Thread: Illegal immigrants benefit from dialysis

Ah, California.
~~~

Friday, November 7, 2008
Illegal immigrants benefit from dialysis

Experts say it's cheaper to provide the service than to see the patients in emergency rooms.

Alan Zarembo and Anna Gorman / Los Angeles Times

Roughly 2,000 times over the past 17 years, Marguerita Toribio, an illegal immigrant from Mexico, has climbed into a cushioned recliner for the three-hour dialysis treatment that keeps her alive.

She has never seen a bill.

U.S. taxpayers have covered the entire cost of her treatment in California: more than $500,000 and rising, not including a kidney transplant in 1993.

The kidney failed when Toribio briefly moved to North Carolina, which refused to pay for her anti-rejection drugs. She needed to go back on dialysis three days a week to clear toxins from her blood, but North Carolina didn't cover that either.

The best a social worker could offer was a prepaid plane ticket back to California.

"When I came back here, I said, 'There is no way I'm leaving for another state again,'  " said Toribio, now 29, before a technician poked two needles into her arm at the St. Joseph Hospital dialysis center in Orange, Calif.

Health services and other benefits available to illegal immigrants can vary by the state. Welfare, prenatal care or in-state college tuition might be available in one place and inaccessible across a state line.

The disparities reflect the nation's conflicting attitudes toward its estimated 12 million illegal immigrants. With limited federal guidance, states often are left to make their own decisions, frequently shaped by political winds.

Dialysis offers a striking example of the dilemmas -- and the occasional absurdities -- that result.

The number of patients is not large. In California, illegal immigrants account for about 1,350 of the 61,000 people on dialysis. Their treatment cost taxpayers $51 million last year.

But dialysis stands out because it is often a lifetime commitment. The investment in a single patient can easily top $1 million over time.

Many states draw the line at illegal immigrants. But officials in California, New York and a few other states figure that not treating patients whose kidneys are failing costs more.

That is because patients without regular dialysis frequently end up in emergency rooms. At that point, federal law requires that they receive dialysis until they are stable enough to be released -- usually only to deteriorate again within weeks and return to the ER.

It's like "rescuing a person from drowning, giving someone a good meal and then pushing them over the side," said Dr. Laurence Lewin, a kidney specialist in Orange County, Calif.

Repeated rescuing not only threatens patients' long-term health, it generally costs more than routine care, some experts argue. In Texas, where illegal immigrants generally can't get routine care, some have cycled through the emergency room at El Paso's Thomason Hospital more than 100 times for life-saving dialysis, said kidney specialist Dr. Azikiwe Nwosu.

Such patients are at increased risk of heart attacks and infections.

"It's heartbreaking," said Dr. Claudia Zacharek, a kidney specialist who until recently worked in Galveston, Texas. "Your hands are tied."

Debates have flared over chemotherapy, life-support and dialysis. In 2002, Arizona Sen. John McCain cosponsored a bill to provide dialysis and other chronic care needed to prevent expensive ER visits.

It failed. What's left is an ambiguous policy that the federal government itself has struggled to clarify.

"We do not pay for chronic care for illegal immigrants," Mary Kahn, a Medicaid spokesperson, said when asked about the issue in early 2007.

If California and other states were using federal funds to help provide routine dialysis, she said, they were mischaracterizing it as an emergency treatment.

More recently, she acknowledged that the federal government has been sharing the cost in California for years. It has long been left to the states to decide whether to provide routine dialysis, she said.

Many states, including Texas, Colorado and New Mexico, take the position that kidney failure does not automatically qualify as an emergency because patients can survive for weeks without dialysis before toxins accumulate to fatal levels.

Other states have wavered. North Carolina, for example, now provides routine dialysis for illegal immigrants. Conversely, the Georgia Medicaid program stopped paying for dialysis in 2006 amid rising sentiments in the Legislature that illegal immigrants were a financial drain.

Last year, 52 of the 1,912 kidney transplants in California were for illegal immigrants.

Several studies show that a transplant pays for itself in three dialysis-free years. Critics, however, say that dipping into the organ pool is a greater outrage because so many citizens are waiting.

"It's not like you go to Costco and pick up a kidney," said Mark Krikorian, executive director of the Center for Immigration Studies.

Toribio is now seeking a second transplant. She said she is grateful for the care she has received in California.

www.detnews.com

Im sorry, but I couldn't finish it. Gotta go puke now.

Originally Posted by SicNTiredInSoCal

Im sorry, but I couldn't finish it. Gotta go puke now.

Understand totally and your avatar is right on too.

Originally Posted by jean

Originally Posted by SicNTiredInSoCal

Im sorry, but I couldn't finish it. Gotta go puke now.

Understand totally and your avatar is right on too.

It's baack!

Originally Posted by SicNTiredInSoCal

Originally Posted by jean

Originally Posted by SicNTiredInSoCal

Im sorry, but I couldn't finish it. Gotta go puke now.

Understand totally and your avatar is right on too.

It's baack!

Yep...bang bang bang.

We've got to laugh at some of the insanity of the situation sometimes or we'll go bonkers.

Added to Homepage:
http://www.alipac.us/article-3708--0-0.html

Sorry, I stopped reading before I could see if the article would mention that it would be cheaper to build the wall and have exhaustive internal enforcement/arrests/deportations...but I bet it didn't.


What would our sick kidneys get in Mexico?

How is it that there has apparently been no thought given to buying the woman a plane ticket to Mexico? If an indigent gringo in Mexico needed dialysis, Mexico would kick him or her out, and not with a plane ticket.

Illegal aliens come here when they are young and able to work. If we don't get on the stick and start attrition through enforcement, they will all eventually be old and sick. 100% of the 12 -20 million illegals. Are the hapless U.S. taxpayers going to have to pay for all their fabulously expensive end of life care? Has anyone in our inert government even realized that their failure to encourage repatriation in the most strenuous way possible (no job, no freebies, no school) is inviting economic disaster?

insane

3 hours of dialisis should be plenty of time for ICE to come and pick them up and deport them. Give them dialisis once to stablize them and send them home with a deportation order where they can't come back. That will take care of the problem.