Posted on 09/03/2010 2:27:12 PM PDT by Oshkalaboomboom
Grady Memorial Hospital said this week it had negotiated a rough agreement with local dialysis clinics to provide care to 38 uninsured immigrants once served by Grady.
While the agreement eased concerns for those patients, most of them illegal immigrants, it does not address the dilemma of the future: What happens to the next wave of uninsured patients facing kidney failure?
Grady closed its outpatient dialysis unit in October to help it balance its books. The hospital said the unit was losing $4 million a year serving about 100 patients.
Most Americans with end-stage renal disease are covered by Medicare. Illegal immigrants, and some legal immigrants new to the country, are not eligible for the program.
Grady does not screen patients based on immigration status, and it treats uninsured patients, whether they are U.S. citizens or illegal residents. Immigration status has figured into the dialysis issue because illegal immigrants make up the bulk of those who need dialysis and do not qualify for Medicare coverage.
Uninsured patients can get emergency dialysis treatments at Grady or other hospitals. But with the Grady safety net gone for outpatient dialysis, those needing regular treatments to survive have few options. They can try to persuade a private clinic to offer charity care, which experts say will be difficult, or they can resort to irregular care in emergency rooms when their life is threatened.
"What will happen is what happens in cities across America,” said Grady spokesman Matt Gove. Social workers would provide patients with contact information about dialysis clinics near where they live, Gove said.
“It would be up to the patient to contact [the provider] and try to work out a program with them,” Gove said.
Some Americans oppose taxpayer-funded care for illegal immigrants, arguing that the care is an expensive drain on already limited public health resources.
Jack Martin, a spokesman for the nonprofit Federation for American Immigration Reform, said the U.S. government should step in to work out a way for the patients to be returned to their home countries for care.
"Logically, this should be a responsibility of the government that these people come from," Martin said. "It is basically not a responsibility of the American people other than immediate emergency care because of the fact that these people have not come into the country legally."
Grady offered last year to pay travel expenses of displaced patients who wanted to return to their home countries, and 13 patients accepted. Grady also agreed to pay for care at local dialysis clinics, which most patients accepted. The contract with the private company that provided the care was to expire this week.
Grady said a framework of an agreement had been reached under which the two large private companies that run most of the state’s dialysis clinics and Emory Healthcare would offer charity care to some patients, with Grady continuing to cover a portion of the costs for the other patients. “We’re still ironing out the details,” Gove said.
Grady did not yet have an estimate of what its costs would be.
It’s unclear how firm the agreement is. DaVita Inc., one of the nation’s largest dialysis providers, is working with community leaders to resolve the issue, said company spokesman James N. "Skip" Thurman.
“In the meantime, it’s important to note we have already provided a significant level of dialysis treatment in recent years to undocumented immigrant patients in this community," Thurman said in a statement.
Dr. Leslie Spry, a kidney specialist from Nebraska who is a spokesman for the National Kidney Foundation, said the problem is a national one.
In states with heavy immigration, Spry said, “they’re being inundated with these kind of folks, and they just turn the people away.”
Spry said that even in Nebraska, it’s becoming a common dilemma. He said the nonprofit dialysis clinic where he works offers charity care to some illegal immigrants without coverage, but only to those with community support and the willingness to pay what they can.
“I get criticized by some folks who are saying, ‘These are illegal aliens and you should refuse them all,’ ” Spry said. “I don’t know if I can live with myself like that. I choose to find those people I think I can help and I do so.”
As more uninsured Americans gain coverage through the implementation of the nation’s health care overhaul, illegal immigrants, who are not eligible for the program, are expected to make up a growing share of the remaining uninsured.
“The immigration issue in terms of health care is not going away,” said William Custer, an insurance expert at Georgia State University.
I would suggest perhaps a final dialysis treatment, then immediately driving them to their consular office and telling their people there they need ongoing medical attention in their home country, as they cannot pay for services here. This way their country can get them home with a day or two of time for them to get dialysis in their home country.
We are not obligated to keep other countries’ citizens alive with treatment they can’t afford or receive in their own country. If they can’t get the treatment in their country, that’s what would naturally happen to those people in that country. We are not the welfare and problem fixer for everyone and every country in the world.
“Jack Martin, a spokesman for the nonprofit Federation for American Immigration Reform, said the U.S. government should step in to work out a way for the patients to be returned to their home countries for care”
Operative word is SHOULD. Just like the feds SHOULD be protecting borders and deporting ANY ILLEGALS found in the country.
sickening. dialysis centers are closing down because of illegal immigrants now? My sister is on dialysis.
Some? Some? Try "Most" for accuracy.
Use some of the drug money for centers.
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