Foreign patient with greencard only staying in U.S. for 'free' medical care

Nurses General Nursing

Published

Basically, I really love my Spanish speaking patients in every way. I'm talking about people born and raised outside of the United States. They have Old World manners, respect for elders, I love their family values. They really are great, and Americans can learn a lot from their old fashioned ways. I love the way they roll up their sleeves and care for their hospitalized family member.

I had a gentleman in his 50s, totally Spanish speaking, had been a farm worker but with too many health problems to work, most of which resulting from IDDM non-compliance leading to heart problems and renal insufficiency. Most of his family was back in Mexico, including his 7 (grown) children. He spoke very little English.

His nephew came in, he spoke English, he was nice as can be. He wanted to know more about what was going on, he gave me more background info. His Uncle had a greencard, wasn't able to work, had wanted to go back to Mexico but was only staying for the free medical care.

Ha ha, 'free medical care', I thought. :rolleyes:. I think most Americans would disagree with that statement. I guess it is free for non-citizens with no means, and for other dirt poor people, but it's not really free, is it? It's really, actually, expensive.

Meanwhile, his uncle, who was very polite, appreciative, nice, was also irresponsible. According to the H&P he had been mostly non-compliant with his meds and treatment plan.

I think there is a disconnect in our system. There is very little personal accountablity. There is lots of talk about Patient Rights, and very little talk about Responsibilty. I'm not just talking about non-citizens who consider the U.S. the land of free medical care, but I'm talking about a system that rewards irresponsiblity.

If we ever get socialized medicine, I seriously doubt if the government will have the backbone to build in any system for accountability into it. I see people abuse their bodies to the point that they are unable to work, then expect the taxpayer to pick up the tab for their medical care, for life, while they sit back and complain what victims they are. I see this over and over again. It's a huge problem in America today, with no solution in sight.

Specializes in UR/PA, Hematology/Oncology, Med Surg, Psych.

Well we can respectfully agree to disagree. No matter how one feels about the war, it cannot be denied that the illegal immigration problem is taxing our hospitals in many areas of the country and costing the taxpayer quite a bit.

And of course my measly paycheck payed for many US programs and services, certainly some of it subsidized healthcare for others.

how? a single payer system will still see my taxes paying for those that do not. i often see you use the single-payer system as the answer, but where will the funding come from if not from additional taxes? where do the taxes come from if not from working citizens? who pays the most taxes? those who have worked hard to climb up and make the most money. my household is technically wealthy (legal term). this means that we pay almost 40% of our earnings back to the feds and state. it also means that our tax money was used to stimulate others while we got zip back. it also means that any raising of taxes (payroll or income as my husband is a small business owner) means more money out of my pocket.

i have three kids to send to college who are not eligible for any aid. we are eligible for no tax breaks. my husband and i both have advanced degrees and work very hard for our income. why can't we keep more of it for ourselves instead of having to fund others' bad choices? why does that make me an evil person?

also, i live in california--a very nanny state. guess who made us that way??? it wasn't conservatives.

your high premium costs may as well be added to your income taxes. we would be far better off if we funded health care through a combination of payroll, income and consumption taxes. see:

a universal public system would be financed in the following way: the public funds already funneled to medicare and medicaid would be retained. the difference, or the gap between current public funding and what we would need for a universal health care system, would be financed by a payroll tax on employers (about 7%) and an income tax on individuals (about 2%). the payroll tax would replace all other employer expenses for employees' health care, which would be eliminated. the income tax would take the place of all current insurance premiums, co-pays, deductibles, and other out-of-pocket payments. for the vast majority of people, a 2% income tax is less than what they now pay for insurance premiums and out-of-pocket payments such as co-pays and deductibles, particularly if a family member has a serious illness. it is also a fair and sustainable contribution.

at http://www.pnhp.org/facts/singlepayer_faq.php#raise_taxes

everyone would be paying into the system and there would be no cost shifting from the un/underinsureds to the insureds. 350 bn in wasted overhead pays for a heck of a lot of care. it is also enough to insure every single person without additional public investment.

look at the evidence from the world stage. countries with single payer have better health and lower rates of health care inflation. as small business owners you would be far better off if you could buy into a large group such as fehbp or medical or whatever. you would have better coverage at lower costs.

see:

administrative costs consume 31 percent of us health spending, most of it unnecessary.

(woolhandler, et al "costs of health administration in the u.s. and canada," nejm 349(8) sept. 21, 2003)

smart public spending will reduce your tax burden along with that of everyone else in the us.

the original post was discussing a poor immigrant with a green card and his health issues. good public health and care for patients in these conditions would reduce our health care cost burden.

immigrants1 and emergency department visits2 by the uninsured are not the cause of high and rising health care costs.

1. mohanty et al. "health care expenditures of immigrants in the united states: a nationally representative analysis," american journal of public health; vol 95, no. 8, august 2005

2. tyrance et al. "us emergency department costs: no emergency," american journal of public health; vol 86, no. 11, november 1996

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research links from pnhp.org.

in a perfect world that would be great. but money and healthcare resources are finite. and while we are providing these illegal immigrants ongoing expensive care for chronic diseases, we are ignoring a large segment of our working poor. those that have no insurance, but do not quite meet the poverty guidelines for assistance. these are the people that fall through the cracks. i know as i have been there before and it is a scary place. while taxes came out of my measly paycheck to support others, i couldn't afford insurance for myself or my family. that is a lesson i will never forget.[/quote']

that is exactly why we need to build a system that guarantees universal access to health care and participation in the finance system.

see:

insurance companies often fail to properly reimburse doctors, needlessly adding more than $200 billion a year to the nation's healthcare tab, the american medical assn. said monday.

an analysis of 3 million medical claims over a six-month period beginning in october also found that
doctors in the u.s. spend 14% of the fees they receive from insurers and medicare on the process of collecting those fees, the ama said in a report issued at its annual meeting in chicag
o.

the analysis sized up insurers and medicare on how often they paid on time, how often they denied claims and how often they paid at the contracted rate and other measures.

medicare outperformed commercial insurers in many areas
, and some insurers paid physicians' bills better than others.

for example unitedhealthcare, whose parent owns california's pacificare, paid physicians the contracted fee 62% of the time. by comparison, aetna inc. paid the contracted fee 71% of the time and
medicare paid the set fee 98% of the time.

at http://www.latimes.com/business/la-f...,4571342.story .

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