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I think they overlooked something..

Yesterday, the Boston Globe had a rather lengthy -- and troubling -- story about the state of Bay State emergency rooms. People seeking medical attention there have long waits to see a doctor, largely due to cutbacks and overcrowding. In short, more and more people are seeking to use scarcer and scarcer resources. It's not a pretty situation.

The story goes into substantial detail about the underlying causes of the problems. Budget cuts in ER beds. Scarcity of beds in psychiatric hospitals, meaning such patients are kept in the ER until space is found for them.

The story is based on reports the hospitals have to file with the state, and as such they don't include other factors that might be germane. And heaven forfend the Globe should actually go forth and commit journalism.

One of the biggest causes of the hospital crisis in the Southwest is the burden of caring for illegal aliens. These people tend to treat the ER as their first, last, and only source of medical attention. Also, they lack medical insurance and rarely pay their bills, meaning that the hospitals get stuck with the tab. As a consequence, many hospitals in that area have had to completely shut down their ERs -- or risk going belly-up.

Massachusetts has a very large illegal alien population. In fact, one Brazilian "immigrant rights advocate" is on record as saying that over 2/3 of the 250,000 Brazilians in the Bay State are there illegally -- and that's just from one nation.

How many of these people overcrowding the ERs are using it as a free clinic? And how many of them are here illegally? The reports don't tell us, because it's illegal for the hospitals to even inquire about such things. (The wisdom of that policy is certainly debatable, but not really germane here.) The Globe could have done a few visits to ERs and asked for themselves, but why bother?

I've been taken to an ER exactly six times in my life, and that is more than enough for me, thank you. (Once was in junior high, when I caught a line drive in my eye -- and they had to pick shards of my glasses out of my eyeball. Another was when I finally couldn't hold my head up straight, and they diagnosed a sprained neck I'd suffered almost a week before. And then there was the time I was having symptoms of a heart attack, but it turned out to be pericarditis.) In each case, I was treated quickly, thoroughly, and professionally. And in one case, when I lacked medical insurance, I got socked with a several-thousand-dollar bill that I eventually paid off.

It would have been nice to just let that bill go, let the hospital suck up the loss and move on. But that wasn't an option. Besides the fact that they had my name, address, date of birth, and Social Security number, I honestly owed the money. It wasn't easy, and it took some serious time, but I paid off that debt.

Had I been an illegal alien, though, I could have simply given a bogus name and address, said I had no Social Security number, and still gotten treated just the same without the worry of that bill coming back to haunt me.

Pity that the Boston Globe didn't even try to find the full story here. But that's pretty much par for the course for them -- when the facts might contradict their agenda, they tend to get short shrift.


Comments (8)

Good post, Jay Tea, ... (Below threshold)
langtry:

Good post, Jay Tea, and absolutely spot-on about who are the main consumers of non-emergency E.R. care. I would, however, assert that hospitals not being able to inquire as to immigration status is absolutely germane: these "immigrants", and the politicians and community activists who agitate and advocate for their consumption of healthcare services, have bastardized the Emergency Medical Treatment and Active Labor Act (EMTALA) laws (seehere: http://www.emtala.com/). They;ve rather brilliantly managed to entwine the inability to question immigration status with entitlement to services, whether or not their condition is acute enough to warrant immediate treatment under EMTALA.

I worked for five years at a major Chicago hospital, and saw first-hand how this works. EMTALA was enacted to prevent patient dumping, especially in cases of women in active labor. A common practice in Mexico is the refusal to treat/admit a woman in active labor if she didn't have insurance, and a Mexico City woman (and her unborn child) died on the sidewalk outside a prominent hospital that refused to treat her. U.S. lawmakers expanded this idea further to include those persons who show up in acute distress (inability to breathe, unstable heart function, etc.), and hospitals are required by EMTALA to stabilize the patient so that he or she can be transfered to a public hospital or other facility where they are eligible for non-acute treatment. Through the politicization of EMTALA, advocates for illegal immigrants have put a choke-hold on the ability of hospitals, medical centers and clinics to deny treatment for persons of specific ethnicity who are not in acute distress, under the guise that denial of EMTALA services for an Mexican illegal's sore throat or minor cold is tantamount to racism.

If people were aware of the degree of consumption of vital services by illegal immigrants, the issue would become the "Hot Button" issue across the U.S.

An acquaintance of mine had... (Below threshold)
tyree:

An acquaintance of mine had a stroke. The doctor couldn't find room in any nearby emergency room for an hour because of overcrowding. My grandson had to wait an hour with a 104 degree temperature. All of the people who were waiting in line ahead of him spoke only Spanish. The politicians keep saying we need illegal immigration so that our food prices can be low. If I could vote on it, I'd vote for $8.50 hamburgers and 10 minute waits at the emergency room. I still don't understand why their "choice" to illegally immigrate is allowed to cause health problems in this country, in addition to the severe overcrowding in the schools, depressed labor rates, reintroduction of disease, crime and the trees that are cut down so that everything can be printed in two languages. Who in this country wants all these problems? Illegal immigration hurts everyone, except the politicians, some employers and the illegal immigrants.

I had an emergency room vis... (Below threshold)

I had an emergency room visit when I was in college and had no insurance. I took a second job that summer and worked the graveyard shift at the donut shop to pay the bill. I eventually paid the whole thing off, but it was a stretch.

When I hear about illegals walking away without even thinking about paying, I remember all those exhausting nights at the donut shop. I had no insurance, but I had honor.

Do illegals outnumber Medic... (Below threshold)

Do illegals outnumber Medicaid patients in Boston?

Medicaid patients are the biggest clog in the ER systems around here. Medicaid doesn't pay for routine doctor visits, so the recipients simply go to the ER with every minor affliction or injury because ER visits ARE covered.

Medicaid reimbursements lag so far behind rising costs that many ERs simply close - they are overburdened with money-losing non-emergencies, and cannot continue to operate. We are now seeing the rise of "private ERs" which don't accept ambulances or Medicaid patients.

No doubt illegals contribute to the burden somewhat, but to attribute the bulk of the problem to them without any evidence beyond anecdote just doesn't wash.

Interesting, that in my lit... (Below threshold)
epador:

Interesting, that in my little town, the undocumented pay their bills, and its the born-in-America types that stiff and gouge the system. Not that anyone said the NW was typical for anything.

From the late 70's to the e... (Below threshold)
Judith:

From the late 70's to the early 90's I spent many hours at the er. My mother suffered from COPD, was frequently brought in by ambulance, and spent a good long while in the er. I generally packed water, food and a good book to read, I love talking to strangers, so I was able to cope with the sometimes 8 hours I spent in the emergency room. What exactly is a "long time" in the er? Is it more than the 8 hours I frequently spent in the er? (that would be back in the good old days of short time (8 hours) in the er.

Jim Addison makes some good... (Below threshold)
tyree:

Jim Addison makes some good points but I was struck by this sentance, "No doubt illegals contribute to the burden somewhat, but to attribute the bulk of the problem to them without any evidence beyond anecdote just doesn't wash." When then you couple that statement with this one from Jay Tea, "And how many of them are here illegally? The reports don't tell us, because it's illegal for the hospitals to even inquire about such things?" There are no hard facts collected anywhere on the cost of illegal immigration. Seriously, Jim go to your local school district and ask them how much educating the children of illegal immigrants is costing your district. Go to a hospital and ask for the information. You won't get it because it can't be collected. My school district closed and sold three elementary schools in 1979 because the area was built over and the population had stabilised. Twenty years later the schools were bursting at the seams and a member of the school board ask, "No new dwellings have been built in this area for 30 years, where are these children coming from?" The newspaper did not record the answer. I will be paying for school bonds for twenty five more years so that illegal immigrants and the children of illegal immigrants can go to school for free. I wish I could use some of that money on my own children. Forced charity is not very far removed from theft.

For a few years I've worked... (Below threshold)
Tim in PA:

For a few years I've worked my way through school as a guard. I have a regular place to work on the weekends, but in the summer I get sent all over the county. This includes all the local hospitals; they hire additional guards to walk around the ED lobby so people don't get out of hand due to the wait.

I have to say that some of the post, and some of the comments, are dead on although my area is a tad different. Medicaid patients seem to make up about 2/3 of the people who show up. Most of them are extremely obese (telling it like it is, you have a problem with that, too bad). Most of the rest are construction workers and field hockey/softball players.

We actually have very few illegals around here; most newcomers to the city come from Puerto Rico. The ones who moved here seem to really like this place; whatever floats your boat, I guess. They make up most of my co-workers, and I'm constantly explaining to the PA Dtuch natives around here who complain about "them Mexicans" that Puerto Rico is part of the US.

The ED is a different story. Now, obviously, they don't announce it, but when you have people who come from Mexico/central America and don't speak english and have no ID or insurance, that's usually a hint. I don't recall seeing anyone hailing from said places around here except for in the ED, though not many even there.

Odd thing is, the apparent illegals only seem to come for major stuff -- obvious serious injuries and illness -- but they have to wait for hours while all the medicaid people who "ain't feelin so good" get processed. I bet if I weighed 400 pounds I wouldn't feel so good either.

This is where I come in; the seriously hurt or sick visitors from south of the border get really agitated and start yelling in spanish because they have to wait behind the local whiners (who are yelling in english). The sight of a uniform tends to keep the peace.

What I can't figure out is how people so poor get so fat. Medical excuses can't possibly cover them all, almost everyone you see in parts of the city are overweight. I couldn't afford enough food to do that, working as few as 16 hours a week for 8 months of the year while I'm in school. Maybe it's because while I qualify for most of the same benefits and programs as they do, I don't use them. My standard of living seems to be a lot higher though, so my theory is that the poverty is caused by the obesity, not the other way around. My food budget per day has sometimes been $2; compare that to the cost of fast food.




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