Thread: Immigrants often afraid to see doctors

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Immigrants often afraid to see doctors
Wednesday, May 10, 2006
Harlan Spector
Plain Dealer Reporter
After six members of a Mexican family tested positive for tuberculosis, Phyllis Marzan expected three others from the household to be checked at the urban health center where she works.

But only two of the three arrived for an appointment on a recent Tuesday, leaving one man possibly untreated and primed to pass on the infectious disease to others.

"One of them didn't show because he was afraid. He had no papers," said Marzan, a case manager at Neighborhood Family Practice on the West Side.

Hispanic immigrants who enter the country illegally have always been wary of the health-care system, according to Marzan and others. Merely asking for a Social Security number can spark fears of deportation.

The anxiety has been heightened by recent anti-immigration developments.

People in health care and social services tell stories of pregnant women who shun prenatal care and others who steer clear of clinics and hospitals because they are afraid.

Many Americans might not sympathize. A recent Time magazine poll showed that three out of four don't believe illegal immigrants should receive government services such as health care.

The uncompensated cost of health care for illegal immigrants is a hot-button issue among hard-liners. They say uninsured illegal immigrants have sapped the health-care safety net in Southern California, causing hospital emergency rooms to close.

"That's the price you pay for trying to provide health care for illegal immigrants," said Ira Mehlman of the Federation for American Immigration Reform, which supports tougher laws.

Yet the actual burden of illegal immigrants on the health-care system is far from clear. The General Accounting Office reported to Congress in 2002 that the cost couldn't be accurately determined.

And a study last year in the American Journal of Public Health showed per capita health-care costs for immigrants is 55 percent lower than the costs for U.S.-born residents, because immigrants have less access.

Illegal immigrants do not qualify for Medicaid, but federal and state government programs cover emergency services and reimburse hospitals for charity care.

Regardless of cost, providers such as Marzan say it is a moral obligation to ensure that babies are born healthy, that children are immunized and that people receive medications.

"We are here to provide a service for people in need, period," said Jeanne Lipps of the Lake County Free Medical Clinic, which treats many Mexican immigrants.

The case of the TB-positive family also illustrates a larger public-health concern often overlooked in the immigration debate. Illegal immigrants who are not treated for infectious diseases pose a risk of spreading them.

Of the six who tested positive for TB, three work at a Lorain County greenhouse and three were children in day-care centers, according to Marzan.

She said Neighborhood Family Practice is seeing more illegal immigrants from Cleveland, Lorain and even Columbus. Some are afraid to give their real names at first, she said.

"They have no trust," said Marzan, a Puerto Rican woman who stores items donated for immigrant families in her home garage.

"They're not going to tell you anything the first visit. They need to be really reassured."

The brusqueness of health-care delivery can be intimidating to anyone, especially to people who don't understand the language. On top of that, rumors run rampant. Some Hispanic immigrants and their advocates said that undocumented residents are increasingly wary of the MetroHealth system because of rumors that the county hospital has called immigration authorities on illegal immigrants.

"There are people not wanting to go to Metro anymore," said Ruth Rubio-Pino, who works as a translator and advocate for Hispanic immigrants on the West Side.

She said the hospital is not turning people in, but she claimed individual employees "take it upon themselves to be [immigration] officers."

None of MetroHealth's critics were able to substantiate the claim. The hospital asks patients about citizenship to see whether the uninsured ones qualify for Medicaid, said spokeswoman Eileen Korey. But policy forbids MetroHealth or its employees from notifying government authorities about illegal immigrants, she said.

"We have absolutely no evidence that there's been a violation of that policy," Korey said.

But the fear is real, even if rumors aren't true, said a waitress at a Mexican restaurant who is in the United States illegally. The 36-year-old waitress said she is afraid to use the MetroHealth system.

She works for cash, serving up chicken and steak burritos to a steady stream of customers. Aside from fears of being turned in, there are other obstacles, she said. Her employer won't provide a letter stating her income, which would help her qualify for subsidized care.

"They don't want any problems," said the waitress, who has lived in Cleveland for two years. She asked not to be named for fear of deportation.

The waitress said illegal immigrants were also rattled by a recent MetroHealth policy requesting photo identification. The hospital began asking for photo IDs after some patients without insurance were caught using the Medicaid cards of other people, a hospital official said.

Demands to prove identity, income and residency are enough to raise suspicions of people who have much to hide.

"They are afraid if they say they don't have papers, that they're going to be deported," said Yolanda Figueroa of El Barrio, a West Side social-service agency that helps immigrants with housing and other needs.

But Figueroa said she is not aware of any hospital employee calling immigration authorities about patients, and she added that MetroHealth has more interpreters to improve access for Hispanic immigrants.

Hispanic immigrants in Cleveland generally go to MetroHealth, Lutheran and Fairview hospitals, Figueroa said. Representatives for the hospitals said they did not have information on the numbers of illegal immigrants they treat or the costs involved.

Cathy Levine, executive director of Universal Health Care Action Network of Ohio, said fears of the health-care system suggest providers aren't doing enough to put immigrants at ease.

"These providers have an obligation to make immigrants feel comfortable getting health care," she said.

"To the extent there are rumors out there, there are serious problems."

The Federation for American Immigration Reform, the group wanting tougher laws, doesn't see it that way.

Mehlman, the spokesman, said hospitals should turn in illegal immigrants when taxpayers foot the medical bill.

"We can't keep erecting firewalls to protect people who broke the laws," he said.

To reach this Plain Dealer reporter:

hspector@plaind.com, 216-999-4543

Ya....I'm afraid to go to the Dr. too. First because of the bill.....secondly of what contagious diseas I might get while waiting.

Most of the waiting rooms I have been in lately are full of illegals that cannot even speak english and you know do not have health insurance. I get really mad when I have to go there knowing that they are getting the same care I am while I pay for it with my taxes.

Originally Posted by crazybird

Ya....I'm afraid to go to the Dr. too. First because of the bill.....secondly of what contagious diseas I might get while waiting.

"undocumented" tuberculosis -- that's nice

I'm afraid of needing hospital care too -- I don't have insurance and they would take my home.

But because our government fails to secure our borders, I, like every other American, am being exposed to potentially life threatening diseases

Where are they afraid, certainly not where I live.

annie, we are afraid of the diseases we will get when going to the doctors office or the hospital while waiting in the room with all these illegal aliens who get free care.

I can tell you this from numerous experiences that they may be afraid to go to doctor's offices, but they are not afriad to show up at ERs demanding service.