Web-posted Sunday, November 19, 2006
Hospitals feel drag of illegal immigrants


Hospitals drained of resources

By Enrique Rangel
Globe-News Austin Bureau
enrique.rangel@morris.com



Dr. Khalil Carter, left, moves a labor and delivery patient to a spot in the crowded hallway at Parkland Memorial Hospital in Dallas. A survey found that 70 percent of the deliveries in the first three months of 2006 in Dallas County were to illegal immigrants.

Tony Gutierrez / AP Archive



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Editor's Note: Morris News Service examined benefits illegal immigrants provide as part of the work force and the cost of providing them services. Read Monday's Globe-News for a look at their impact on the job market.

AUSTIN - Dallas and Tarrant counties may be neighbors, but when it comes to health care for illegal immigrants, the two North Texas communities are worlds apart.

In Tarrant County, which consists mainly of Fort Worth, hospitals require foreign-born indigent patients to furnish proof of legal residence. However, at Parkland Memorial Hospital in Dallas County, management has a de-facto don't-ask, don't-tell policy. Last year the facility spent $76 million caring for non-county residents or people believed to be illegal immigrants, hospital officials say.

However, the Parkland policy is wearing thin.

Dallas County Judge Margaret Keliher recently asked the county to sue Mexico and other countries for the care their nationals receive in Dallas.

The story of Dallas and Tarrant counties is the story of the United States, particularly in states with large immigrant populations such as Florida or states with a recent influx of foreign-born newcomers such as Georgia.

In some communities, hospital and public officials complain that uninsured illegal immigrants are burdening the health care system while for others the problem is exaggerated.

"The problem with illegal immigrants getting free health care is great," said John Stone, spokesman for Rep. Charlie Norwood, R-Georgia, a dentist and co-sponsor of a new law that requires immigrants to furnish proof of legal residence before receiving non-emergency indigent care. "No one knows for sure what the cost is, but it's high."

However, Paul Rosenberg, senior vice president of Shands HealthCare, which owns nine hospitals in Florida, sees it differently.

"I would not characterize it as a major problem, at least not in north Florida," Rosenberg said. "It may be in south Florida where there's a significantly higher immigrant population."

About 20 percent of Shands patients get free care through Medicaid - the joint federal-state program to help the poor - a percentage much higher than the industry average, Rosenberg said.

Like Tarrant County in North Texas, the Hospital District in Montgomery County, Texas, decided three years ago not to provide non-emergency health care for illegal immigrants, officials say. Montgomery County is a bedroom community in the Houston metropolitan area, which has the second-largest Hispanic population in the United States after Los Angeles.

And then there are the impoverished communities along the Texas border with Mexico. From Brownsville to El Paso, the rapidly growing number of "anchor babies" is costing hospitals millions of dollars, health officials say. "Anchor babies" are the newborns of undocumented immigrants, who use such children to become legal since anyone born in this country is automatically a citizen regardless of the parents' nationality.

"It is a major problem for us," Thalia Mu-oz, Starr County Medical Center administrator in Rio Grande City, said of the suspected illegal immigrants. "Once they come in, we have to take care of them, even though we believe they won't pay."

However, the Medical Center, like most border hospitals, doesn't ask patients whether they are here illegally, Mu-oz added.

Like most of Texas, neighboring Oklahoma has a major problem providing health care for its illegal immigrant population, despite a 3.8 percent foreign-born population, one of the smallest in the United States.

Nico Gomez, spokesman for the Oklahoma Health Care Authority, said that in fiscal year 2004-05, 3,558 illegal immigrants qualified for medical care through Medicaid at a cost of $7.8 million. For fiscal year 2005-06, which ended on June 30, the cost was $9.7 million, a 24-percent increase.

"It's staggering to know the amount (of money) we provide," said state Rep. Kris Steele, a Republican who sits on the Health and Human Services Committee.

In Kansas, which has fewer residents than neighboring Oklahoma and also has a small immigrant population - despite the recent influx of Hispanic immigrants - health care has not become a hot issue, some officials and immigrant rights advocates say.

Nonetheless, thanks to Spanish-language media and word of mouth, many illegal immigrants everywhere are aware of the heated debate. And to avoid being asked for proof of legal status or from being turned down for medical care, some like Aurelio Rodriguez of Lubbock are buying health insurance or avoiding hospitals.

Rodriguez, a 46-year-old construction worker who came here illegally from San Luis Potosi, Mexico, recently bought a low-premium policy "just in case" he ever needs it.

"I don't ever want to go to the Medical Center without insurance because they will ask me if I am here illegally," Rodriguez said of the University Medical Center in Lubbock County. "And I don't want them to turn me down if I am really sick or get hurt in an accident."

Greg Bruce, corporate affairs vice president at the University Medical Center, confirmed that the hospital asks indigent patients if they are U.S. citizens, have a valid visa or hold a permanent-resident card - popularly known as the "green card."

If the answer to such questions is no, the hospital assumes the patient is here illegally and tries to qualify him or her for care through Medicaid, Bruce said. Besides, like other American hospitals, in emergency situations the Medical Center is required to treat all patients, even if they are here illegally. Fortunately for the Lubbock hospital, out of the $52 million a year that it spends on indigent care, only about $300,000 is spent on illegal immigrants.

In Dallas County

# 70 percent of women who gave birth in the first three months of 2006 were here illegally.

In Oklahoma

# 83 percent of the money spent on illegal immigrants is in maternity wards.

In Georgia

# $100-$300 million is spent each year in non-emergency care for illegal immigrants.

Health care for illegal immigrants in a nutshell

# In most communities wrestling with this issue, the biggest chunk of money is for delivering babies. In Dallas County for example, a recent survey showed that in the first three months of 2006, 70 percent of all women who gave birth were here illegally. And in Oklahoma, 83 percent of the money spent on illegal immigrants is in maternity wards.

# Although illegal immigrants do not qualify for Medicaid, federal and state government programs reimburse hospitals for emergency services.

# Despite the controversy, a recent Harvard/Columbia University study concluded that many illegal immigrants pay Medicare taxes in their wages but receive less than half the medical care U.S. citizens get.

# Georgia loses between $100 million and $300 million a year in nonemergency care for illegal immigrants.

Source: Morris News Service research

Source: Morris News Service research

Erin Medley of the Shawnee News Star in Shawnee, Okla., contributed to this report

http://www.amarillo.com/stories/111906/ ... 0844.shtml