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12-14-2012, 01:04 PM #1
Fewer health care options for illegal aliens
Fewer health care options for illegal immigrants
Posted: Dec 14, 2012 12:25 AM PST
Updated: Dec 14, 2012 6:42 AM PST
By CHRISTOPHER SHERMAN and RAMIT PLUSHNICK-MASTI
ALAMO, Texas (AP) - For years, Sonia Limas would drag her daughters to the emergency room whenever they fell sick. As an illegal immigrant, she had no health insurance, and the only place she knew to seek treatment was the hospital - the most expensive setting for those covering the cost.
The family's options improved somewhat a decade ago with the expansion of community health clinics, which offered free or low-cost care with help from the federal government. But President Barack Obama's health care overhaul threatens to roll back some of those services if clinics and hospitals are overwhelmed with newly insured patients and can't afford to care for as many poor families.
To be clear, Obama's law was never intended to help Limas and an estimated 11 million illegal immigrants like her. Instead, it envisions that 32 million uninsured Americans will get access to coverage by 2019. Because that should mean fewer uninsured patients showing up at hospitals, the Obama program slashed the federal reimbursement for uncompensated care.
But in states with large illegal immigrant populations, the math may not work, especially if lawmakers don't expand Medicaid, the joint state-federal health program for the poor and disabled.
When the reform has been fully implemented, illegal immigrants will make up the nation's second-largest population of uninsured, or about 25 percent. The only larger group will be people who qualify for insurance but fail to enroll, according to a 2012 study by the Washington-based Urban Institute.
And since about two-thirds of illegal immigrants live in just eight states, those areas will have a disproportionate share of the uninsured to care for.
In communities "where the number of undocumented immigrants is greatest, the strain has reached the breaking point," Rich Umbdenstock, president of the American Hospital Association, wrote last year in a letter to Obama, asking him to keep in mind the uncompensated care hospitals gave to that group. "In response, many hospitals have had to curtail services, delay implementing services, or close beds."
The federal government has offered to expand Medicaid, but states must decide whether to take the deal. And in some of those eight states - including Texas, Florida and New Jersey - hospitals are scrambling to determine whether they will still have enough money to treat the remaining uninsured.
Without a Medicaid expansion, the influx of new patients and the looming cuts in federal funding could inflict "a double whammy" in Texas, said David Lopez, CEO of the Harris Health System in Houston, which spends 10 to 15 percent of its $1.2 billion annual budget to care for illegal immigrants.
Realistically, taxpayers are already paying for some of the treatment provided to illegal immigrants because hospitals are required by law to stabilize and treat any patients that arrive in an emergency room, regardless of their ability to pay. The money to cover the costs typically comes from federal, state and local taxes.
A solid accounting of money spent treating illegal immigrants is elusive because most hospitals do not ask for immigration status. But some states have tried.
California, which is home to the nation's largest population of illegal immigrants, spent an estimated $1.2 billion last year through Medicaid to care for 822,500 illegal immigrants.
The New Jersey Hospital Association in 2010 estimated that it cost between $600 million and $650 million annually to treat 550,000 illegal immigrants.
And in Texas, a 2010 analysis by the Health and Human Services Commission found that the agency had provided $96 million in benefits to illegal immigrants, up from $81 million two years earlier. The state's public hospital districts spent an additional $717 million in uncompensated care to treat that population.
If large states such as Florida and Texas make good on their intention to forgo federal money to expand Medicaid, the decision "basically eviscerates" the effects of the health care overhaul in those areas because of "who lives there and what they're eligible for," said Lisa Clemans-Cope, a senior researcher at the Urban Institute.
Seeking to curb expenses, hospitals might change what qualifies as an emergency or cap the number of uninsured patients they treat. And although it's believed states with the most illegal immigrants will face a smaller cut, they will still lose money.
The potential impacts of reform are a hot topic at MD Anderson Cancer Center in Houston. In addition to offering its own charity care, some MD Anderson oncologists volunteer at a county-funded clinic at Lyndon B. Johnson General Hospital that largely treats the uninsured.
"In a sense we've been in the worst-case scenario in Texas for a long time," said Lewis Foxhall, MD Anderson's vice president of health policy in Houston. "The large number of uninsured and the large low-income population creates a very difficult problem for us."
Community clinics are a key part of the reform plan and were supposed to take up some of the slack for hospitals. Clinics received $11 billion in new funding over five years so they could expand to help care for a swell of newly insured who might otherwise overwhelm doctors' offices. But in the first year, $600 million was cut from the centers' usual allocation, leaving many to use the money to fill gaps rather than expand.
There is concern that clinics could themselves be inundated with newly insured patients, forcing many illegal immigrants back to emergency rooms.
Limas, 44, moved to the border town of Alamo 13 years ago with her husband and three daughters. Now single, she supports the family by teaching a citizenship class in Spanish at the local community center and selling cookies and cakes she whips up in her trailer. Soon, she hopes to seek a work permit of her own.
For now, the clinic helps with basic health care needs. If necessary, Limas will return to the emergency room, where the attendants help her fill out paperwork to ensure the government covers the bills she cannot afford.
"They always attended to me," she said, "even though it's slow."
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12-14-2012, 05:13 PM #2
12-14-2012, 05:34 PM #3
Maybe they should look South of the border.
Healthcare in Mexico
With a free market economy, Mexico is considered to be the 12th largest economy worldwide as measured in the purchasing power parity of Gross Domestic Product (GDP).
Generally speaking, the healthcare in Mexico is very impressive, and in some cases, excellent.
Most of the healthcare practitioners in Mexico have been trained in western countries. Mid-sized and larger cities in Mexico have at least one first-rate hospital and the cost of healthcare is generally lower than one might expect to pay in the US. This being the case, a lot of North Americans travel to Mexico for simple dental work or minor surgeries. The same applies for prescription drugs. On average, prescription drugs that are manufactured in Mexico are about 50% cheaper compared to similar drugs manufactured in the United States. Aside from affordable costs, larger centres in Mexico offer first class restaurants plus a full range of healthcare services. Medical practitioners will also consider doing house calls, depending on the situation.
Generally speaking, the cost of medical care services vary by hospital, by physician, or by the seriousness of one’s condition. On average, an office visit with a doctor-specialist included could cost you between 250 and 300 pesos, or roughly $25. Lab tests could cost about one-third of the comparative cost in the United States. CAT scans are 25% cheaper than in the US. Overnight stays in a private hospital room can only cost you about three-hundred pesos, roughly $30. Furthermore, visiting the dentist for some teeth cleaning will cost about two hundred pesos or $20.
Healthcare planning in Mexico
The development of the healthcare system in Mexico is being carefully planned. This includes equipping hospitals with the latest in medical technology. Aside from having excellent medical practitioners and accommodating medical staff, the healthcare system of Mexico has continuously made a name for itself as one of the few countries that provide relatively affordable, quality healthcare. From medicines to medical services, everything is surprisingly just within one’s reach.
Some health concerns in Mexico
Compared to other countries, there are some health risks more evident and prominent in Mexico, simply because of its lifestyle and culture. Mexico has shown a rapid increased in certain health problems due to pesticide use. In fact, this problem is starting to become a major area of concern, particularly in states like the Chiapas where 58% of the total population are engaged in agricultural work, including pesticide use. Although most of the residents are aware of the importance of safety precautions, those from outside these areas do not seem to appreciate or understand the possible dangers.
Another major health concern is the rapid increase in the number of AIDS cases. AIDS ranked 11th in 1988 among the leading causes of death, but in a span of eight years it has become the third leading cause of death in Mexico.
Healthcare in Mexico