The Cost of Permanent Patients

The United States currently has an estimated 11 million immigrants who entered this country illegally. According to the National Research Council, the migration of these individuals into the United States costs American taxpayers $346 billion annually.

Now we are starting to get a feel for the costs being absorbed by one sector — the U.S. healthcare system — to treat this population. And the cost is staggering.

The Center for Immigration Studies estimates that the current cost of treating uninsured immigrants who entered this country illegally at all levels of government to be $4.3 billion a year, primarily at emergency rooms and free clinics. This doesn’t take into account the billions being absorbed by in-patient care delivered by hospitals.

Who is picking up these costs? Every American taxpayer — not to mention medical facilities and insurance companies who turn around and raise their rates for everyone else.

For instance, it may surprise you to learn that immigrants who entered this country illegally, who have not paid one dime into Medicaid, are receiving Medicaid benefits. Kaiser Healthcare News reports that “federal law generally bars immigrants who enter this country illegally from being covered by Medicaid. But a little-known part of the state-federal health insurance program for the poor has long paid about $2 billion a year for emergency treatment for a group of patients who, according to hospitals, mostly comprise this class of immigrants.”

A 2007 report by the Journal of the American Medical Association found that in a four-year period, about 99 percent of those who used Emergency Medicaid were determined to be immigrants that entered this country illegally.

This only covers emergency room care, but many thousands of patients in the United States who lack health insurance but who need long-term care wind up lingering in hospitals for many weeks, months or even years because the current healthcare system doesn’t offer workable solutions for them.

There is a term for these people: “permanent patients,” because they have no relatives, insurance or an established address where they can go once released.

Ashish Jha, associate professor of health policy and management at Harvard School of Public Health, told NBC, “It’s completely illogical that hospitals have to spend about $2,000 a day on patients who could be cared for much more cheaply in a skilled nursing or rehabilitation facility. But because the law prohibits hospitals from discharging patients without a plan in place for ongoing care — and because nursing homes and rehabs are not required to take patients without insurance — many hospitals wind up keeping these patients for long periods of time.”

Many patients are stuck because they have no money or insurance to pay for long-term care. Other patients may have insurance, but their medical needs are too complex for most skilled nursing facilities to accept. Then there are those in limbo at the hospital waiting sometimes for months to qualify for Medicaid. Once they’re approved, Medicaid will cover the nursing or rehab facility they need.

In a case documented by NBC News, a Polish native, who had cleaned homes in the Chicago area for 20 years, suffered a stroke while on the job. An ambulance took her to Adventist La Grange Memorial Hospital in Illinois. She stayed at La Grange for two years, costing the hospital $1.4 million. A skilled nursing facility would have been a fraction of the cost, but they were prohibited from transferring her because she couldn’t pay for care and had no insurance.

Once a patient is in stable condition, the hospital is technically not required to continue care. However, some desperate hospitals have turned to “medical repatriations” — a term used when a hospital deports an injured or sick immigrant to a different medical facility in their home country without their consent. A report reveals that over the past six years, several organizations have registered over 800 cases of attempted or achieved medical repatriations.

This, despite the fact that according to the Emergency Medical Treatment and Active Labor Act, hospitals are required to screen and treat all patients for emergency care regardless of their health insurance coverage or immigration status.

In one recent case that received extensive press, a Colorado medical facility that had been treating two illegal Mexican immigrants for some time without any compensation or a timeframe for discharge, flew them back to Mexico.

We talk about an immigration policy where people can become permanent legal residents, but instead find ourselves dealing with illegal permanent patients. This is a sad little secret in our overall immigration and healthcare discussion that gets little attention and is costing us dearly.

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