Comment: Helen Redmond
socialistworker.org/

Denying care to the most vulnerable
socialistworker.org/2008/09/05/denying-care-to-vulnerable

Helen Redmond explains how two of the most contentious and heatedly debated issues in mainstream politics--health care and immigration--become linked.

September 5, 2008

OMAR CASTILLO sat on a bench in front of the University of Illinois (UIC) Medical Center in Chicago, holding a sign that pleaded, "I want to live just like you."

The teenager needed a kidney transplant. Omar had insurance, All Kids, which is available to every child in Illinois, regardless of immigration status. And he even had a donor who was a perfect match. But Omar is undocumented and doesn't have a Social Security number, and because of that, the hospital was denying him the transplant.

Instead of accepting the decision, however, Omar's family and friends and the League of United Latin American Citizens (LULAC) held a protest at the hospital. They carried signs that said "Please Save Omar." Hoy, a Spanish language newspaper, ran a front-page article and photo of the protest.

Soon after, the hospital decided to "reevaluate" Omar's case, and he got the transplant on August 7.

Francisco Pantaleon was not so lucky. The 30-year-old from Mexico was also an undocumented patient at UIC Medical Center. He suffered a brain aneurism and was in a coma when the hospital started making plans to deport him back to Mexico. As his family fought to keep him here, he died.

Before Pantaleon's death, a spokesperson for the Illinois Hospital Association said "the family ought to be grateful" that UIC found a facility in Mexico willing to take him and volunteered to pay for the trip.

Anti-immigrant bigot Lou Dobbs picked up the story and declared, in a classic divide-and-conquer rant, "While the battle rages over illegal aliens and health care in Chicago, families all across this country are struggling more than ever to afford even basic medical care. A new study released today finds that 72 million Americans--American citizens--between the ages of 19 and 64 say they have problems paying for their medical bills."

Dobbs ended by asking his viewers this question: "Do you think it's time illegal aliens said 'thank you' for all the help and support they receive in this country--help and support they don't receive from the countries they left?"

It was in this climate of hate that the Pantaleon family received a death threat. The letter warned, "Worthless spic parasite, go back where you came from! We know where you live. You will DIE. The only good spic is a dead spic." According to Julie Santos, an advocate for the family and midwest commissioner for LULAC, security at his hospital room had to be increased.

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TWO OF the most contentious and heatedly debated issues in mainstream politics are linked in cases like these: health care and immigration.

All over the country, hospitals have been deporting seriously disabled immigrants to their country of origin, even though some have lived and worked in the U.S. for decades. "Repatriation is pretty much a death sentence in some cases," Dr. Steven Larson, an ER physician at the Hospital of the University of Pennsylvania and expert in migrant health, said. "I've seen patients bundled onto the plane and out of the country, and once that person is out of sight, he's out of mind."

That's the story of Luis Alberto Jiménez. His plight, chronicled in an article in the New York Times, shows the inhumanity of the system.

Jiménez suffered a catastrophic brain injury in a car accident and almost died. After years of legal battles and while waiting for an appeal, the hospital sent him by air ambulance to Guatemala--unbeknownst to his lawyer or family.

Luis now lives in a remote part of the country and is cared for by his frail, 72-year-old mother. He is bed-ridden. Since he arrived at his mother's one-room home, he hasn't seen a doctor or taken any medicine for the frequent and violent seizures he suffers.

The backlash against immigrants is taking place during an economic recession in which health care is less accessible for millions of people--and the media and right wing are scapegoating immigrants for the crisis.

They falsely claim that undocumented immigrants are a burden on taxpaying citizens because they "overuse" health care resources that they're not entitled to and don't pay for. When 10 emergency rooms closed in the last five years in Los Angeles County, hospital officials cited losses from treating the uninsured.

But according to a study by researchers at UCLA, Latinos living in the U.S. without legal documents are 50 percent less likely to visit emergency rooms than U.S.-born Latinos, and the undocumented are 30 percent less likely to have any regular source of health care.

Federal and state governments have passed laws that make it difficult for immigrants to access medical care without being at risk of incarceration and deportation--and that outright refuse to provide medical services.

For example, the 1996 welfare "reform" bill, signed into law by Democratic President Bill Clinton, denies legal immigrants the right to Medicaid for the first five years that they live in the U.S. The 2005 Deficit Reduction Act requires all persons applying for or renewing Medicaid coverage to provide proof of identity and U.S. citizenship. Since the law went into effect, at least eight states have reported dramatic decreases in Medicaid enrollment.

Georgia has passed a law requiring immigrants to show proof of legal residency when applying for many health services. "We've started seeing a lot of kids not going to the doctor," Flavia Mercado, a pediatrician at Atlanta's Grady Memorial Hospital, told Susan Okie, author of an article in the New England Journal of Medicine. "Everyone is fearful."

Atlanta organizations are scaling back health services for Latinos and have stopped sponsoring health fairs, fearing that they will be raided by local police or Immigration and Customs Enforcement (ICE.)

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HOSPITALS FACE a basic problem--they don't get paid for the medical care they provide to uninsured patients, undocumented or documented. Lack of reimbursement has a knock-on affect through the entire health care system that leads to cutting services, and closing units and sometimes entire hospitals and clinics.

Complicating the problem is the fact that uninsured patients who need long-term care can't be transferred from hospitals to rehabilitation facilities or nursing homes, because, by law, these institutions don't have to accept the uninsured--and they do not. Hospitals are caught in a Catch-22, in which patients that should be moved to another level of care remain in their facilities.

Because the U.S. health care system is driven by profit, it is in the financial interest of all health care institutions to avoid treating the uninsured--and to evict them fast if they are treated.

Thus, the dilemmas faced in health care facilities, and felt especially in the case of immigrant patients, also serve to pit staff against patients and families, whip up racism and divert attention from the real problem: a for-profit health care system that leaves close to 50 million people uninsured and that kills anywhere from 18,000 to 100,000 every year due to lack of access to care.

There is a grassroots movement fighting for a humane health care system in this country and to pass Rep. John Conyers single-payer health care bill. This legislation, known as HB 676, abolishes the private insurance industry, pays for all medical care and includes every single person--regardless of immigration status.

One critical part of the fight for health care justice right now is for nurses, doctors and social workers to stand up for the rights of the undocumented and uninsured to get medical treatment, without fear of deportation or punishment.

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