's liberal vision. They boast to
> constituents that they've saved border hospitals by pushing through the
> Medicare reimbursement plan, which provides a relatively small amount of
> money over four years.
>
> But that's another Hobson's choice, which is to say no choice at all. What
> do you do, let hospitals go under? Kyl, who pushed to get the
reimbursement
> money, says an emphatic no.
>
> "If we want those ERs to be there for us, then we'd better keep them in
> business," says the Arizona senator. "If our hospitals are required by
> federal law to treat anybody who comes into the ER, and the federal
> government has failed to control the border, then it's appropriate for the
> government to reimburse these hospitals."
>
> But some argue that the system as it stands now, with EMTALA firmly in
> place, is rigged to produce two results: The federal treasury will remain
> wide open to illegals, and that all but guarantees that more and more of
> them will bust the line to get here.
>
> After all, this is the end of the rainbow for them, where jobs await,
> education is free, health care is free. Who wouldn't come? And the more
they
> come, the more American health suffers--from such diseases as Chagas and
TB,
> further cutbacks in hospital services to American citizens, and even
> possible closures.
>
> Where's the compassion in that? Copper Queen ER nurse Josie Mincher,
herself
> Hispanic, puts her health, and possibly her life, on the line to treat
> illegals. Listen to the emotion in her voice as she describes what that's
> like:
>
> "I go to work every day feeling like I'm on a torture wrack. My
heartstrings
> get pulled in one direction by these sick people I want to help. Because
I'm
> Hispanic, I know how they live. And I'm pulled in the other direction,
too,
> thinking that if our hospitals aren't around, where do I take my own kids?
>
> "But we have to treat them because of EMTALA. It says that anybody who
comes
> within 250 yards of an ER gets treatment. What would happen to Safeway if
> the law said anyone who comes within 250 yards of the store gets free
food?
> They'd go out of business. Well, we're a business, too."
>
> Mincher's solution? "Send the bills to Mexico. If it affected them
> financially, they might do something about all these people coming across.
> My grandparents came here legally, and it took a long time and a lot of
> money. They respected the law. These people just walk across now. They
> weren't brought up the same way."
>
> Burns at UMC says he wants the U.S. and Mexican governments to work
together
> to find a solution. But, as Kyl cautions, don't expect any breakthrough
> soon. Mexico benefits far too much from our illegal immigration
> nightmare--in jobs for its citizens and cash sent home--to step up with
> money to care for its own people.
>
> Until the border is brought under control and the invasion stopped, we'll
> continue to pay the bills of people who illegally tiptoed across the line
in
> the dead of night.
>
>

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