Thread: Jackson Halts Dialysis for Poor

A percentage of this is due illegal aliens. They also treat all kinds of illegals for other ailments. This is killing the county as part of the county sales tax pays for it.

http://www.miamiherald.com/486/story/1413134.html

Jackson Health System halts dialysis for poor patients
BY JOHN DORSCHNER AND JUAN CARLOS CHAVEZ
jdorschner@MiamiHerald.com


C.MN. GUERRERO / EL NUEVO HERALD
Emelina Garcia Cordovi had her treatment cut off. The financially strapped Jackson Health System has stopped paying for dialysis treatments for 175 poor patients with failing kidneys -- a decision that experts say could be deadly.
``It is no game,'' says Emelina GarcÃ*a CordovÃ*, 67, whose treatments at a South Miami-Dade center were cut off Dec. 31. ``We are talking of the lives of persons who depend exclusively on their dialysis.''

Jackson, Miami-Dade's government health system intended to be a safety net for the poor and uninsured, said it expects to save $4.2 million by stopping payments for outpatient dialysis treatment for the 175 patients. Of those, other avenues for care have been found for all but 41, says spokesman Robert Alonso. About a third of those are undocumented immigrants, who are not eligible for government programs.

``This decision was not taken lightly,'' said Eneida Roldan, chief executive of Jackson, which is trying to reduce a projected loss of $168 million for fiscal 2010. She said patients can still get treated in the emergency room.

The situation is so serious that Brian Keeley, chief executive of Baptist Health South Florida, suggested Wednesday that, if Jackson cannot handle the patients, a ``public-private partnership'' of hospitals be formed to provide care. Jackson officials said they would welcome anything that helped solve the problem.

``These people are going to seek treatment,'' Keeley said. ``They're going to migrate to the nearest emergency room,'' after they become sick, meaning care will be more expensive. Such a scenario is ``very very inappropriate'' when they could be kept well at outpatient dialysis centers, he said.

Under the healthcare reform proposals now before Congress, the emphasis is on getting cheaper basic care for an additional 30 million Americans so that they don't need expensive ER visits.

`ALMOST CRUEL'

Raul de Velasco, a longtime Miami-Dade nephrologist who serves on several local ethics panels, said Jackson's decision was ``almost cruel.''

Kidney failure results in impurities building up in the blood. Missing dialysis and waiting to get sick before going to the ER could lead to inflammation of the heart, nerve damage and other problems. ``They will not die quickly or suddenly -- but they will die, a slow death,'' he said.

De Velasco says ER treatment in such cases will also be considerably more expensive because the patients will be sicker when they enter the ER. ``So trying to save money -- that doesn't work.''

ANOTHER WAY

Gerard Kaiser, Jackson's chief medical officer, said the system will indeed save money, because various government programs pay for inpatient dialysis that don't pay for outpatient treatment, and patients may end up at ERs other than Jackson's.

Most patients need care three times a week -- at a cost of about $50,000 a year. Federal law allows virtually all Americans with end-stage kidney failure to get on Medicare, which will pay for their treatment. But it can take more than a year to get that coverage, and people need to have paid into the Medicare fund for a certain period of time in order to be eligible. People in the United States illegally don't qualify under any circumstances.

In the case of Garcia, she has been in this country legally for about five years, but doesn't have the work history to qualify for Medicare. Her trips to the Kidney Treatment Center of South Florida stopped last week. Her husband, Pedro Valdés, 66, said they received notification of the change last month, with a list of 36 centers offering dialysis.

``When we went to those sites to seek help, they told us they could not attend to us,'' Valdés said. ``They asked for an insurance card or the option of paying with our own money, but that is impossible.'' A one-time private security guard, he has been unemployed for almost two years.

Linda Quick, president of the South Florida Hospital and Healthcare Association, said patients' decisions are shaped by federal law, which requires hospitals to treat all patients who come to their ERs. There is no such requirement about those showing up at dialysis centers.

For some time, Jackson had been paying for dialysis for such Miami-Dade residents who fell through the cracks by contracting with outpatient dialysis centers throughout the county. The system does not provide outpatient dialysis on its own.

BAPTIST'S HELP

About a year and a half ago, Jackson stopped funding outpatient dialysis for indigents who had gone to other hospital ERs. The Baptist system reports that last year it spent $1.4 million to pay for outpatient dialysis for people who had gone through its ER.

Keeley said Baptist had done that ``for both humanitarian and practical reasons,'' since the unfunded patients would otherwise end up sick and needing expensive treatment at the hospital once again. ``We face up to our responsibilities. What we don't want is to be a deep pocket for all the hospitals who want to dump on us.''

That's why Keeley recommends that the county's public and private hospitals fund three nonprofit dialysis centers -- in the north, center and south -- to help those who need life-saving care. Reaction from other hospitals to the idea was not immediately available.

Several other South Florida hospitals said that they treat dialysis patients in their hospitals, but don't pay for outpatient treatment.

Lourdes Garridos, spokeswoman for the HCA hospital chain, said, ``Unfortunately this is a system where the funding does not follow the patient and resources need to be identified to assist in their care.''

The South Broward Hospital District, a government entity, reports it spends about $800,000 a year on outpatient dialysis for the uninsured. North Broward also provides such services.

Susan Witzel-Kreuter, a social worker at the North Beach Dialysis Center in Miami Gardens, said she has been scrambling to find treatment for a half-dozen patients Jackson had been paying for. ``This is absolutely a life-or-death issue.''

So far, she has been successful -- but at a cost. Her most poignant case is a man who has been in the United States legally for a year and was working full-time -- at a company that didn't offer insurance.

When Jackson stopped its support, Witzel-Kreuter said, he quit his job so he could qualify for Medicaid, the government health insurance for the poor.

``So now he's on food stamps and all that, when he could have been working,'' she said. ``It's a very very sad story.''

This is INSANE! Americans sentenced to death because of illegal immigration, and spinless politicians! This should outrage the LEFT as well as the right!

About a third of those are undocumented immigrants, who are not eligible for government programs.

Grady Hospital closed its Dialysis treatment center to residents in Atlanta and surrounding areas due to financial costs, and due to illegal aliens. The illegal aliens threatened to file a lawsuit, and Grady still pays for some treatments and for passage to other nations for treatment there.

Mexico, and the other nations need to start paying for their own citizens, and the billions that we send to help them and their corrupt governments need to cease, if they cannot pay their people's bills and transportation.

There are only so many chairs, and if illegal aliens are occupying them, where is the compassion for the American citizens and other legal residents who are penalized?

Psalm 91

Why should we pay $50,000 per year for each foreign dialysis patient, when they can get the same treatment in their home country for $10,000? Now it is poor US citizens who will suffer.

Most patients need care three times a week -- at a cost of about $50,000 a year. Federal law allows virtually all Americans with end-stage kidney failure to get on Medicare, which will pay for their treatment. But it can take more than a year to get that coverage, and people need to have paid into the Medicare fund for a certain period of time in order to be eligible. People in the United States illegally don't qualify under any circumstances.

But illegals get that treatment because we are a humane country. And continually we are accused of being racist and inhumane.