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Hospital Falters as Refuge for Illegal Immigrants

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ATLANTA — Each had crossed the border years before, smuggled across the desert by a coyote, never imagining the journey would lead to a drab and dusty clinic on the ninth floor of Grady Memorial Hospital in Atlanta.

Some knew before the crossing that they had diabetes or lupus or high blood pressure, but it was only after they arrived that their kidneys began to fail. To survive, they needed dialysis at a cost of about $50,000 a year, which their sporadic work as housekeepers, painters and laborers could not begin to cover.

And so they turned to Grady, a taxpayer-supported safety-net hospital that would provide dialysis to anyone in need, even illegal immigrants with no insurance or ability to pay.

a sampling of the hundreds of reader comments:

All those wire payments to Mexico? Remittances? They should be taxed 75 percent to pay for medical, school, police, etc costs.

Poor. Isolated by language. Unable to work because of the law and because you feel so weak. Constant threat of deportment or arrest. With dialysis you might live another ten or twenty years, but without it you will die in a week or maybe two. How desparate would you feel?

With the numbers of dialysis patients dramatically increasing, it's difficult to find chairs for people who can actually pay, or have the resources to pay. As for illegal aliens, maybe the large dialysis companies like Davita or the pharmacutical companies can help pay.

I am an RN working in an area where many uninsured seek treatment. Someone ultimately has to pay for that treatment and it is those of us who are working and have insurance.

Trillions in bailout to wall street billionaires. This country has lost it's heart and it's soul.

No compassion anymore. We need to be more harsh. Kick every illegal out . Racism? I really don't care if you call it that. All of them: white, brown, yellow, black----out! In Mexico they don't pamper their illegals.

Please note that the Illegal's are not only paying taxes but they are also contributing to the U.S. economy by taking jobs which the natives or legal would not touch.

The solution is pretty clear-cut, isn't it? Emergency treatment for undocumented workers? Sure. Long-term care? No way.

Isn't it clear that we must become an ethical country where matters of health are concerned? Isn't it clear we must lead the way to a global community?

Of course the hospital has to stop treating these patients if the treatments are pulling the hospital under.

Perhaps, young man, you can change your name to Goldman Sachs and then try again for welfare.

How is this different from sneaking into someone's house and complaining that their refrigerator is empty?

I am irritated by their sense of entitlement to free care when there are so many legal Americans who go without care and prescriptions because of the cost. The fact that they crossed the border knowing they had a chronic health condition that would require care is completely irresponsible.

http://www.nytimes.com/2009/11/21/health/policy/21grady.html

Edited by Anxious Patient

I agree with one of the above comments...GET OUT. My mother and other family members came from a 3rd world country....the right way. Obtained a visa, worked and became citizens. If my family can do it, so can they! My mother became an RN at 19. It makes me very angry that these people get away with this when I have friends born and raised here that get turned down for health insurance because of ACNE!

DolceVita, BSN, RN

Specializes in IMCU. Has 10 years experience.

OK then. But when you Americans travel to Europe, get sick or have an accident, pay your own bloody bills.

That is fine! Precisely why I have insurance that follows me when I travel...even when I did travel to Europe. :D

MedSurgeMess

Specializes in Med/Surg, ICU, educator.

This is really tough. Yes, we should be compassionate, but we need to face the reality that the funds are not there to give free care to everyone, especially when they don't live legally in that country. If they want to come in the legal way and do things right, then more power to them. But looking for a free handout is not a way to run a business. It can only go on for so long. I feel bad for these folks, but how about people in this country who have lost insurance and cannot afford COBRA or private insurance, and maybe make just a little too much for Medicaid? Tough choices need to be made, no one said it would be easy or pretty.....

PostOpPrincess, BSN, RN

Specializes in M/S, MICU, CVICU, SICU, ER, Trauma, NICU. Has 19 years experience.

This is really tough. Yes, we should be compassionate, but we need to face the reality that the funds are not there to give free care to everyone, especially when they don't live legally in that country. If they want to come in the legal way and do things right, then more power to them. But looking for a free handout is not a way to run a business. It can only go on for so long. I feel bad for these folks, but how about people in this country who have lost insurance and cannot afford COBRA or private insurance, and maybe make just a little too much for Medicaid? Tough choices need to be made, no one said it would be easy or pretty.....

We cannot save the whole world. We can only do what we can do. Reality is reality...I totally agree with what you say.

When I did not have health insurance and became deathly ill, I went nowhere near medical care (for whatever reason, but I felt if I couldn't pay for it, I couldn't run up the bill). Did anyone show any compassion for me when I nearly died when my illness went just too far for me to be walking around? No. Not at all. I say, these people should receive medical care in their home country from their home government. They can get all the compassion there that they need and so rightly deserve. Why do I have to pay for them to receive what I can't get for myself or my family? No sense. And no pity from me.

Interesting thread. I'm usually the heartless republican in the discussion. his one made me think. Honestly, I'd be a lot more comfortable paying for their care then I would with many americans.

There are two groups of immigrants. Those that come here because they can make way more then they can at home, and send it all back out of the country to their families back home, until they have enough saved up that they can go back and live happily. You know, the ones that are milking the system. On the other hand, there are those that come here because it's the only chance they have. Often times they come from places riddled by extreme poverty, gang violence, corrupt governments. Illegals don't have it easy in the least, as they have to scrape out a living with the constant paranoia of being caught. But it just shows how bad it was back home.

I cannot, in any decent conscience, judge these people. The legal channels are often not an option, as the lists can take years, if you can even get on them. If I was in their position, I have to say....I'd be jumping the border too. If you have families depending on you, they come first. Even above the law.

Furthermore, they have the American dream firmly in their minds. Noone embodies the American spirit quite like immigrants do. To come from nothing, and to be so grateful for the simplest opportunities. As opposed to those who grew up here and never knew anything else, who feel entitled to everything and go on endlessly about how horrible this country is and how it doesn't give enough.

A lot of these people WANT to succeed, whatever it takes. Which is more then I can say about a lot of americans. They just never had the chance in any aspect of their lives. I'm so tired of inner city youths going on about being "disadvantaged" when they have so many options available to them if they'd only put in the effort. Immigrants on the other hand have nothing when they come here. They can't even get a job flipping burgers, and have to settle for under the table work. They have no prospects at education, or anything else. But they're damn sure going to try. And I don't care who you are, you have to respect that much. As I said, I would much sooner part with my tax dollars to give them a shot then I would to support lifetime welfare recipients pregnant with their third or fourth child.

But I'm also a realist. The financial strain of caring for these people is immense. I've heard of hospitals in the southwest that have had to close due to their emergency rooms being flooded by illegal uninsured. And programs like this offer only serve as to attract more of those that come seeking to abuse the system. There really needs to be a path towards citizenship for illegals. And no, I'm not talking about blanket amnesty. That's just stupid. But programs that involve a sweat equity, that force them to contribute to the betterment of our country while at the same time offering them the basic opportunities of providing for themselves, and obtaining an education.

The military already does this. You can work your way towards citizenship through active service, and I feel a lot of illegals would gladly choose this path if they weren't fearful of revealing themselves. But I'd love to see a civilian counterpart to this program, either via community service or some other public works. And set up milestones along the way that they have to meet, like learning english and advancing in a specified trade. I wouldn't have the slightest reservation about contributing to such programs. I also wouldn't feel the least bit guilty on cracking down on any illegals that chose not to participate.

You know, this post actually made me think. I'm surprised at myself. I thought I'd be a lot harsher on illegals.

jessiern, BSN, RN

Specializes in Med-Surg.

Very often, I see patients in the hospital that can not afford to eat and pay for their medications. They have no clue how they are going to pay for their hospital bill, or the RX for the $100 antibiotics the MD just handed them...not that the MD cares. These patients are Americans, some of them elderly that helped shape our country, fought for our freedoms today. Raised our generation. As long as our healthcare system can not support our own citizens, then we are foolish to provide free care for people that illegally jumped the fence. I'm sorry if the American dream is not what they thought it would be.

Alot of these discussions turn into "Americans are getting screwed, so why shouldn't Illegals?"

I think the better question is: "Why are Americans getting screwed?" On one hand, that does open up a whole new can of worms. But we should refocus on priorities on the real problem: our broken HC system. But I guess there are 30 other threads for that.

So for the sake of discussion, lets say we live in a world where all the Americans arnt getting screwed in healthcare, would you still be comfortable paying a little more to provide EMERGENCY coverage for illegals, because it is the "humane" thing to do?

Does our artificial nationality really supersede our shared humanity, to the point where we would allow another to die because they "don't belong here"? Should we just accept that the world is a cruel and merciless place, and being able to take care of yourself and your loved ones is good enough, much less helping a random stranger. I guess I'm in the latter category, cause the plight in Africa sure isn't keeping me up at night.

"There are two groups of immigrants. Those that come here because they can make way more then they can at home, and send it all back out of the country to their families back home, until they have enough saved up that they can go back and live happily. You know, the ones that are milking the system. On the other hand, there are those that come here because it's the only chance they have."

I'd like to know why Americans see to argue the reasons behind illegal immigration matters. Does anyone care why people who commit crimes such as stealing or using illegal drugs? Many of these people come from horrid backgrounds and feel forcing into their situation, but the punishment is the same. We don't sit around and classify them as "those who use illegal drugs due to severe abuse as a child",etc...

BOTTOM LINE: It is a crime to come and reside in a country illegally. Not to mention absorb the benefits such as welfare, our schooling system, job workforce, without putting your taxes in.

So it should not even be a factor what their reasoning for committing a crime is. It is unbelievable how the government is going to legalize this mess and soon be covering their healthcare...

Jerry 75

Specializes in ER, Psych, Telephone Triage.

I used to work in a USA Border Hospital in Cali. Cops or Border Patrol would get a pregnant almost ready to drop illegal boosted over the fence who wound up with a broken ankle. As soon as they dropped the Patient off with us and finished their coffee they booked.

He where are you guy's going I asked? "She's yours now" "If we stay with her our agency will have to pick up the tab"

So now this Illegal may need surgery on the ankle and a stay in OB. After a few thousand dollar bill she is discharged to who knows where maybe East County, Riverside, LA???

So now she will drop the kid on our side of the Border and he will have American citizenship!!!

So here we have Police agencies who are not really policing and are actually setting prisoners free???

The Cost of Illegal Immigration on Health Care:

http://www.portfolio.com/industry-news/health-care/2009/11/20/illegal-immigrants-cost-local-hospitals-while-feds-avoid-issue/

http://blogs.abcnews.com/politicalpunch/2009/07/why-the-health-care-clock-might-be-ticking.html

http://immigrationcounters.com/

"There are two groups of immigrants. Those that come here because they can make way more then they can at home, and send it all back out of the country to their families back home, until they have enough saved up that they can go back and live happily. You know, the ones that are milking the system. On the other hand, there are those that come here because it's the only chance they have."

I'd like to know why Americans see to argue the reasons behind illegal immigration matters. Does anyone care why people who commit crimes such as stealing or using illegal drugs? Many of these people come from horrid backgrounds and feel forcing into their situation, but the punishment is the same. We don't sit around and classify them as "those who use illegal drugs due to severe abuse as a child",etc...

Well, I have no faith or respect for the law. My definition of a crime is something I wouldn't do under my own moral compass. I'm not the sort to give sex offenders a free pass because they had a rough childhood or anything. But as far as stealing? There's a huge difference between stealing because you're starving and have no other means to obtain food and ganking an ipod.

I'm not going to come out and outright say you're wrong. But it's a complicated issue from the humanitarian side.

Well, if Americans try to go to Mexico and get "benefits" they are thrown out on their rears. I'm sorry, but NO intelligent society does what we do here in accepting responsibility for their care.

I'm not too excited either about the thought of allowing them into our military. As a military spouse, I am cognizant of the fact that it takes extreme loyalty to THIS country to serve and to be asked to give your life for our country. You have to be literate, as well, to pass the tests to get into the military. Many of these immigrants are not even literate in their own language, and I'm not entirely certain I want them in our military armed and in charge of military equipment, or to have received military training on our dime. The military would also then be responsible as well for taking care of their dependents.

How would these "paths to citizenship" even be enforced? And how would we stop chain migration? I don't think there would be ANY limits to the onslought of chain migration if we were to grant amnesty to those who are already here.

I feel they need to go HOME. They have outstayed their welcome here, and should go back to fight for benefits and justice in their own countries, not take from this one. I also resent many of them for not learning our language and DEMANDING interpreters and other services tailored to them. No other immigrant group has ever demanded so much. Many do not seem to want to assimilate into our society, but prefer to stay and be identified as yet another minority "victim" group. Sorry -- I worked for what I've earned, and so should they.

PhoenixTech, LPN

Specializes in Float. Has 3 years experience.

there are two groups of immigrants. those that come here because they can make way more then they can at home, and send it all back out of the country to their families back home, until they have enough saved up that they can go back and live happily. you know, the ones that are milking the system. on the other hand, there are those that come here because it's the only chance they have. often times they come from places riddled by extreme poverty, gang violence, corrupt governments. illegals don't have it easy in the least, as they have to scrape out a living with the constant paranoia of being caught. but it just shows how bad it was back home.

i cannot, in any decent conscience, judge these people. the legal channels are often not an option, as the lists can take years, if you can even get on them. if i was in their position, i have to say....i'd be jumping the border too. if you have families depending on you, they come first. even above the law.

furthermore, they have the american dream firmly in their minds. noone embodies the american spirit quite like immigrants do. to come from nothing, and to be so grateful for the simplest opportunities. as opposed to those who grew up here and never knew anything else, who feel entitled to everything and go on endlessly about how horrible this country is and how it doesn't give enough.

a lot of these people want to succeed, whatever it takes. which is more then i can say about a lot of americans. they just never had the chance in any aspect of their lives. i'm so tired of inner city youths going on about being "disadvantaged" when they have so many options available to them if they'd only put in the effort. immigrants on the other hand have nothing when they come here. they can't even get a job flipping burgers, and have to settle for under the table work. they have no prospects at education, or anything else. but they're damn sure going to try. and i don't care who you are, you have to respect that much. as i said, i would much sooner part with my tax dollars to give them a shot then i would to support lifetime welfare recipients pregnant with their third or fourth child.

you know, this post actually made me think. i'm surprised at myself. i thought i'd be a lot harsher on illegals.

so, you have no empathy for americans but tons of concern for illegals? you don't judge them but you cast harsh judgements on americans? may i just add that the conditions you describe are present and prevalent right here in the good ole united states of america! you really just described the conditions of many of those 'inner city youths' you're going on about. do you have any idea of what goes on in the 'inner city'. do you really think that it's as simple as putting a few programs in place and curing the unrest in our own backyard?

tell me, how are the illegals jumping the border to take advantage of these services any better than americans being on welfare and popping out their third or fourth child? have you ever been in a wic office and seen the actual amount of children these 'illegals' have? who's to say that because they jumped the border, they're gonna work any harder than the people already here? how do you figure americans don't 'want' to suceed?

do you realize that many of these inner city youth also never had a chance in any aspect of their lives? what do you think happened to all the crack babies of the '80's and early '90's? they grew up! there's more damage than you can imagine in the inner city and believe me, when one does find a way out, you've never seen anyone more grateful for the chance!

i feel your generalizations are sloppy, careless and not even 50% close to the actuality of inner city life! :angryfire

as far as this thread goes, the american government is always trying to fix other countries for whatever reason and many times, these attempts backfire, causing more damage than not. i can identify as could anyone in healthcare, especially nurses, with this nurturing tendency. however, the reality is that we as a country are in trouble, especially healthcare, and should be focused on fixing our own mess before we extend a hand to others.

So, you have no empathy for americans but tons of concern for illegals? You don't judge them but you cast harsh judgements on americans? May I just add that the conditions you describe are present and prevalent right here in the good ole United States of America! You really just described the conditions of many of those 'inner city youths' you're going on about. Do you have any idea of what goes on in the 'inner city'. Do you really think that it's as simple as putting a few programs in place and curing the unrest in our own backyard?

I guess I'm just tired of americans, who think they have it so horribly. Comparing even the worst cities to third world countries is just a joke. It just shows how spoiled we've become as a country. With welfare/food stamps/section 9, there's no such thing as poverty in this country. Not real poverty anyways.

Just some optional reading so you can see how horrible inner city conditions really are. (http://www.elpasotimes.com/news/ci_13801840)

Btw, detroit...thats doing so horrible and becoming a ghost town? Per capita income comes out to an inhuman $14,000. How does that stack up on a global scale?

Nicaragua - $2779

Honduras - $2793

Cuba - $3000

Bolivia - $3049

Mexico - $10,000

I guarantee you, they're government assistance programs look nothing like what we have.

The bottom line is, even in the cities, kids have the paths available to succeed in whatever they want. Whether or not it's easy isn't really my concern. I'm not worried about fixing the problems in our backyard. They have the tools to fix their own problems should they decide they want it badly enough.

Tell me, how are the illegals jumping the border to take advantage of these services any better than americans being on welfare and popping out their third or fourth child? Have you ever been in a WIC office and seen the actual amount of children these 'illegals' have? Who's to say that because they jumped the border, they're gonna work any harder than the people already here? How do you figure americans don't 'want' to suceed?

Like I said, there are two groups of immigrants. Some abuse the system. Some don't. Just like there are two groups of americans, I suppose. You got your down on your luck mother who's husband just passed away and facing downsizing at work, who needs help getting by. Then you have people having babies for profit abusing the system.

At the end of the day, jumping the border isn't any better then those that milk the system here.

Do you realize that many of these inner city youth also never had a chance in any aspect of their lives? What do you think happened to all the crack babies of the '80's and early '90's? They grew up! There's more damage than you can imagine in the inner city and believe me, when one does find a way out, you've never seen anyone more grateful for the chance!

I live outside of Miami. I don't live in the inner city, but close enough to catch glimpses. I also attend comunity college that's fed by a pretty bad area. It's dominated by lower income students, who recieve all the financial aid they can spend. And then some for their trouble. Some abuse it, drop the classes, take the money and run. Some actually take the opportunity and use it to better themselves and step up a rung. Most of them just go through the motions, and complain that classes are too hard and there's too much work. You wouldn't believe how watered down some of these courses are just so they can keep up. And they still demand extra credit at every turn so they can eek by with a C. So as far as I'm concerned, there are channels in place for those that are willing to wor for it. And thats all that matters. Again, I'm not the least bit concerned with whether or not it's easy for them.

I had a kid in my microbiology class who was here illegaly from macedonia. He already had a degree in marketing I think, but he was working towards the nursing program because it's still considered an "in demand" job and would facilitate the legal channels. But in the meantime, he works as a server under the table making...not much. He's an illegal, so no financial aid/grants/loans. He's not considered a resident so he has to pay out of state fees, which...even for community college is -expensive-. And he's gotta pay for all the other costs of living. He was the sharpest in the class, really devoted to his studies.

Inner city students don't have to go through nearly as many hurdles. The paths are there to be taken, but I think most are bitter at the world, find it easier to succumb to victimology and class warfare, rather then decide to take their futures into their own hands. Everything in life is a choice.

I feel your generalizations are sloppy, careless and not even 50% close to the actuality of inner city life! :angryfire

As far as this thread goes, the American Government is always trying to fix other countries for whatever reason and many times, these attempts backfire, causing more damage than not. I can identify as could anyone in healthcare, especially nurses, with this nurturing tendency. However, the reality is that we as a country are in trouble, especially healthcare, and should be focused on fixing our own mess before we extend a hand to others.

Well, that's a valid point. Whatever I personally believe we should be doing to help others will always be tempered by limited resources. Naturally, we have to look out for number 1 first, and I don't agree whatsoever with offering open ended incentives for illegals. But there has to be a way to offer paths for those who are really devoted to carving a better life for themselves to find opportunities.

Jerry 75

Specializes in ER, Psych, Telephone Triage.

http://www.abajournal.com/news/article/misconduct_by_sekhon_firm_lawyers_puts_up_to_700_clients_in_peril/

This is unacceptable! I could care less about their situation in their country-to bad, tough luck! Illegals are breaking a law and in crossing that border and in doing so are hurting US economy and adding a tremendous burden to America which impacts many aspects of our life.

Bottom line is Illegals add to an already overburdened medical system, prison/jail / police departments, system, school system, cause an increase in crime, use up allot of taxpayers resources.

Why should I have to pay for someone else's medical care who is not even an American citizen? It is bad enough that we have to pay for the medical care of our own loosers such as junkies and alcoholics, prisoners!