News: The INS crackdown along the Mexico-US border is driving thousands of
would-be illegal immigrants to cross in remote desert areas, where the harsh conditions
send many to nearby US hospitals. But the government won't pay for their care,
saddling already strapped rural hospitals with billions of dollars in unpaid bills.
On a blistering day in May, US Border Patrol agents in southern California's
Imperial County found a man collapsed in the desert. The 39-year-old had successfully
sneaked across the border from Mexico, only to succumb to heat stroke. The agents
called an ambulance to take him to nearby El Centro Regional Medical Center, where
he spent two days in intensive care and several more in recuperation. The agents
didn't come back for him, so he left with relatives bound for Los Angeles -- leaving
the hospital with his unpaid bill for $26,890.
No one at El Centro Regional was surprised. The public hospital is losing more
than $1 million a year treating undocumented immigrants, many of whom were injured
trying to cross the border -- people who've broken bones jumping from the 20-foot
border fence in Calexico, nearly drowned trying to swim the All-American Canal,
or become dehydrated in the Imperial Valley desert.
Neighboring Pioneers Memorial Hospital lost more than $500,000 on similar cases
last year, not to mention unpaid ambulance service and physicians' fees. The two
hospitals have to cover 150,000 people in a county that already has some of the
highest unemployment and poverty rates in the country. "We're struggling
to treat needy people, and the cost is bearing down on people least able to afford
it," says Ted Fox, CEO of El Centro Regional.
Other border counties in California, Arizona, New Mexico, and Texas are similarly
deluged with a rising tide of illegal immigrants, and likewise left unaided with
the burden of caring for those that need medical attention. That burden has increased
drastically since 1994, when the Immigration and Naturalization Service launched
Operation Gatekeeper, a massive crackdown on illegal border crossings at urban
Human-rights groups have protested the deaths and injuries caused by Operation
Gatekeeper, but another issue has gone virtually unnoticed: Who pays for the immigrants'
hospital care, ambulance service, autopsies, and burials? Federal law mandates
that hospitals treat anyone who needs emergency care, including illegal immigrants;
but the federal government only pays for the medical care of illegal immigrants
who are in INS custody. When no arrest is made, hospitals and local governments
are left to cover any medical costs. Those unpaid bills add up to billions every
year, a fiscal crisis that has already helped drive at least one hospital out
of business and several health care workers to abandon border areas....
At the same time that federal government policies are putting more demands
on border hospitals, government support for them is dwindling. Federal Medicaid
and Medicare reimbursements to El Centro Regional have been slashed by more than
$3 million over the past three years, and next year the hospital faces a cutback
of almost further $2 million.
San Diego County's Scripps Memorial Hospital was forced to close just last
spring because it was losing $5 million a year, due in large part to unreimbursed
care. A general surgeon and two anesthesiologists have recently left El Centro
Regional because they were suffering financially. Physicians' charges are broken
down separately from general hospital costs, and when patients can't pay, the
doctors aren't paid. Now El Centro Regional has only two general surgeons to share
Imperial County has helped form a coalition of 24 border counties lobbying
for federal aid to offset the losses hospitals suffer in fulfilling their obligation
to treat illegal immigrants. As a result, bills are now pending before the House
and Senate that would allocate $800 million over four years to states and counties
to reimburse medical-care costs for undocumented immigrants. But those funds would
be divided among 17 states, and would cover only a fraction of what hospitals
spend annually treating illegal immigrants -- a figure Congress estimated at $2.8
billion two years ago. And in fact, says a spokesperson for Rep. Brian Bilbray,
R-CA, who introduced the House bill, the legislation may not even come to a vote