http://nctimes.com/articles/2006/05/...6_545_6_06.txt

Illegal immigration debate could affect Prop. F

By: PAUL SISSON - Staff Writer

As the June primary election approaches, proponents of Prop. F, Tri-City Medical Center's $596 million construction and renovation bond, increasingly find themselves talking about an issue they cannot control: illegal immigration.

At a forum Thursday hosted by Oceanside's Oceana senior community, one man, who refused to provide his name, stood during a question-and-answer session and asked what Tri-City was doing to make illegal immigrants pay their fair share in the emergency room.

"Is the hospital doing anything to make sure they pay?" the man asked.

Dr. Richard Burruss, director of Tri-City's emergency department, responded that illegal immigrants who do not pay their bills were only 0.3 percent --- or 109 --- of the 40,876 patients treated in Tri-City's emergency department in the last eight months.

He said the hospital is participating in a new federal program, called Section 1011, that pays the bills for illegal immigrants who do not pay on their own.

"We work very hard to try to identify these people and get payment any way we can," Burruss said.

If it passes on June 6, Prop. F would increase property taxes in most of Oceanside, Vista and Carlsbad by $23.40 per $100,000 of a property's assessed value. According to the hospital's master plan, the bond would pay for 70 percent of Tri-City's existing facilities to be demolished and replaced with a modern new six-story medical tower on Vista Way.

Tri-City's emergency department saw 57,358 patients in 2005. But it is unclear how many of those patients were in the country illegally.

Short of asking each and every patient for a birth certificate at the door, Burruss said, it would be difficult, if not impossible, to determine which patients are in the country legally and which are not.

"When people come into the emergency room, they may see someone who is speaking Spanish, and maybe has a large family," Burruss said. "They make the assumption that they are illegal, but that is often not the case."

The doctor noted that he treats patients every day who are Latino and have legal residency. Also, because of immigration patterns in California, families are not monolithic.

"A baby you treat may have been born in the U.S. so they are a legal citizen. But their parents may have come across the border illegally," Burruss said.

Nurses ask a series of billing questions to determine how each patient will pay after treatment, Burruss said.

"That's how we have to do it," he said. "We are required by federal law to treat all patients first before we worry about how the bill is going to get paid."

Even though illegal immigrants may not leave a large hole in Tri-City's annual budget, their care is subsidized with taxpayer dollars.

California's Medi-Cal program, a state health care program that pays for poor and disadvantaged residents, covers costs for certain portions of the immigrant population, such as those who are younger than 21, blind, disabled, pregnant or older than age 65.

A 2004 research paper published by the Federation for American Immigration Reform, a Washington D.C.-based anti-illegal immigration advocacy group, calculated that paying for medical care for illegal immigrants cost $1.4 billion per year.

When asked for its own estimate on the cost of illegal immigration, a Medi-Cal spokesman said he was unable to provide the information.

To pass, Prop. F requires a two-thirds majority vote at the primary polls June 6, and it is unclear how much recent debate over illegal immigration might affect that vote.

Tommy Chanick, an Oceanside resident who has been following Prop. F, said recently that he will not vote for any hospital bond as long as he continues to feel the illegal immigration issue has not been resolved.

"I'm not going to vote for it as long as they're getting taken care of for free," Chanick said.

But others who oppose illegal immigration take a more nuanced view, suggesting that a voter's stance on the issue may not necessarily dictate their willingness to support Tri-City's hospital bond.

Ray Carney, a blogger and anti-illegal immigrant activist who lives in Fallbrook, said he did not understand an urge to vote against the bond based on the illegal immigration debate. Though he noted that taxpayer money does indeed subsidize care for illegal immigrants, he added that hospitals do not have a choice in who they treat.

"It's true that you are paying for it, but we can't be that cruel," Carney said. "When people are in pain, you have to treat them, no matter where they're from. If I lived in Oceanside, I would vote for the bond."

But Carney drew a distinction between one taxpayer-funded government service and the next. He said he would vote no on a school bond because: "Education is not a matter of life and death."

Contact staff writer Paul Sisson at (760) 901-4087 or psisson@nctimes.com.

Previous Story:
Next Story: Lincoln campus in Vista crumbling from within



.
Comments On This Story

Note: Comments reflect the views of readers and not necessarily those of the North County Times or its staff.
Randy wrote on May 07, 2006 4:01 AM:"After story after story after story about Prop. F in which the opposition is never given a chance to respond (other than through this blog), we have held our peace. But this is so one-sided, so out-of-hand as to be absurd. Why bother to feign objectivity? This is not reporting of the news; this is part and parcel of the hospital's public relations campaign! If you have even one iota of journalistic integrity remaining, endorse the bond on your editorial page and be done with it! But please, cease patronizing your remaining readers with this pulp!"

Randy wrote on May 07, 2006 4:21 AM:""Dr. Richard Burruss, director of Tri-City's emergency department, responded that illegal immigrants who do not pay their bills were only 0.3 percent --- or 109 --- of the 40,876 patients treated in Tri-City's emergency department in the last eight months." If you swallow this statistic, I have Florida swampland for sale. Perhaps you prefer a bridge in Brooklyn. This typifies the balderdash spouted in support of Prop. F. If the ER patients represented the population, this would mean that we have only 0.3 percent (less than even 1%) illegal immigrants! We know that the ER patients do not represent the population. Illegal immigrants overuse the ER for free treatment of routine illnesses that should be treated at Vista Community Clinic or North County Health Services. How felony stupid do the proponents of Prop. F think that the voters of our community are? "

Read the Article wrote on May 07, 2006 8:45 AM:"Dr. Burruss did not state how many illegal immigrants were treated in the ER - just how many did'nt pay. But, this is really a totally separate issue - the "main thing" is to repair Tri-City now so that we save our local hospital. "

Melba...... wrote on May 07, 2006 8:54 AM:"I can't believe Dr. Burruss's stats of only 0.3%,the emergency room is alway full of illegal immigrants and Tri- City writes-off millions of dollars of bad debt every year,I'm voting no on prop"F"!!"

Tom wrote on May 07, 2006 9:00 AM:"I will not vote for Prop. F or a school bond because I do not want my tax money going to illegal aliens."

Surfer........ wrote on May 07, 2006 9:04 AM:"Dude! Dr.Burruss! What world are you living in?? When ever I go to the Tri- City emergency room it's wall to wall illegal immigrants,I was born at night but not last night!!vote no on"F"!!"

Ray wrote on May 07, 2006 9:08 AM:"Since I was interviewed for this story, let me ask people in the district a question. You are going to punish your only hospital in the area because they treat illegal aliens? Why not shoot yourself in the foot and get it over with. So your going to deny major improvements to a hospital that serves you. What would happen if you or your children required services only to find out they had no room or the equipment was out of date. Than your complaint would be different. Try going to Fallbrook Hospital where these things happen every day. At least you have a hospital that is somewhat current in technology, why not make it better. Here in Fallbrook as well as Vista, Escondido and Oceanside most migrants both legal and illegal do take their non-emergency care to the community clinics, here in Fallbrook, we have two here in town. All I can say to the people in the district, ignore the far left immigration loonies, think for yourself and don't cut your nose to spite your face, you might need their services one day."

Tri City Blues wrote on May 07, 2006 9:14 AM:"Why are the questions about conflicts of interest, conflicting interests, and the appropriateness to participate in the discussions of the strategic plan and master facility planning sessions being avoided? Doctors who participated in the strategic plan and master facility plan closed session meetings were paid to attend and are the very ones who benefit from the "insider information." Why have the local “rags” failed to do the follow-up on this story when they were informed? Who’s in bed with whom? "

HILLARY....... wrote on May 07, 2006 9:14 AM:"DIDN'T DR. BURRUSS TAKE THE HIPPOCRATIC OATH TO TELL THE TRUTH? VOTE NO ON PROP "F"!!"

Tri City Blues wrote on May 07, 2006 9:36 AM:"Most doctors promoting support for the Bond do not live in the Tri City Hospital District. Their tax base will not be affected. “Support Prop F” mailings are being sent by the Foundation’s PAC as a signed letter from your “local doctor.” How dare them!! How dare the Foundation use patient addresses of Tri City hospital, Foundation donors, or supporting doctors to access their patients mailing addresses in order to intimidate their patients into voting for a Bond. This is clearly an inappropriate way to use patient information. These supporters and doctors have stooped pretty low...they are no better than a lottery win junk mailer or telemarketers who prey on seniors and should be reported! "

Tri City Blues wrote on May 07, 2006 9:39 AM:"The doctors who are the loudest to sway public support for the Bond have the most to gain if the Bond passes since they have hospital contracts and joint ventures! "

Coach_Joe wrote on May 07, 2006 9:52 AM:"I am a voter and have done my own homework. Tri-City has stepped up to the plate - providing a detailed plan, making sure there's a group separate from the hospital to monitor it, and resulting in a hospital for us and our kids in the future. They are using what they can of the current buildings and the whole thing is fiscally responsible. They've covered all bases and voters will bring 'em home...Grand Slam on June 6 for the community. Good job, Tri-City! "

Jimmy wrote on May 07, 2006 9:57 AM:"I believe that our country should have a quid pro Quo health care balance sheet, add up every dollar we spend on what ever health care we give to what ever national, list that nationals nation and our federal government would reimburse those costs locally and our federal government would demand that our citizens recieve the equalvalent health care exchange in kind at no cost to our citizens who are in that nation until they return home. This would eliminate the controversy as the respective Federal Governments would be in charge of collection from their respective citizens if it is desired. There have been too many stories of folks in dire medical straits in other nations where health care was needed but could not be rendered due to costs or other factors. This credit system would eliminate that problem with whatever nation, ours or theirs, and provide a needed service for our citizens till they get back home. If it, the health care credit, wasn't recieved from the other nation then direct recompense could be achieved by tarrif taxes from exchanges of goods on that other nations trade balance and used to help our citizen overseas thus governing negligence, use and/or abuse eliminating the local impacts as reimbursements plus administrative costs would be automatic. Since this is an international problem it should be shifted under such a system from the local hospital-care giver institution to the respective federal governments. But the idiots in charge all the way around avoid such simple processes, why? simple profits and politics."

Nancie wrote on May 07, 2006 10:36 AM:"Ray - You make some good points. It is not prudent to deny major improvements for Tri-City - we need a close hospital. That ER probably takes a bigger hit from uninsured citizens who don't pay than illegal immigrants. While politically motivated blogs might provide some short-term entertainment, voters will look at the facts and vote YES ON F for the long-term benefit of our community."

Lynn wrote on May 07, 2006 10:53 AM:"The issue is not about illegal immigrants. The issue is about TRUST and TRUTH. Do you really trust this administration? Do you think you are hearing the truth? I once heard a lecture from Dr. Gonzalez about the need to live within one's budget. When the budget calls for bloated salaries and bonuses, there is little if anything left for home (hospital) improvement. No wonder they are asking us as tax payers to pay for it. "

Tri City Blues to Ray wrote on May 07, 2006 10:55 AM:"The Tri City master facility plan DOES NOT INCLUDE CHILDREN. Directors Reno and Sterling continue to bring this point up that children need to be included. The only number of beds planned is for newborns - Children and their needs have been excluded! How can management / board expect the public's children and children's children to pay for a 1/2 billion dollar Bond that does not include a Pediatric Inpatient Unit and a Pediatric Intensive Care Unit while proponents for the Bond claim there’s growing needs for the Tri City District? The swing bed unit for children is now shared with adults. It is dismal and although a start it is a failure set up by management to fail. Why? Pediatricians won’t admit their children to unsafe conditions. Whether the board appoints or decides to let the public to determine replacement of the three and half year missing board member in November... VOTERS BE SURE to support Children - Future Taxpayers & VOTE for Candidates who will SUPPORT CHILDREN for a Pediatrics Unit! Currently Reno and Sterling are overshadowed by rubberstampers who are near-sighted and self-serving! "

Voter For Ethics and Oversight wrote on May 07, 2006 10:57 AM:"The doctors who are the loudest to sway public support for the Bond have the most to gain if the Bond passes since they have hospital contracts and joint ventures! "

Beth SM wrote on May 07, 2006 11:07 AM:"Right. only .3% were not paid for. Ha ha ha, how stupid does this Doctor think we are. Numbers dont lie! But liars do! Maybe the questioner didnt ask the right question? If the fed or state govt pays for their bills, where the hell does that money come from. Hell no Vote No. and close the damn border now."

TCMC wrote on May 07, 2006 11:13 AM:"Ray- you touched on good subject ‘old equipment’ did you know that these Bond propositions are to cover only the ‘building’ not equipment? Yeah, it says so in writing but who cares VUSD used prop O funds to buy a bunch of doodads and now the money is gone with no high schools what a disgrace. "

Voter For Ethics and Oversight wrote on May 07, 2006 11:16 AM:"ER Dr. Burruss sits on TCHD board standing committees and district public funds paid for him to attend closed session meetings for the facility planning. ER Doc is President of Tri City Hospital Foundation & PAC supporter for Prop F. Other paid doctors who attended the closed session meetings gained insider information, participated in the discussions bought property around hospital... expecting to flip and make a deal initiated by CEO blessings. Their hope is the TCHD rubberstamping board will go along. One board member has gone so far as to say “a doctor’s loyalty to the district guarantees the board to buy.” Unbelievable! "

Michael of Carlsbad wrote on May 07, 2006 11:17 AM:"I have a friend that owns a milk farm in the San Joaquin Valley. One day I asked him: how can you live with that smell? He told me that you only notice the smell for a few days, your brain then automatically stops telling you that manure stinks. “You become numb to the smell”, he said. I never believed him. Now I understand exactly what my friend was talking about. I’m 26 years old, for years I have read (and seen) the hateful treatment of Latinos in this area. We see a person with indigenous (you referr to as “Mexican”) characteristics and automatically assume he/she is an immigrant, most likely an “illegal immigrant”, right? Hey wait, “illegal immigrant” is to humane, these people are not humans, lets call them just “illegals”. Yes, that’s better! This despite the fact that their ancestors were the owners of this land. But who has time for historical irrelevancies? Who has time to remember that our Anglo ancestors robed the early (original) Californians or Californios of their land? No way! We are to busy, like Tom said, making sure that we do not vote for anything that would, in any slightest way, benefit these “illegals”. Besides the obvious and naked hate and bigotry in these comments (Randy, Melba, Ray, and Surfer’s) there seems to be a great sense of misinformation on issues regarding the real purpose of the article: the funding public infrastructure and services such as the Tri-City Center is essential for the well being of our community. Let me put it in words you can understand: “our white, Anglo-Saxon community”. To those Latinos reading this, if the North County Times allows this comment to be published on their site, not all of us support the comments made by people like Hillary, Ray, Tom, and the rest of the regular bigots on the comment section. Some of us are actually working in finding real solutions for our current immigration issue. The difference is that contrary to persons named above, we take on this issue without malice, contempt, but mainly without hate. I’m numb the xenophobic and biased comments, but I worry that due to my Anglo phenotype characteristics, people might want to associate me to Surfer, Ray, or god forbid, Tom. "

Suspicious reader wrote on May 07, 2006 11:21 AM:" Tri City Blues- everybody has conflicts here in the North County what is new. What makes you think that the San Diego Union or the North County Times is going to report on them when they are all buddy, buddy with these clowns. San Diego Union is perhaps the worst, talk about the ‘Albondigas Club’. All the politicians are in bed with each other no exceptions and nobody is going to squeal on anybody here that is the name of the game. If we had a DA maybe we could get some cleaning going but we don’t. "

Kathy wrote on May 07, 2006 12:03 PM:"The error in this argument is that the problem is not the illegal population, it is the uninsured/self pay population of which the illegals may be a portion but definitely not the majority. In fact, the illegal population often pays before others out of fear of getting caught. The bigger problem that needs to be addressed is the inability of so many to to get insurance or access care through less costly alternatives."

A voter wrote on May 07, 2006 12:24 PM:"I can't vote for this bond but it has nothing to do with who does or does not pay their bills. Inserting the illegal immigrant/alien question makes absolutely no sense at all. Not everyone can pay the outrageous prices charged by any emergency room- doesn't matter if you're a citizen or not! Until every citizen has some sort of free medical care we will continue to see outrageous bond issues and disinegenuous arguments about the cost of illegals. This bond is going nowhere. I can't afford it and the board of Tri City is using smoke and mirrors to justify their dream campus!"