Posted on 03/01/2005 6:03:18 AM PST by Dog Gone
RESOURCES
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OUT-OF-COUNTY PATIENTS More than 1,000 patients from other counties were admitted to Harris County Hospital District facilities last year. They're often drawn by the county's better facilities and easier eligibility requirements: Harris County: A family of four making up to $19,350 a year qualifies for free care, and those making up to twice that pay on a sliding scale, often with minimal fees. State standard, applied by many surrounding counties: A family of four qualifies only if it earns less than $4,064. |
He suffered a heart attack in late December and was treated at a Harlingen hospital. But immigration authorities balked at paying for heart surgery and released him, advising him to seek treatment on his own, he says.
Still weak, he made his way to Houston and eventually to Ben Taub General Hospital, where he underwent heart surgery in January.
As the cash-strapped Harris County Hospital District operates on a budget that can't keep up with the needs of the county's poor, almost a third of its admitted hospital patients are coming from outside the county and even outside the nation.
Over the past 10 years, the district has provided $510 million in unreimbursed care to illegal immigrants, the district says. Another $101 million was spent on unreimbursed care for residents of surrounding counties.
Radack and others are less enthusiastic about providing free care to residents from other counties.
The district last year spent 10.4 percent of its budget on unreimbursed care for illegal immigrants $80 million out of a $770 million budget, a Radack aide found while researching district spending.
Federal law requires hospitals to treat everyone who comes to emergency rooms. Passed by Congress two years ago, the Medicare Modernization Act was supposed to provide some relief by funneling $1 billion over four years to hospitals providing emergency care to illegal immigrants.
Texas was to get $47.5 million a year. The hospital district assumed it would be in line for some of the money and that it would help offset other cuts in Medicare, said Clifford Bottoms, the district's chief financial officer.
But state officials decided the money would go to private hospitals that provide care to illegal immigrants, not charity hospitals such as Ben Taub, Bottoms said.
Money has become so tight at the district that its officials are contemplating severe measures to balance the upcoming annual budget, to be considered by Commissioners Court on March 8. These include limiting patient prescriptions covered by the district and cutting available beds at Ben Taub and Lyndon B. Johnson hospitals.
Even though demand for the district's services has risen 8.2 percent annually since 2000, the district is expected to be given an annual budget next month calculated on a 1.3 percent increase in patient demand.
Not everyone agrees that the district should feel compelled to provide treatment for undocumented immigrants.
"It's going to break all of us. There's no way we can provide health care for illegal aliens," said J.C. Hernandez, founder and president of Houston-based Americans for Zero Immigration.
County officials don't buy the argument that the county ought to refuse treatment to illegal immigrants.
"It's a moral issue; it's a public health issue," said County Judge Robert Eckels. "This is how we do things in America."
Radack said the federal government should increase funding for such care because it has the mandate of keeping people from crossing the borders and isn't doing enough to prevent illegal immigration.
Advocates say illegal immigrants would have few places to turn if the district closed its doors on them.
Mark Zwick, who runs Casa Juan Diego, a nonprofit Houston shelter for immigrants, said that in the past year, four illegal immigrants fell from scaffolding while working for low wages on construction sites in Harris County. The accidents left three of the workers paraplegics and the fourth a quadriplegic, he said.
Casa Juan Diego cared for them while they recuperated in one of its Heights-area homes or paid for them to be cared for elsewhere.
Ricardo lives in one of the homes and hopes to regain his strength following his heart surgery. When he does, he will work as an electrician or painter and begin to send money back to Honduras, where his wife is trying to care for their children, he said through a translator.
"They depend on me," he said. Ricardo said he is grateful for the care he has received at Ben Taub. "They attended me very well."
Ricardo asked not to be identified fully because he is in the country illegally.
"If they are building our houses, mowing our grass, watching our children, the least we can do is to take care of them when they are sick," Zwick said. "To abandon people when they work very inexpensively is unconscionable."
County officials don't take issue with that but do complain about another strain on the district's budget providing unreimbursed care to residents from surrounding counties.
Last year, the district spent more than $15 million on such care.
Radack said he will ask County Attorney Mike Stafford to see if civil action can be taken against out-of-county residents who don't pay their bills and will ask District Attorney Chuck Rosenthal whether criminal charges could be brought.
"This money is coming straight out of the pockets of the Harris County taxpayers. This is a theft of services," he said.
Intended to provide a safety net for the county's poor, the district now serves as a regional safety net, Bottoms said.
Trauma patients from around the region are taken to Ben Taub because it is a top facility. And residents from surrounding counties turn to the district because fewer services are offered to the poor in most nearby counties, Bottoms said.
Some out-of-county residents falsely claim to live in Harris County because it is easier to qualify for indigent health care than in most surrounding counties.
"You have to be dirt poor now before we'll take you," said County Commissioner Tom Stavinoha of Fort Bend County, where a family of four earning more than about $4,000 a year doesn't qualify for free care.
State Sen. Royce West, D-Dallas, has filed a bill that would allow a regional hospital that serves as a draw to surrounding counties to recoup some of the costs of treating out-of-county residents.
The bill would require all counties to pay for health care for people with annual incomes as high as 200 percent of the federal poverty level. That poverty level is $19,350 for a family of four.
Harris County Commissioner El Franco Lee said more federal funding, not state or county money, is needed to pay for health care statewide.
"You aren't going to get anything from small counties with one bulldozer," he said.
The Mexican border averages five guards per mile, and still hundreds of thousands cross every year. If five per mile doesn't work how many would you estimate it would take to stop all of them? Ten per mile? Twenty? The cost per guard is $150,000 per year. At just ten per mile that's $1,500,000 per mile per year.
Since there are over 100,000 miles of border around the U.S., that means we would need one million border guards at an annual cost of $150,000,000,000. Even if you could find one million people willing to walk the deserts and mountains, the illegals would still get through.
That's a very high price to pay for no real reason.
Again, we already have more than five guards per mile on the Mexican border and your fellow anti-immigrants call that an "open border".(And yes they know how to work crossroads)
I have never heard any credible person make a serious case that the border can be sealed. And I don't consider Michael Savage to be a credible person.
I don't even know what you were talking about in post #13.
I've never heard of a charity hospital getting a writ of attachment for current wages. In Texas, the only time I've seen wages garnished is for child support.
But it's very common for citizens to avoid garnishment by changing jobs every six months when the courts catch up with them. I've never known of an illegal needing to do it.
"Again, we already have more than five guards per mile on the Mexican border"
Can you provide the reference for this statement?
Well, how about immediate deportation as soon as state or local law enforcement agencies learn that an individual is an illegal? I have relatives who are cops, and they arrest people ALL THE TIME who they know to be illegals, yet can't do a thing about it. The feds shoulder the burden but can't handle it, so let the local LEOs get involved and maybe that will help stem the tide. Put 'em on a bus back to Mexico after first serving a prison sentence for breaking our laws.
That, and a wall along the border. With land mines. Sure, it'll never happen, but I can dream...
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