'Illegals' and healthcare

Citizenship and medical care (0.00 / 0)

Thanks for this, Filosa. I work for a health website and so many of our users are people without insurance or access who are searching for information on how to heal themselves. I can't tell you how often we read posts from folks with pain or symptoms they can't identify.

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by: donmiguel @ Fri Oct 12, 2007 at 10:17:37 AM CDT

thanks (0.00 / 0)

donmiguel, thanks for sharing.  and thanks for creating an account here.  look forward to more comments or diaries from you -- you must have a wealth of experience and stories from the work that you do.

Personal blog: Los Anjalis

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by: los anjalis @ Sat Oct 13, 2007 at 13:59:05 PM CDT

[ Parent ]

I agree (0.00 / 0)

with the basis of your argument.  However, I would like to see it such that AFTER treating an illegal medically, they are then turned over to immigration.  I, in my professional life, have seen too many times where we have had to turn down a transfer admission to a child who really needed to be treated because we were already full.  (I work in a Pediatric ICU at a tertiary care center).  Now you have the situation where because of treating illegals, we are turning away treatment of an American citizen.  How do we fix this issue?

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by: martygrn @ Mon Nov 26, 2007 at 21:27:25 PM CST

First and foremost (4.00 / 1)

a doctor's or nurse's job is to treat the sick, regardless of what citizenship they hold. So I agree with you... up until that point.

My view of people who are here as undocumented (the word 'illegal' makes me ill so I'll refrain from using it) is that they are here to work, to live, to survive. They are here because our economic policies (ahem... NAFTA is an example) have made finding work in their homeland extremely difficult. And while they are here playing a substantial role in our economy, I see it as only fair that they have access to basic needs, access to health care being one of those.

According to your proposal, an undocumented individual would be turned over to immigration after receiving medical treatment. Let's say, for a moment, that you are undocumented (or if you'd prefer 'illegal', I'll hesitantly call you that) and you are in need of medical attention but you know that going to a doctor for treatment would get you sent to immigration and then probably deported. What would you do? Would you seek medical care? Or would you try some other venues like medicating yourself, or waiting it out until whatever it is you had has gotten unbearable?

The barrier between health care provider and patient is already quite tall, daunting and lined with barbs of red tape. It already interferes way too much in my opinion with what a doctor/nurses job is (see above: "to treat the sick"). Do we need to make our system even more prohibitive for those seeking care for their ailments?

I think not.

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by: nalin @ Tue Nov 27, 2007 at 02:22:42 AM CST

[ Parent ]

I also have a problem... (0.00 / 0)

...with this line from your comment:

I, in my professional life, have seen too many times where we have had to turn down a transfer admission to a child who really needed to be treated because we were already full.

Maybe I'm misunderstanding your intention but it seems to me that you're saying the transfer admission is in more need of care than those already there. But then you go on to say that you work at a Pediatric ICU tertiary care center. Aren't ICUs in tertiary care centers for the sickest of the sick? Then shouldn't everyone who is there be someone who "really need[s] to be treated"? I refuse to believe that the beds of a Pediatric ICU in a tertiary care center are filled with less needy cases.

So the only assumption I can make based on your comment is that you believe the 'illegal' people seeking treatment are of less importance than the 'legal' people seeking treatment. If that is what you are saying, then that is a very disturbing stance, especially from someone who is a health care worker themselves!

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by: nalin @ Tue Nov 27, 2007 at 02:36:46 AM CST

[ Parent ]

First, allow me to address (0.00 / 0)

your problem with the term 'illegal'.  Those who are undocumented BROKE THE LAW in crossing the border.  They may not be 'criminals' now that they are here, working what jobs they can, etc.  But the basic fact is that they already BROKE THE LAW just by coming here.  How else would you define the term 'illegal'?

Now, as to the argument that the beds are filled with less needy cases, allow me to provide some insight.  This is how things really work.  We know that those who are here illegally, as well as those without insurance, are much less likely to keep follow up appointments after discharge from the hospital.  The solution to this is rather than discharge them from the hospital, we keep them in the hospital until they are beyond the point needed for follow-up.  This prevents the problem of not being willing to show up at an appointment at the doctors office.  So, to answer your question, yes we do have beds being used by patients who are much less ill.  On a purely medical basis, they could be discharged from the hospital and followed on an outpatient basis.  However, we have learned from experience that once we send them 'home' from the hospital, that is likely the last time we will see them, so we keep them in much longer than is medically necessary.  Oh, we 'find' a medical reason to keep them in since Medicaid is now covering them, but they never seem to understand that Medicaid will cover the follow-up visits as well.  Bottom line is that, yes, the beds are absolutely taken up by those with less need.  How do we determine who to keep and who can be discharged?  It is not by immigration status since we are prevented, by LAW, from asking about legal status.  Rather, we assess based upon observations made during the hospital stay.  How do they react when told they will need to continue to see the cardiologist.  (I specialize in children needing surgical repair for congenital cardiac defects).  Some will even be shaking their head 'no' when told they must come back in 6-8 weeks to see the surgeon.  If your child was critically ill, would you be willing to wait for treatment while someone else was being treated for the sniffles?  Is that not what we are doing?  Treating in the hospital for something that could be done in an office?

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by: martygrn @ Tue Nov 27, 2007 at 07:19:42 AM CST

[ Parent ]

documents, illegals, health and human rights (4.00 / 1)

Thank you all for the moving post and interesting discussion.  I'm a resident in the Bronx, where the line between legal and illegal immigration is blurry.  To give an example, I have a patient who is a 50 year old woman from Ecuador.  Her son first came to the US w/o documents ("papeles" as she calls them) 10 years ago.  2 years later, my patient's husband received a work visa and so they are here w/ documents.  They have since applied for citizenship and are now US citizens.  Her son married a Bronx-born Puerto Rican woman, so she and their 3 children are all US citizens.

So am I to treat my patient and her son differently because of this distinction?  Should her son be denied medical care while the entire rest of his family receives care?  And if he were to develop pneumonia or asthma or cellulitis and require treatment, should I turn him in to the feds?

Last year, the state of New York was going to require all Medicaid recipients to show certified birth certificates or passports to become enrolled or stay enrolled.  This was couched as a way to keep undocumented folks off the rolls.  It quickly became clear that a lot of other people would be affected.  Many of my elderly African-American patients, for example, were born in the South, have no clue how to obtain a birth certificate, may have been born at home and thus never had a birth certificate, and have never traveled outside the US and don't have a passport.  What should they do?

All of this seems preposterous to me.  Watching the Republican debates, you'd think that undocumented immigrants are the major cause of our country's economic, health, and security problems.  The data, of course, do not bear this out.  But hey, election season is always good time to beat up on some "enemy" that isn't us - especially when the enemy  (in this case, "illegal aliens") can't vote.

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by: Minesh @ Wed Dec 12, 2007 at 21:06:27 PM CST