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| Immigrants Swamp Border Hospitals |
| 2002-12-15 |
| By Lynn Brezosky The Associated Press BROWNSVILLE, Texas — Ambulances regularly race across the bridges of the Rio Grande, bringing some of Mexico's most ill to the nearest U.S. emergency room. Obligated by federal law, the hospitals provide the care and worry later about whether the billing addresses patients give them are accurate. Often the addresses are false — and the hospitals get stuck with the bill. Immigrant patients have inflated medical expenses for insurance companies, Medicaid and paying customers, officials say, and are overwhelming already busy hospitals in one of the nation's fastest-growing regions. One recent study by the U.S.-Mexico Border Counties Coalition, an American lobbying group, found U.S. border hospitals provided at least $200 million a year in uncompensated emergency care to illegal immigrants — $74 million of that in Texas. "Shh, don't tell Iowa farmers that part of their taxes are paying for trauma that occurs south of the border," Dr. Lorenzo Pelly, a south Texas doctor, told state lawmakers at a recent hearing. Republican state Sen. Chris Harris said he was shocked by what he called the "dumping" of Mexicans on U.S. hospitals. Policymakers are just beginning to assess the size of the problem. Brownsville Medical Center estimates losses averaging at least $500,000 per month. At Thomason Hospital in El Paso, officials said their first attempt to estimate the cost found $1 million over just three months. Thomason Hospital responded by retaining a Mexican lawyer and requiring patients to sign "pagares," or promissory notes, that carry weight under Mexican law. It also signed on with a firm that specializes in collecting past due accounts in Mexico. Even without the influx from Mexico, U.S. border hospitals are straining to meet the region's growing medical needs. Some have resorted to importing doctors and offering nurses tuition grants and signing bonuses. But the load really jumped as Mexicans looking for work stream to factories along the border. The North American Free Trade Agreement has stimulated business on both sides of the border, but hospitals have not kept up. NAFTA "lacks the social economic infrastructure and capacity" to address the growth, said Eva Moya of the Mexico Border Health Commission, made up of U.S. and Mexican officials. For the sick or injured on the Mexican side of the border, the choice in a life-or-death situation can be a three-hour journey inland to Monterrey, Mexico, or a minutes-long trip to Brownsville, Laredo or El Paso. The issue drew attention in September, when 4-year-old Larissa Guajardo, a U.S. citizen, died of heart problems after crossing the Hidalgo-Reynosa international bridge on the way to a hospital. Family members blamed a delay caused by immigration officials, who would not let the mother enter the country. The mother lacked paperwork and had crossed the border illegally before. The Immigration and Naturalization Service said the inspection process took only a few minutes and that inspectors did not know the girl's illness was critical. Once the seriousness was discovered, the mother was allowed to enter on humanitarian grounds, the INS said. The Sept. 11 attacks have also complicated the situation along the border, with some authorities worrying about what the ambulances might be holding. "It is a security threat if they are going across the border unchallenged, but at the same time, we don't want to interfere with an emergency procedure," said Carl Rusnok of the INS in Dallas. The B&M International Bridge, which links Brownsville with Matamoros, Mexico, has emergency crossings down to a science, said Joe Galvan, president of the company that runs it. The company has its own security guards staffing both sides of the crossing, and in medical emergencies a call goes out for the U.S. side to clear a lane for fast passage. Under a 1986 federal law, U.S. hospitals must treat anyone who seeks emergency care, without regard to immigration status or ability to pay. The government gives hospitals extra funding to help poorer regions absorb the costs of unreimbursed care, but hospitals say it is not enough. "This becomes a particular philosophical question that these doctors are having," said Dominic Dominguez, an administrator at Brownsville Medical Center. "Part of my signing to serve in this community is, I'll cover this emergency room. But I didn't sign on to cover Mexico." |
| Posted by:Anonymous |
| #2 Actually, what they're describing sounds more like a business opportunity than an immigration problem. The situation is a statement that there's a requirement for a major medical facility in Matamoros. I'd guess it'd be set up in partnership with one of the Brownsville hospitals, and its core would come from one of the clinicas on the Mexican side of the border. There should be some sort of subsidy available from the Texas government and the Mexican state (Coahuila?) government, and probably similar kick-ins from the U.S. and Mexican feds. Somebody with a silver tongue should also be able to talk some out of whatever HMOs are prominent in the area, with maybe a second helping from Texas state medicaid and the Mexican state equivalent. Set the operation up as a partnership deal, with ancillary services (labs, x-ray, MRI, all that sort of stuff) incorporated on the Mexican side for purely local consumption, and a cross-billing arrangement for the treatment facility. The existing clinicas can form the basis for the outpatient treatment facilities, and the ER can be cloned from the U.S. facility. Why do it? Because it's a horrendous long drive from any of the border towns to Monterrey, scenic as the drive may be. (When you're being transported with lights and sirens you're not really concerned with the scenery.) There are a number of thriving towns on the border, which would provide the clientele for a major regional hospital. All that's needed is a silver-tongued devil to put together the consortium to set it up, plus the money, guns and lawyers needed for the mechanics. |
| Posted by: Fred 2002-12-16 09:44:34 |
| #1 Neal Boortz, Atlanta talk show host, came up with and idea about this. When the Mexican ambulance arrives, confiscate it. Then sell it to pay for the medical bills. Works for me. |
| Posted by: Denny Wilson 2002-12-15 21:26:09 |