As a report by the Center for Social Justice released Tuesday reveals, during the past five years, an estimated 600 immigrants who entered the U.S. illegally have been deported by American hospitals in a little-known removal system called “medical repatriation.”
As inhumane as the end decision seems, the underlying complexities regarding illegal immigration and health care costs are to blame here, not the hospitals.
In one of the 600 cases detailed in the report, days after a near-fatal car accident, Jacinto Cruz and Jose Rodriguez-Saldana lay comatose in Iowa Methodist Medical Hospital. Both did not immigrate legally and the hospital was unsure of whether the victims’ health insurance would pay for long-term rehabilitation, according to the Latino Post.
In the end, the hospital took matters into its own hands by quietly loading Cruz and Rodriguez-Saldana on a chartered international flight back to Mexico.
Shipping unconscious patients back home might sound harsh, but many key points have been left out or understated by the media in its sensationalized retellings of these stories. Before categorizing hospitals as insensitive and ruthless, a closer look shows that they really had no choice in light of financial pressures and responded with the most rational plan.
First off, the immigrant patients that the report speaks of were not just “unconscious” but were in a chronic vegetative state. Both Cruz and Rodriguez-Saldana had been in a coma for more than 11 days when the hospital deported them, according to Salon.
After receiving treatment in a Veracruz hospital, Cruz and Saldana woke up with life-altering disabilities. With such severe medical conditions, if these immigrants had stayed in American hospitals for care, the costs that taxpayers and hospitals would have to shoulder would have been exorbitantly high.
Comatose patients are often placed in intensive care units, and the national economic cost for intensive care in U.S. hospitals was an estimated $75.6 billion in 2010, according to the Center for Disease and Prevention Control. That comes out to an average of $2,000 to $3,000 a day for intensive rehabilitation, according to the American Journal of Respiratory and Critical Care Medicine.
With such severe injuries, these patients are better off in their own countries where they possibly have family to look after their long-term well-being as well as to make legal decisions for them.
Additionally, because patients who immigrated illegally are often uninsured and families are not available to provide care, medical personnel are left with simply monitoring them in the hospital, which could be detrimental because such unconscious patients are bound to be at a higher risk for nosocomial infections, and other complications, according to the CDC.
The fact that the medical repatriation system is not government-run, but hospital-initiated, also sheds light on the danger of being quick to judge hospitals as evil just because of these deportations. As much as we wish it were the case, hospitals in this country cannot afford to distribute free services generously to all, because they are also for-profit businesses that rely on funding to continue saving lives.
According to Salon, the Iowa hospital officials allege they had received permission from Saldana’s parents and Cruz’s long-term partner for the flight to Mexico. Though the men and their families filed a lawsuit in 2010 because of alleged minimal rehabilitative care in Veracruz, the court found that Iowa Methodist was not to blame. Moreover, although the families denied giving consent for the flight, they also failed to object to it.
In addition, the two patients were treated in accordance with hospital guidelines, which state that patients must be cared for regardless of their citizenry or ability to pay — that is, until the patients are stabilized. With that policy, a happy medium of providing service and avoiding long-term costs is reached.
Also, the Huffington Post reported that many hospitals tried contacting immigration authorities about undocumented patients, but most calls were ignored, leaving care providers no other alternative than taking matters into their own hands. Though the American Medical Association’s Council on Ethical and Judicial Affairs told doctors in 2009 not to let “hospital administrators to use their significant power and the lack of regulations to send patients to other countries,” if there aren’t any legal protections or another solution to the ever-looming need to maintain revenues, what, frankly, is a doctor to do?
Under President Barack Obama’s health care reform plan, set to go into effect in 2014, immigrants who have not entered the country legally will have to wait eight years before becoming eligible for public health care benefits, Fox News reported. This attests to the hard times still to come. In a time, when, as Salon reported, the federal government plans to cut payments to hospitals that make room for the uninsured instead of American citizens eligible for Medicaid, doctors and hospitals have to make adjustments in their care-giving priorities.
These deportation measures might seem harsh, but before protesting them, it’s time for a reality check.
Valerie Yu is a freshman majoring in biological sciences and English. Her column “Heart of the Matter” runs Fridays.