- The Washington Times - Monday, March 18, 2002

Illegal aliens who fall ill or injure themselves sneaking across the Mexican border are forcing many U.S. hospitals to the brink of bankruptcy.
The hospitals, many of which are located in sparsely populated and poor counties, are spending millions treating the broken bones, heat exhaustion and wounds of aliens they cannot refuse to treat and who cannot pay. The result, says James J. Dickson, head of the Copper Queen Community Hospital in Bisbee, Ariz., is "a tragic and contentious situation."
Sheri Jorden, senior policy director for the Arizona Hospital and Health Care Association, calls it a "huge problem."
"Here you have a population that is not supposed to be here, that urgently needs care which must be given and no one will pay for it. The situation may be worst in Arizona, but it impacts New Mexico, California, Texas even Illinois, New York, Iowa and other states far from the border."
George Mead, spokesman for the Texas Hospital Association, says that doctors and hospital administrators are not inclined to ignore those who are hurt. And even if they wanted to, they couldn't.
The Emergency Medical Treatment and Active Labor Act requires hospitals and ambulance services to provide care to anyone needing emergency treatment regardless of citizenship, legal status or ability to pay. There are no reimbursement provisions, though, and the poor, desperate job seekers infiltrating the United States usually have no money.
It's difficult to determine how much the situation costs border hospitals in a given year. For one thing, doctors don't ask the nationality or legal status of patients. Still, administrators at 16 border hospitals recently tracked the expenses incurred from treating indigent and uninsured foreign nationals over a three-month period. The cost: $44 million.
In testimony last week before a subcommittee of the House Government Reform Committee, Mr. Dickson reported that uncompensated costs attributed to "Border Patrol apprehensions" and "compassionate entry trauma" have risen more than 400 percent over the last four years.
"Border Patrol apprehensions" refers to what critics say is a deliberate Immigration and Naturalization Service policy of avoiding payment for the care of injured or sick illegal aliens that Border Patrol officers track down. The officers refuse to officially apprehend such victims. They take them to area hospitals for treatment, and since the victims are not officially in INS custody, the agency isn't legally obligated to foot their bills.
Some months ago, for example, a van that the Border Patrol was chasing overturned, and the nearest hospital went on disaster alert. Because the Border Patrol refused to formally arrest the injured, the hospital had to absorb the costs.
Such costs can easily escalate, especially for surgery patients who need post-operative care. Hospitals are constrained from discharging patients without a letter from the patient's family in Mexico, stating a family member will cooperate and see that the patient receives needed care when transferred back to Mexico.
Frequently, however, patients don't give their real names. Even when they do, U.S. authorities find that the families can't or won't declare the patient will get the needed medical attention back home. In such cases, the hospital must arrange and pay for skilled nursing, physical rehabilitation or other post-hospital care.
Mr. Dickson told members of the subcommittee on criminal justice, drug policy and human resources that two trauma centers near Tucson had announced they were closing because they could no longer sustain the losses. The facilities were given a brief reprieve when the state provided an infusion of funds.
But the University Medical Center in Tucson, Ariz., predicts it will have to absorb $8 million to $10 million this year "in uncompensated care to foreign nationals," Mr. Dickson says. And Good Samaritan Regional Medical Center reported it lost $1 million treating 75 undocumented immigrants in the first quarter of fiscal 2002. It anticipates greater losses in the months ahead.
Rep. Jim Kolbe, Arizona Republican, and Rep. Ed Pastor, Arizona Democrat, are trying to win support among their colleagues for legislation to ease the situation.
Their bill calls for the Department of Health and Human Services to set up a five-year pilot program for directly reimbursing hospitals and ambulance services for emergency treatment given to foreigners who are in the country illegally or who are "paroled" for humanitarian reasons.
"Parole" is the government's term for the practice of waving into the country seriously ill or injured persons seeking help at U.S. hospitals. The practice is humanitarian because there are few, if any, properly equipped Mexican health facilities for Mexican border dwellers. Miss Jorden reports, for example, that the nearest Mexico facility providing trauma care is about 150 miles from the Arizona-Mexico line.
Consequently, when an exploding propane tank severely burned four Mexican children in Naco last year, they were rushed across the border to the 49-bed Copper Queen Community Hospital. All the physicians and the entire staff were called in.
When the children's conditions stabilized, they were whisked in four helicopters to a Phoenix burn center. Three died, and the fourth lived after an amputation and lengthy recovery. The Copper Queen hospital had to cover $277,292 in treatment costs.
Arizona's medical community is particularly affected by the influx of aliens, but the health care problem caused by uninsured illegals increasingly affects other areas to which they flee. "The border is now north of Kansas," Mr. Mead says.


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