http://www.newstimeslive.com/news/story.php?id=1027451


Illegal immigrants' effect on health care remains unclear

By Elizabeth Putnam
THE NEWS-TIMES


Lee Parker, left, a physican’s assistant at New Milford Hospital, and Mike Gesmondi, a medic, handle paperwork on incoming patients.

This is the final installment in a four-day series looking at immigration in Danbury. Click here to read all the stories.

Although illegal immigration is clearly a top social issue facing the Danbury area, its effect on local health-care services remains a blur.

People advocating a strict crackdown on illegal immigration say these immigrants significantly drain the health-care system and burden hospitals financially. That drives up Medicaid costs and pushes legal citizens to the bottom of the waiting list for services, the argument goes.

"Go to the emergency room at Danbury Hospital. You'll see it," said Paul Streitz, a founding member of Connecticut Citizens for Immigration Control.

But the reality is leaders from area hospitals and a downtown free clinic are reluctant to discuss illegal immigration and its impact on the services they provide. And although these officials acknowledge that they serve the undocumented population, they say they can't quantify its effect.

Patients are not asked about their immigration status during admission to the Danbury Hospital and New Milford Hospital emergency rooms. Under a 1986 federal law, hospitals must provide a medical examination and treatment to stabilize the condition of any patient who requests care in its emergency room, regardless of the person's ability to pay or immigration status, and according to the Centers for Medicare and Medicaid Services, hospitals are prohibited from asking a person's immigration status.

"While we recognize that we do serve the undocumented population, we do not distinguish patients in that way," said Linda Wiseman, Danbury Hospital spokeswoman.

Officials from AmeriCares Free Clinic on Main Street, which only treats people without health insurance, declined to discuss the topic of illegal immigration, adding that AmeriCares, too, does not record a person's immigration status.

Locally, at least, there is no way to prove how much illegal immigrants are taxing our health-care facilities.

Nationally, different groups have tried to quantify the impact of illegal immigration on health care.

According to the Rand Corp., a nonprofit research company, American taxpayers spent about $11 per household in 2000 to foot the bill for the health care of adult illegal immigrants. The research, published in the November/December edition of the journal Health Affairs, put the cost at $1.1 billion nationally for the health care of illegal immigrants between the ages of 18 and 64.

That's a small fraction of America's health care spending. A total of $88 billion in government funds was spent on health care for all non-elderly adults in 2000, according to the Rand Corp., which computed estimates of health costs by immigration status by combining information about an individual's use of health services with studies that estimate the cost of individual health services.

Researchers developed their estimates by analyzing information collected by the Los Angeles Family Neighborhood Study, which interviewed nearly 2,400 English- and Spanish-speaking adults throughout Los Angeles County during 2000 and 2001. National estimates of health-care costs for the foreign-born were obtained by applying the experiences from Los Angeles County across the nation.

What local institutions do record is the amount of money they spend on charity care, a term that refers to services provided to patients who are unable to pay and for which the hospital does not bill.

Danbury Hospital provided nearly $4 million in charity care from Oct. 1, 2005 to Sept. 30, 2006, Wiseman said. That's significantly down from $8.5 million over the same period in 2005 and $7 million in 2004.

Wiseman said the numbers are so different because there's been a change in reporting standards.

"There has not been a decrease in charity care in 2006. It is increasing ...," she said.

The hospital did not have an accurate number of uninsured patients, but Wiseman said the charity care total for each year reflects patients -- all kinds of patients -- who do not have insurance.

The number of visits to the Danbury Hospital Emergency Department also has been increasing. About 68,000 people visited in 2005, nearly 66,000 in 2004 and more than 63,600 in 2003.

"We are a non-profit organization that provides urgent care to everyone, regardless of their immigration status or ability to pay. We do ask for identification, but that is a practice to ensure patient safety. If a patient does not have identification, he or she still will be treated in the Emergency Department," Wiseman said.

New Milford Hospital hasn't experienced a "discernible impact" from illegal immigration, said Dick Pugh, president and CEO of New Milford Hospital. But the amount of money the hospital spends on care continues to grow.

In fiscal year 2005, New Milford Hospital wrote off about $1.8 million in unpaid medical care. That's up from $1.14 million in fiscal year 2004 and about $1 million in fiscal year 2003. The number for fiscal year 2006 was not available.

People either don't have insurance, have lost insurance or insurance benefits have been cut, Pugh said.

"We take care of everybody," he said.

The number of people visiting AmeriCares' free clinic in downtown Danbury and the amount of money the clinic spends on medical care has fluctuated over the past three years.

The free clinic, which has received an unlimited range of laboratory and diagnostic testing as well as emergency room visits from Danbury Hospital since 1997, recorded about 2,500 patient visits in fiscal year 2006 and spent about $1.3 million on care.

In fiscal year 2005, the clinic spent $984,000 on 2,600 patient visits, and in 2004, the clinic spent $1.04 million on about 2,500 patient visits.

How New Milford Hospital and especially Danbury Hospital continue to serve the undocumented population remains to be seen.

"We strive for an open dialogue that will support an equitable solution related to serving undocumented population," Wiseman said.

Jennifer Barrows, spokeswoman for the Connecticut Hospital Association, said all Connecticut hospitals provide care and services to anyone who may walk through their doors.

"Hospitals do end up often absorbing the costs associated with providing care to those who may be illegal immigrants and who cannot afford to pay out of pocket. We do not have exact numbers as to how many of these individuals we are serving and the numbers vary by region and by hospital," Barrows said.

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Contact Elizabeth Putnam

at eputnam@newstimes.com

or at (203) 731-3411.