Thread: Decatur AL: Health care a growing concern

http://www.decaturdaily.com/decaturdail ... alth.shtml

SATURDAY, NOVEMBER 18, 2006


Daily photo by Emily Saunders
A Hispanic woman at the public health center on Cherry Street Northeast, which provides free prenatal care. Many Hispanics turn to the center and WIC for help with their American-born children.

Decatur's Hispanic Influx: Fusión Cultural

Health care a growing concern
Lack of prenatal care can translate into postnatal burden on taxpayers

Editor's note: This is the sixth of a seven-part series on Decatur's Hispanic influx

By Paul Huggins
phuggins@decaturdaily.com· 340-2395

The next seven months offer days filled with worry for Sara Caballero.

The expectant mother rubs her growing belly and can only wonder whether she will give birth to a healthy child in June.

She gave birth to two healthy babies since arriving from Mexico City six years ago, but this pregnancy brings uncertainty. She's hurting and having fainting spells.


DAILY Photo by Emily Saunders
Blood is taken from a Hispanic child at the public health clinic in Decatur. The number of Hispanics using the clinic has jumped 74 percent in the last three years from 5,300 visits to 9,200.

"I worry if my baby is OK," she said through a translator.

Caballero, 27, won't see a doctor till it's time to deliver, and she goes to the Decatur General Hospital emergency room.

She and her husband, an unemployed window installer, are illegal residents, although their children are American citizens. The couple has no health insurance, no Medicaid assistance and no extra money to pay for visits to a private physician. She will give birth with no prenatal care.

It's a common problem for Hispanic mothers that has caused rising infant deaths as well as more babies with birth defects, who often become taxpayer responsibilities.

According to the Alabama Department of Public Health, only 50 percent of Alabama Hispanics receive prenatal care compared to 85 percent of non-Hispanics. Last year, the Hispanic infant mortality rate rose to 8.4 percent, compared to 7.2 percent for whites. The real concern is that the Hispanic death rate has nearly doubled since 2000.

Preliminary studies by the state show the birth problems are the result of health issues in mothers such as diabetes, high blood pressure, incompetent cervix and renal disease.

"Things that could be controlled with good prenatal care and before getting pregnant," said Sherry George, director of women's health for the state. "There needs to be more of a focus on preconception care."

The reality is, however, any kind of in-depth care for illegal residents is hard to get. They're mostly uninsured and except for their children born here, they don't qualify for Medicaid.

Maria Hernandez, 33, said her family can barely pay bills for rent, food and utilities, so they can't afford to be sick.

She and her husband both lost jobs because of work-related injuries. They did not receive worker compensation and couldn't afford the simple physical rehabilitation to repair their injuries, which makes it harder to find or keep jobs.

$2,500 hospital bill

Last year Hernandez took one of her two boys (both born in Mexico) to Decatur General's emergency room for a stomach virus. They left with a $2,500 bill.

She said she doesn't have the money to pay it, and noted she had to wait a week before she could afford her son's $80 prescription.

"I'm afraid one of my boys will get sick and when I take them to the hospital that the doctors will send me away because I owe too much," Hernandez said.

Health care is a cash business for illegal residents, and they usually have to pay all costs up front.

Caballero said she paid $1,000 to a private physician for prenatal care with her first child. By the time she got pregnant again, the price rose to $1,500. Now it's $2,000, she said, and well beyond her family's means.

Hispanics do have some low-cost medical options. Many take advantage of opportunities at the public health clinic on Cherry Street Northeast.

"We don't refuse treatment to anybody," said Judy Smith, Area 2 public health administrator. She added that the Health Department has an obligation to treat everyone in the community because failure to do so puts the entire community at risk.

Hispanics are good participants in family planning programs, child immunization programs and the Women, Infants and Children program, she said. As a result, clinic visits by Hispanics have jumped 74 percent in the past three years from 5,300 visits to 9,200.

The Health Department relies mostly on Medicaid to cover the cost of treating low-income patients, but because illegal residents don't qualify for Medicaid, the staff is "constantly" scrambling to find grants to pay for their health services, Smith said.

Bigger clinic needed

Also, combined with overall increases, the clinic's visits are up 33 percent, and overcrowding has Health Department officials positioning for a bigger facility, she added.

The biggest problem, Smith said, is keeping bilingual translators. The clinic only has two and to stretch limited funds they must perform other duties. Other services suffer when one of them is called to translate.

When a translator is unavailable, the clinic uses a translator phone service. It works, Smith said, but it doubles the length of time for treating Hispanic patients.

Hernandez and her family first came to Decatur three years ago and then tried Utah for a year before coming back here 1½ years ago. She said they're still learning the community and she was unaware of the Decatur-Morgan County Free Clinic.

Apparently, most Hispanics don't know about it, or are afraid to try something new, because only 2 percent of the free clinic's patients are Hispanic.

Decatur General remains the most popular choice.

During the past fiscal year the hospital, which accepts indigent patients, provided $5 million in free care to Hispanics. That's up significantly since 1998 when that number was $563,000; however, medical costs generally have increased.

Hospital records show that of the 3,168 Hispanics admitted in 2006, 61 percent didn't pay their bills, while 26 percent paid with taxpayer-funded Medicaid and 11 percent with private insurance.

Lost hospital revenues

Vanessa Walls, vice president of marketing and business development for Decatur General, said the lost revenue slows expansion and improvements. Specifically, its delaying the hospital's plan to add private rooms, she said.

"We try to collect," Walls said. "We do ask them to pay their bills. We do ask for money up front. But we do not deny care if they are unable to pay."

About a dozen U.S. states offer Medicaid to illegal residents. One area that would appear to be cost effective would be prenatal care.

A study by the University of California in 2000 showed elimination of public funding of prenatal care substantially increased unhealthy babies as well as postnatal medical costs.

For every dollar cut from prenatal care, California had an increase of $3.33 for postnatal care and another $4.63 in incremental long-term costs for continuing to treat the unhealthy child, the study showed. In other words, the state could choose to pay $58 million for prenatal or pay $405 million for postnatal and long-term care, the study showed.

Baldwin County, which has two to three times more Hispanics than Decatur, has found a way to avoid those postnatal costs. It started a program four years ago to help pregnant women, combining it with an existing service called La Clinica de Baldwin.

It has a staff of 15 full-time employees, seven of whom speak Spanish. It relies mostly on two part-time doctors and a certified nurse midwife. An annual $545,000 grant from the Bureau of Primary Healthcare lets it charge minimal prices to its low-income patients.

La Clinica charges $20 per visit plus a no-profit rate for any lab work and medications.

Robert Renner, interim chief executive officer of La Clinica, estimates a typical pregnancy costs $600 to $700. An emergency medical fund provided by a local donor helps pay extra costs associated with medical complications.

Use has grown from 32 expectant mothers in 2004 to 120 this year.

"It's helping a mother in a difficult time," he said, "but it's also helping a child to begin life with the most positive rather than a negative standpoint of view."

Hispanic health

# Decatur General Hospital provided $5 million in free care to Hispanics during the past fiscal year.

# Of 3,168 Hispanics the hospital admitted, 61 percent did not pay, 26 percent paid with Medicaid and 11 percent paid with private insurance.

# Hispanic visits to the Morgan County Health Department have increased 74 percent in the past three years.

- SOURCES: Decatur General Hospital, Morgan County Health Dept.

Two illegals can't make an American.

Dixie

See this post on the draw for Decatur AL.
http://www.alipac.us/modules.php?name=F ... ic&t=46851

Last year Hernandez took one of her two boys (both born in Mexico) to Decatur General's emergency room for a stomach virus. They left with a $2,500 bill.

About 150 bucks at a doctor's office...

Originally Posted by Dixie

Two illegals can't make an American.

Dixie

I soooo agree!! why don't we deport them before they give birth? then there is no question of citizenship, mexicans create mexicans.

To bad alot of American's are in the same boat. But we have to have leins put on our house's if we go to the emergency room. Health care is getting so it's only for the well off and teh illegals. The rest of us suffer. High health care cost or insurance we can no longer afford? Believe me I know about health care insurance i was a agent for years. I remember when i had to go to a awards dinner and the speaker said we had to keep national health care out of the hands of us citizens and they were greasing the palms of politicians in washington to make sure. That was 10 years ago and i remeber his last part of the speach. He said that health care would bring American's to their knee's in the very near futute. Feel like we are being managed and our futures are all ready planned?