The medical cost of illegal immigration: The crisis for US hospitals
By John David Powell (12/06/05)
President Bush’s plan to deal with illegal immigrants
may not be the best idea on the table, but it
increased the national discussion, and forced the
mainstream media to make the issue their lead stories,
if only for a few hours. Rarely mentioned by
politicians, pundits, and promoters of special
interests is the silent threat to our nation’s
healthcare system because of lax border enforcements
and liberal policies regarding medical care.
The Emergency Medical Treatment and Active Labor Act
(emtala.com) requires all emergency departments to
treat any person seeking help for a medical condition,
which can range from a gunshot wound, to a traffic
accident injury, to labor, to a splinter in a finger,
to a cough. The emergency department must provide
screen and treat the patient until ready for
discharge, or stabilize the patient for transfer,
regardless of ability to pay.
Uncompensated costs to hospitals and other healthcare
providers run into the billions of dollars annually.
States bordering Mexico take the biggest hits. The
Federation for American Immigration Reform, or FAIR
(fairus.org), estimates that last year, California
lost $1.4 billion, Texas lost $850 million, and
Arizona lost $400 million. Officials believe care to
illegal immigrants make up 25 percent of those costs.
If that is true, then hospitals serving the 24 US
counties along the border ate $190 million in the year
2000, according to an oft-cited study by MGT of
America (mgtamer.com) sponsored by the United
States/Mexico Border Counties Coalition
(bordercounties.org)
No one can say for sure if the 25-percent estimate is
high or low, because federal laws prohibit healthcare
providers from asking residency status of a patient.
But, no one contests the guess. The Government
Accounting Office figures lack of a Social Security
number is the best proxy in hospital records for
assessing the cost.
Most folks have a hard time grasping the concept of
billions of dollars; the numbers are so huge they just
pass through the mind. That is why it is always
better to break down the numbers to more
understandable portions by looking at individual
examples.
A 12-year-old illegal immigrant from Mexico, as
reported by the New York Times in 2003 (“Burden Grows
for Southwest Hospitals”), received burns over 25
percent of his body when a gasoline can caught fire
while he and some friends torched ants. His
unreimbursed hospital charges at a Phoenix, Ariz.,
medical center exceeded $250,000.
Between 1993 and 2003, sixty California hospitals shut
their doors because half of their services went
unpaid. Nine more hospitals closed last year from
losses associated to medical care to illegal aliens.
In 2003, Sen. Diane Feinstein (D-Cal.) said her state
spent about $980 million on emergency services for
undocumented immigrants. That same year, the Los
Angeles County Board of Supervisors estimated public
hospitals and clinics in LA County spent $340 million
a year to treat illegal aliens.
Mississippi’s state auditor (www.osa.state.ms.us) is
conducting a performance audit to determine how much
his state’s citizens pay out to provide health care to
illegal residents. The University of Mississippi
Medical Center (umc.edu) wrote off $48 million in
indigent care in 2003, and $73 million in 2004.
Then there is the issue of “anchor babies” born in
this country, at no cost to the parents, for the sole
purpose of pulling the rest of the family into
permanent residency. Anchor babies make up about ten
percent of all newborns in the US annually, according
to the Center for Immigration Studies (cis.org). In
2003, anchor babies accounted for seventy percent of
all births in San Joachim General Hospital in
Stockton, California. New Mexico hospitals lose about
$210 million a year because of anchor babies and
illegal aliens.
The federal government will allot $1 billion,
distributed among all states and the District of
Columbia over the next four years, to cover a small
portion of the cost of emergency care for uninsured
patients, regardless of citizenship status. Providers
can apply for this special reimbursement only after
they seek reimbursement from Medicaid or private
health insurers. The six states that arrest the most
illegal aliens for each fiscal year will get one third
of the funds. This year, California receives $70.8
million, Texas receives $46 million, Arizona gets $45
million, New York gets $12.5 million, Illinois gets
$10.3 million, and Florida gets $8.7 million.
Hospitals will receive most of the funds, with
physicians and ambulance services also sharing in the
reimbursements.
As our nation’s acceptance and dependence on illegal
workers and their families grow, so will the costs to
our taxpayers and their families. In this case,
however, cost is not measured exclusively in dollars.
The cost also will include lives lost because
emergency departments that should have provided
life-saving services may not be open for business.
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