Sunday, August 3, 2008

Injustice, Immigration and A Broken System

We well remember the story of the young boy scout who was nearly deported, though his mother was here legally and his siblings were U.S. citizens. This weekend, the New York Times reveals a much graver injustice: the deportation of the sick and injured in the name of medical cost control. The intersection of our broken health insurance system and our broken immigration policies is a realm of horrors and family tragedy.
Mr. JimĂ©nez’s benchmark case exposes a little-known but apparently widespread practice. Many American hospitals are taking it upon themselves to repatriate seriously injured or ill immigrants because they cannot find nursing homes willing to accept them without insurance. Medicaid does not cover long-term care for illegal immigrants, or for newly arrived legal immigrants, creating a quandary for hospitals, which are obligated by federal regulation to arrange post-hospital care for patients who need it.
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Hospital administrators view these cases as costly, burdensome patient transfers that force them to shoulder responsibility for the dysfunctional immigration and health-care systems. In many cases, they say, the only alternative to repatriations is keeping patients indefinitely in acute-care hospitals.

“What that does for us, it puts a strain on our system, where we’re unable to provide adequate care for our own citizens,” said Alan B. Kelly, vice president of Scottsdale Healthcare in Arizona. “A full bed is a full bed. - The New York Times
There will be anti-migrant voices who say "good, send them home." And there is a bizzare logic in such thinking. If these folks are not U.S. citizens, why should U.S. hospitals have to care for them? Of course, such narrow-minded, nativist thinking discounts the universal American value of justice. In the same way that separating a young teenager from his family for the sake of bureaucratic consistency is unjust, separating the sick and injured from theirs is a travesty of justice.
One Tucson hospital even tried to fly an American citizen, a sick baby whose parents were illegal immigrants, to Mexico last year; the police, summoned by a lawyer to the airport, blocked the flight. “It was horrendous,” the mother said.
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In a case this spring that outraged Phoenix’s Hispanic community, St. Joseph’s planned to send a comatose, uninsured legal immigrant back to Honduras, until community leaders got lawyers involved. While they were negotiating with the hospital, the patient, Sonia del Cid Iscoa, 34, who has been in the United States for half her life and has seven American-born children, came out of her coma. She is now back in her Phoenix home. - The New York Times
You read that first anecdote correctly. A hospital tried to send an American citizen to Mexico. In the second case, the woman in question was a legal resident, with seven citizens as children. This is not deporting migrants without correct documentation, it is dumping legal residents when the cost/benefit of having them in America dos not pay off. And with such admissions, the underlying reason for many of these deportations rears its ugly head: fear of the other, the different. Send the brown people back, even if they are American citizens, if they're not paying off any more.

And the sad truth is deportation is often tantamount to a death sentence for many of these patients.
“I can think of three different scenarios that would have led to a fatal outcome if they had moved her,” John M. Curtin, her lawyer, said. “The good outcome today is due to the treatment that the hospital provided — reluctantly, and, sadly enough, only in response to legal and public pressure.” - The New York Times
Is it fair to send catastrophically ill patients abroad to health care systems even less able to care for them than ours? Absolutely not. Is it fair to require hospitals to carry the burden of care for these uninsured patients so that the rest of society can forget they exist and ignore the problem? No. Is it fair that millions of people in America have no recourse to our laws or our services when faced with extreme difficulties? Absolutely not.

This nexus of legal and medical neglect for people who are striving as hard as our forebearers did to make a better life for their children is the very definition of injustice.

And in America, we must be better than that.