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Immigration, health care, corporate malfeasance, and too many attorneys.

By sudogeek in News
Mon Aug 04, 2008 at 01:12:22 PM EST
Tags: health care, lawsuits, illegal aliens (all tags)

This story has got it all. The executive summary: An illegal alien is involved in an auto accident with a severe injury requiring over two years of hospitalization. After he has somewhat recovered, he is shipped back to Guatemala where he now languishes in a small village with no income or health care. Lawyers are now suing the hospital for $$$$. Read it - it's a fascinating story and fairly accurate.


I actually know Luis or "Louie" as we called him. He spent most days sitting in his wheelchair in the hall next to the nurse's station speaking with staff. Luis had very little education but he actually seemed quite intelligent. Luis spoke Spanish fairly well. In Indiantown, many illegals do not speak Spanish but some "Indian" dialect. Most speak Quiché, the dominant Mayan dialect; Luis' first language was Kanjobal. He picked up a little English as he stayed in the hospital. The left hemispheric closed head injury initially put him in a coma then rendered him mute until he recovered much of his language over several months. He was essentially unable to use his right arm and hand. Weakness of the right leg prevented him from walking without the aid of at least one physical therapist, even with a walker and a brace. Some element of frontal lobe injury may have left him very passive - he never seemed to initiate much of a conversation but would converse if you started talking with him. For the last year of his hospital stay, he basically lived at the hospital and received no other medical treatments except physical therapy. As an uninsured US national, I know I would have been tossed out onto the streets months earlier. I've seen it many times.

The hospital and doctors provided all his care and ate the costs, estimated at $2-3 million over 2+ years. Arguably, a community hospital has a responsibility for the care of members of the community. Legally, EMTALA requires that persons admitted to the ER must receive an "appropriate" evaluation and in-hospital care, if needed, and not be transferred to another facility unless the hospital cannot provide the care needed. The taxpayers of Martin County provide the hospital with about $2 million a year to fund uncompensated care of uninsured residents. This usually represents less than 30 cents on the dollar at the end of the year. Uninsured non-residents are treated gratis. The cost of this exceeds $10-15 million a year for this mid-sized (200 bed) not-for-profit hospital. According to the article, the hospital provides over $20 million a year in charity and uncompensated care. That seems accurate. Coastal Corp., the parent company, is not-for-profit. The corporation "makes" about $20 million a year, all of which must be spent on services, investment, capital goods, etc. The article says that the executives make $4 million a year, but that is the aggregate of all the salaries.The CEO makes a little over $500,000 a year. Of course, there are sweetheart deals and monies spent in questionable ways, but this is American business, after all. In the main, the administration has done a good job keeping the hospital afloat while many small hospital are closing their doors or being gobbled up by for-profit chains.

In the article, one of the attorneys attempts to place the all of the financial responsibility for Luis' care on the hospital:

Jack Scarola, representing Mr. Jiménez's guardian, said that he empathized with the hospital's "significant economic burden" but said that it was the "quid pro quo" of accepting Medicare and Medicaid funds to help finance the hospital's services.
Actually that's not true, as the article points out. Medicare or Medicaid are programs for US residents funded by the taxpayers and through premiums. Medicaid does not cover illegal aliens (except for emergency care mandated by EMTALA). In particular, Medicaid explicitly does not provide long term care for these patients. So how does accepting Medicaid for covered patients obligate one to care for a person who is not a beneficiary? It doesn't, or so the hospital's attorneys say. Luis' attorneys allege that the hospital must not only eat the costs of the care given Luis as a charity but also fund his care either in the US or Guatemala indefinitely. The article notes that assets of the hospital amount to over $200 million, which includes buildings, etc. Do the attorneys really expect that a county hospital should have to liquidate some of their assets or use some of their operating income to pay for the care of Luis and others like him? What would that do to the residents of Martin County, who actually (partially) foot the bill for the hospital and depend on its services?

On the other hand, should illegals be repatriated if such repatriation would result in harm to the person? Should an alleged terrorist be sent back to Turkey or Syria where there is reasonable certainty that they will be tortured? Of course, they could stay here because we don't torture in the US. If an illegal is on dialysis and dialysis is not available in their home country (such as Guatemala of Mexico unless you are rich), must they stay in the US since repatriation is a death sentence? It would seem that such an action would be immoral.

I would argue that the employers of illegals have some, perhaps the lion's share, of the responsibility. If one is injured in the performance of your job, including travel to and from the job, you can make a claim under workmens' compensation programs. Many employers provide health insurance for their employees. My company certainly does. But those companies which hire illegals do not. By hiring illegals, they provide an incentive for the illegals to come to the US and stay. They pay substandard wages (often in cash under the table to avoid FICA, workmens' compensation, unemployment and other taxes), often provide a unsafe work place (and depend on the illegals fear of la migra to prevent the employees from complaining), provide no benefits, and depend on us, the taxpayers and law abiding business owners to pick up the tab.

It appears that the case might actually be decided, at least at the trial level, in favor of Luis. So, does a hospital have an obligation to provide care for illegal aliens? Does the state or federal government have such a duty?

Es un problema grande y no hay una solución fácil.

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Immigration, health care, corporate malfeasance, and too many attorneys. | 40 comments (31 topical, 9 editorial, 0 hidden)
It seems that in the current system (none / 1) (#3)
by sausalito on Sun Aug 03, 2008 at 05:05:24 PM EST

the responsibilities are not allocated in a fair manner, resulting in absurd situations:
  1. Hospitals deport patients. They should not do that, it's not their responsibility. They probably haven't the legal skills and administrative experience to do that scot-free.
  2. Hospitals and long-term care facilities  fight over the post-critical care of illegal immigrants. This leads to situations where illegals are hospitalized for longer than necessary (this is inefficient as hospital care is more expensive)
  3. As you point out, employers are basically encouraged to hire illegals, as they do not pay any consequence if something happens to the people they hire.

In the end, it's fairly clear what the right way to do things would be. Employers should shoulder the cost of care and government should take care of moving the illegals around.

So I disagree that the problem is complicated. It's just complicated to implement common sense  in the face of a lobbies-infested and mis-regulated system.

_____________

GBH - "The whole point is that the App Store acts as a firewall between busy soccer moms and goatse links"

An employer-based system should continue? (3.00 / 3) (#4)
by sudogeek on Sun Aug 03, 2008 at 05:37:50 PM EST

I disagree. Some of the problems with the current US health care system is that it is employer-based. Many businesses and the GOP reject employer mandates. For small businesses, the costs of such a mandate is substantial. The cost of health insurance for a single employee in Florida, with a $1000 deductible, exceeds $700. The wages of a 40 hour per week employee at minimum wage is $1280 and the employer expense (FICA, unemployment, etc.) can be another $200. This provides a disincentive to hire new employees and an incentive to pay under the table - a major portion of the jobs in construction, for example.

There is always the free-rider problem. One solution is a tax on gross business income (not declared wages) to fund a universal system. That will not pass in the current political environment so these perverse situations will continue to occur.

Don't be fooled - you are paying for this in inflated medical charges and insurance premiums as the costs are shifted around. You may object saying "No new taxes," but you're already paying them without knowing it. An overt system would at least allow some accounting and controls and would probably save money.

You're an arrogant, condescending, ignorant dipshit. - trhurler
[ Parent ]

I have to agree with this (none / 1) (#12)
by bodza on Sun Aug 03, 2008 at 08:08:01 PM EST

Of course I'm just a foreigner so you can take it with appropriate amounts of salt.

But having your health insurance tied to your employment would seem to open up huge avenues for abuse of workers based on their fear of losing insurance. It also seems very anti-capitalist as it turns health insurance into "spending other peoples money", one of the reasons government is often so inefficient.

I can understand why various vested interests want to keep it this way, but I'm curious as to how the situation arose. Was this a planned thing or has it just become the way things are done? Also, is there any differentiation in policy in your coming election on either major issue raised in this article, economic migration & health care?
--
"Civilization will not attain to its perfection until the last stone from the last church falls on the last priest." - Émile Zola

[ Parent ]

There was no policy at first. (3.00 / 3) (#13)
by sudogeek on Sun Aug 03, 2008 at 08:36:34 PM EST

In the 50's, many were employed by large corporation which were unionized. In this setting, the cost of health insurance was borne by the employer, often as a result of union contracts. At that time, medical care was not so expensive or, I might add, effective.

The current system arose from that by inertia and a failure of vision by Congress. Now that medical costs are a significant line item, many corporations are interested in off-loading these costs. This takes the form of two polar positions.

1. The GOP/DLC/Clinton corporatist policy of health insurance "portability" In this model, employees are responsible for buying their own insurance. There is, of course, no policy to require corporations to pay employees more (as they cut their own costs by dropping health insurance) or to prevent insurance companies from continuing to screw beneficiaries. Costs will be magically reduced by "the market" as people somehow are organized into "purchasing groups." Other such hand waving is used to fill in the absence of any real plan or policy - much like the case with Iraq. You know, "the war will pay for itself." "We be greeted as liberators," etc. There is, importantly, no solution for the free-rider problem or any plan to care for the uninsured, unemployed, illegals, or others. This is McCain's plan (or lack thereof).

2. Universal health insurance, either a single payer or single provider plan. The latter is not likely (as the government is not going to nationalize all the doctors and hospitals). Medicare for all or some other insurance scheme, priced below what private insurers can charge, is more likely. Such a plan is unlikely to pass even though a substantial fraction of Democrats favor it; Republicans, Blue Dogs, and DLC types have a majority in Congress and are liekly to remain in the majority for the next Congress.

Since wrapping up the nomination, Obama has made rather vague noises about this. In the primaries, he and Hillary were forced by Edwards to come up with a policy. Ever the politician, his plan straddles the middle. His stated policy is to provide some sort of (subsidized?) insurance plan for the uninsured and for children but leaves the existing insurance schemes for employees and Medicare alone.


You're an arrogant, condescending, ignorant dipshit. - trhurler
[ Parent ]

Thanks for the detailed answer (none / 0) (#14)
by bodza on Sun Aug 03, 2008 at 09:04:24 PM EST

And the original article pointer. I kept going to close the tab as tl;dr but somehow made it to the end. +1 FP from me. Alas, off to work now.
--
"Civilization will not attain to its perfection until the last stone from the last church falls on the last priest." - Émile Zola

[ Parent ]
Look (none / 0) (#19)
by sausalito on Mon Aug 04, 2008 at 02:43:04 PM EST

the system in Europe is employer-based too, if by that you mean that the employers pay for the cost of health care (actually the so called "social security contributions" are split between employer and employee, but in the end it's the employer to take the money from the paycheck and pay the social security).

The problem causing cost is that insurances are private and quite fragmented. This means that there is a significant share of costs that go towards marketing and processing of claims.

In Europe, by contrast, there is a centralized payment system and no marketing. Private operators are mostly (e.g. in France) top-up services you pay to have better than standard levels of care. Also, private hospitals and practitioners have "conventions" whereby they can if they want to provide part of their services under the state umbrella, for a pre-agreed cost, and part of the services outside of it, at a cost they set.
_____________

GBH - "The whole point is that the App Store acts as a firewall between busy soccer moms and goatse links"
[ Parent ]

That is correct in some countries. (none / 0) (#20)
by sudogeek on Mon Aug 04, 2008 at 03:09:04 PM EST

Correct me if I am wrong. In Germany, the system is employer based with administration by insurance companies derived from the old sickness funds. The lander (states) also kick in some tax revenues. In France, the system is similar to the US - there is a employee and employer contribution (the amount differ from the US) but the care is administered by a state run agency. One can by additional ("mutuel") insurance, much like Medigap policies to supplement Medicare. In England, the majority of the funding is from the government. Again, private insurance is available but is an add-on,

There is no one model in Europe. As you point out, in our employer-based system, the major problem may lie in the number and lack of coordination between insurance companies, the lack of sensible regulation, and the increased costs due to marketing, administration, and higher demands for profit. That is why many, including this writer, favor a single payer plan. There could still be a role for insurance companies to offer additional coverage over the base and to administer the system (much as Blue Cross acts as the intermediary Medicare in some locales).

You're an arrogant, condescending, ignorant dipshit. - trhurler
[ Parent ]

Not familiar with Germany (none / 0) (#22)
by sausalito on Mon Aug 04, 2008 at 03:26:48 PM EST

only France Italy and the United Kingdom. Your facts seem correct, based on my limited knowledge on the matter (user rather than researcher or worker).

However, I think there is one common thread in the European system: all are centrally administrative and the private sector acts in a  "subsidiary" role (i.e. it assists or integrates the public system, does not replace it).

This means that conflicts like in the US never happen. Or perhaps happen but it is not evident from the outside.

Sometimes, each party benefit from the other. The private companies place themselves where there is lack of capacity from the public sector (of course, as people go to the private companies if there are long waiting times or the level of care is better). Private operators can prescribe drugs at the low centrally-contracted price.

Not everything is good though. For example, there are often cost overruns. I think that some tax go in when there is a cost overrun or revenues shortfall in Italy and France, too. Quality of care is somewhat uneven, especially in Italy where care is regional (not national) so rich regions like Lombardy (the region of Milan) offering good care, others like Campania in the south (the region of Naples) much less so. So there is a sort of local migration of sick people from the South to the North.
_____________

GBH - "The whole point is that the App Store acts as a firewall between busy soccer moms and goatse links"
[ Parent ]

No. (none / 0) (#15)
by GhostOfTiber on Mon Aug 04, 2008 at 10:38:04 AM EST

The ER only has to stabilize you.

They are under no obligation to do anything once they can pass you off to the appropriate doctors office for the correct services you need, nor are they equipped to do much more than prevent you from dying.

So if he couldn't pay the bills after the ER saved his life, TOO FUCKING BAD.

[Nimey's] wife's ass is my cocksheath. - undermyne

That's true if you do not need admission. (none / 1) (#16)
by sudogeek on Mon Aug 04, 2008 at 11:11:49 AM EST

If the ER doctor, after appropriate evaluation, believes the patient requires further in-patient care then he/she must arrange for admission with a physician on the hospital staff. The admission is considered part of emergency care if admission is required to stabilize the patient - i.e., the patient cannot be stabilized with a short-term intervention in the ER. Most hospitals have doctors on call who are obligated as a condition of their hospital privileges to admit these patients - whether funded or not.

The hospital cannot transfer these patients to another hospital until they are unable to provide the patient with services needed (for example, no neurosurgeons available).

Once the patient is stabilized, that is once he/she no longer requires acute care hospitalization, then the patient can be discharged of transferred to an appropriate facility. In this case, Luis was unable to care for himself, couldn't walk or even tranfer himself from bed to wheelchair without help. He needed a level of assistance which could not/would not be provided by his family and there was no funding for rehabilitation (which may have helped further) or nursing care. [From a legal point of view, the hospital was also required as part of their policies to have a discharge plan with a higher level of specificity than that which they provided. The hospital did not follow their own policy, which is one of the points that may sink their case at trial.]

You're an arrogant, condescending, ignorant dipshit. - trhurler
[ Parent ]

OR, we could shoot them and eat them (none / 1) (#17)
by GhostOfTiber on Mon Aug 04, 2008 at 11:30:31 AM EST

I love mexican food.

[Nimey's] wife's ass is my cocksheath. - undermyne
[ Parent ]

blah (none / 0) (#40)
by akma on Thu Aug 21, 2008 at 01:47:29 PM EST

Cook them very well first....no medium rare or such allowed. Wouldn't want to get intestinal parasites or such from them.

__
Those in the world shouting "Yankee go home" should bear in mind that the people of the South have been saying the same thing for over 100 years now, but the damned bastards won't leave.
[ Parent ]
tax free medical spending accounts (none / 0) (#18)
by nlscb on Mon Aug 04, 2008 at 02:34:37 PM EST

combined with catastrophic insurance ($5000 + medical costs) both funded by the individual + tort reform is the only way out of this mess.

setting up the tax code so that only employers can use tax-deferred dollars to spend on medicine is idiotic. Yes, a rich person somewhere would most likely see their tax burden fall somewhat under such a plan, but this would definitely be offset by total reduction in government expenditures.

We already have universal healthcare for the elderly, who consume the lionshare of healthcosts. It's called Medicare, and it consumes more of US GDP than healthcare in many other developed nations. No one has ever provided an explanation on how making this universal would somehow magically reduce US medical costs. They just say "oh, well it works everywhere else - it will just work the same here". Yeah, just like unions work everywhere else.

Comment Search has returned - Like a beaten wife, I am pathetically grateful. - mr strange

I don't think HSA'a are the answer. (none / 1) (#23)
by sudogeek on Mon Aug 04, 2008 at 04:44:42 PM EST

I actually have had one twice. I don't want to get into a too long-winded post.

  1. They are time consuming to manage. In essence, each person becomes their own insurance administrator. If you need a procedure or test or whatever, you need to call and negotiate the price. If you don't, you may get screwed. As you may know, the prices quoted for cash patients are usually inflated and much higher than the negotiated prices for HMOs or Medicare. For someone in the biz, this is doable, but most people don't have the background. Also, many people just have a hard time bargaining.

  2. Just as there are many insurance companies that try to make the actual provisions of their policies opaque, the same holds for the very same insurance companies which offer HSAs. The provisions of the policies are not so simple.

  3. The median income in the US (2006) was below $50,000 a year. The average savings rate in the US is -1.2%. So how do you expect most people to afford a $5000 deductible? Further, the HSA account generally must be fully funded within a year. So where does the average person get this $5000?

  4. Most importantly, they do not eliminate the role of private insurance companies. The HSA actually increases the scope for insurance company shenanigans - as they are holding your money and (presumably) making money on your deposited funds. Meanwhile, they continue the shuck and jive, bait and switch tactics regarding what is covered or not, what applies to the deductible or not, what they will pay the provider or not, what is an appropriate expenditure (podiatry? orthotics? chiropractic?) or not, and so on.

The role of private, for profit insurance companies in the health care system is the biggest flaw. The insurer makes money by denying and delaying your care while the beneficiary has no comparable assets to fight the company.

Regarding Medicare expenditures, I agree that the amount is out of control. That is the problem - no control. Congress adds entitlements on (SSI, disability, survivors' benefits, COLA) and all of these increase spending. Further, there is no significant regulation of which medical procedures, tests, and meds a beneficiary may receive, either based in cost-effectiveness or simply effectiveness. I have seen many patients who have received, say, a colonoscopy every year when most authorities recommend them every 5 or 10 years, depending. Others get echocardiograms every 6 months, only to finance the cardiologist's Lexus. Abuse is common and fraud also plays a role. But patient and family expectations also are important. One advantage of a single payer system should be that the data is all in one place and appropriate auditing could be done. Sadly, Medicare has failed in this regard.

Tort reform? I have a truly marvelous solution of this problem that this margin is too narrow to contain. I don't want to be tl;dr, so perhaps another time.

You're an arrogant, condescending, ignorant dipshit. - trhurler
[ Parent ]

lol what? (none / 0) (#30)
by jubal3 on Tue Aug 05, 2008 at 03:50:09 AM EST

"It's called Medicare, and it consumes more of US GDP than healthcare in many other developed nations."

Show me where this is true in any developed nation with a national health-care system.
Medicare actually has a very substantially SMALLER overhead in administrative costs than health insurance companies, particularly if the program was expanded to eliminate state-by state medicaid programs.

"Currently, Medicare incurs only 2% for administrative costs and does not need to advertise or pay commissions. According to Bernstein, private insurance spends considerably more on advertising and management. Administrative costs run as high as 30% because providers and insurers have to employ large staffs to cope with thousands of different plans for billions of billings a year. Similarly, federal and state public needs-tested programs must determine whether applicants meet the different programs' eligibility criteria, and these administrative costs run about 7% above Medicare's.

"Medicare-for-All would eliminate the need to ascertain eligibility for billions of billings," Bernstein says. "Shifting employer, federal and state funds already earmarked for medical care to the new plan would provide huge savings and coverage for the uninsured."
-Merton C. Bernstein, a founding member of the National Academy of Social Insurance and the Coles Professor of Law Emeritus at Washington University in St. Louis


***Never attribute to malice that which can be easily attributed to incompetence. -HB Owen***
[ Parent ]

It *is* a complex problem (none / 1) (#21)
by jubal3 on Mon Aug 04, 2008 at 03:15:57 PM EST

Or there would have been a solution a long time ago.

First of all, the idea that the U.S., with a higher proportion of illegals than anywhere else in the industrialized west, can afford to insure 12 million extra folks is a joke. We can't do it. Particularly not when we have some 12,000 miles of borders and coastlines we couldn't close off if our lives depended on it.  It is a genuine problem that mexicans routinely come to American emergency rooms, knowing they can't be turned away, so they can get medical care or to have their children, who automatically become U.S. citizens when born in the U.S.
So comparing the U.S. to say Germany or France isn't an apples to apples proposition.

Also, for all our constitutional protections, which I think are superior to just legal tradition, the Constitution and the case law it engenders also present problems.

You can't just nationalize private property in the U.S., nor can you force someone to work only under for a government agency. And sadly, you can't stop giant corporate interests from having unequal access and influence over politicians. Not without amending the constitution's 1st amendment, which isn't gonna happen.

When people talk about government-run medicine in the the U.S., they tend to immediately think of the British system, which frankly is awful.
This just gets compounded by the deliberate lies and misdirections of very powerful interests who
benefit from the status quo. Looking at the U.K. as the "only" solution is to ignore vastly superior systems which would fit the U.S. a lot better.But the U.K. comparison is mostly the one that gets made, and it scares the proles to death.

Most people have *some* kind of coverage, sometimes awesome, sometimes seriously lacking. But the 40 million or so uninsured are also people at the very bottom of the ladder in all the political terms that matter. These are the folks who always get screwed, whether its criminal justice or fair wages, or health care. I doubt there's likely to be a change in those facts any time soon.

Historically, health care in the U.S. was comparatively cheap and accessible. Even those without insurance were able to get decent care for a modest fee. I know this, because my grandparents, once they got kicked out of China by  Mao, practiced general medicine and general surgery in the midwest, and never had a pot to piss in, because they routinely accepted chickens, eggs or yard work for their services. This was actually not uncommon until well after WW2.

But things change. Medical procedures, as they became more complex, cost more to perform,  life-saving new machinery came about which added a lot of costs, and the big killer for doctors: malpractice insurance became not only a necessity, but the price sky-rocketed.

The U.S. pays about three times what anyone else does for health care. And if you have a decent insurance policy, the care you get, and the waiting time involved, is much better than the average in countries with a state-run system. Of course the problem is that it doesn't provide any coverage at all for 40 million americans, and provides shitty coverage for a lot more.

It's the American way. If you have money, it's terrific. If you're struggling, you're screwed. Noblesse Oblige is a totally unknown concept in the U.S. and solidarity among the people is considered some kind of blasphemy. It's just a part of the American identity, and all the wishing in the world won't change it.

Americans in general don't view health care as a "right." So to think you could get political support for covering illegals with anything other than say free vaccinations, is a fantasy.

The good news is that there has been a lot of improvement to the system over the last 15 years. Coverage has been expanded substantially, particularly for mental illness and children. The Massachusetts plan actually appears to be working, with people required to have their own health insurance, with employers paying part or most of the cost, and low-income people being subsidized by taxpayers so they can afford it.

The costs are finally starting to hit people who AREN'T poor and powerless, which is why the issue is gaining traction. And of all the problems in the U.S., I'm more confident this one will get a reasonable solution than I am about most things.  

But as for illegal aliens? Give me a break. It's not going to happen.


***Never attribute to malice that which can be easily attributed to incompetence. -HB Owen***

Unfortunately, you can't exclude illegals. (none / 1) (#25)
by sudogeek on Mon Aug 04, 2008 at 04:59:07 PM EST

Political will or not, unless you are truly as callous and self-centered as GhostofTiber pretends to be, you can't just sit the illegals out in the hospital parking lot until they die.

They are here, they will get injured or become sick, and they will come to the hospital. Now what? Most physicians (I was going to say "No physician I know" but then I though of one) will not refuse to take care of a person in need whether illegal, uninsured, or whatever. So, there will be hospitalization and, with the carnage on the highways and uninsured drivers (estimated to be as many as 20% of Florida drivers), more cases like Luis. So the question is not whether the US provides coverage for them or not. It's how do we pay for these predictable and substantial expenses?

You're an arrogant, condescending, ignorant dipshit. - trhurler
[ Parent ]

who says we wont? (none / 1) (#29)
by jubal3 on Tue Aug 05, 2008 at 03:34:20 AM EST

Governing is the art of the POSSIBLE.

There is no way in hell you're going to get a measure past even a state legislature, much less congress, extending national health-care to illegals, unless it's the massachusets variety, which really isn't a state-run program at all in the traditional sense. And even it does not cover someone whose employer didn't even report their presence, or who lives on the underground economy.

It's not going to happen.

You can talk all you want about what we SHOULD do, it doesn't mean a damn thing. We live in a country where the "peepul" control what gets through congress by and large, and the voters won't stand for it.

Everyone is ALREADY covered for emergency treatment at an emergency room. You can't be turned away. But officially covering people who are here illegal with the full gamut of a health care plan?  In your dreams.

NOT, I repeat NOT going to happen.


***Never attribute to malice that which can be easily attributed to incompetence. -HB Owen***
[ Parent ]

Read the last paragraoh. (none / 1) (#31)
by sudogeek on Tue Aug 05, 2008 at 12:42:38 PM EST

The illegals are here. They are in the hospital. Their care is being paid for right now - basically by overcharging you and all other users of the medical system.

So the question is not whether the US provides coverage for them or not. It's how do we pay for these predictable and substantial expenses?

You're an arrogant, condescending, ignorant dipshit. - trhurler
[ Parent ]

so many terrific (none / 0) (#24)
by nononoitaintmebabe on Mon Aug 04, 2008 at 04:54:10 PM EST

questions and issues are raised here.  thanks for putting it in the queue. i'd have voted it up, except i missed the vote.  
i just got in the door here and read it hastily. i will read it again later in more depth.  

Hopefully not a crude comparison... (none / 1) (#26)
by tchuladdiass on Mon Aug 04, 2008 at 05:26:29 PM EST

Lets say you are walking along the side of a highway, and you spot a bag of trash laying there.  Now, being curious, you pick up the bag to look through it (in other words, you "took possession" of it).  After rummaging through it, you decide that there is nothing of value, so you return the trash to the spot where you found it.  Are you now guilty of littering? (From both a legal and a moral position.)

The bag is not a human life. (none / 0) (#32)
by InternetMarketer on Wed Aug 06, 2008 at 12:42:35 PM EST

Littering only affects the look of an area. Your comparison is better suited towards cosmetic surgery.

[ Parent ]
Technically, yes you are guilty of littering .... (2.00 / 2) (#36)
by icastel on Fri Aug 08, 2008 at 12:05:46 PM EST

Also, your analogy, though, is flawed in so many ways.  I'm not sure how you managed to cram so much stupidity in only 2.5 lines of text :|


-- I like my land flat --
[ Parent ]
An addendum (none / 1) (#27)
by sudogeek on Mon Aug 04, 2008 at 07:04:09 PM EST

The NYT article mentions another patient, Neptali Diaz. This was an undoocumented Mexican national who was admitted to the hospital with severe pancreatitis. He had an prolonged hospitalization with multiple compllcations. Physicians in the readership will recognize this patient and know how lucky he is to be alive. After over a year of hospitalization and a nominal bill in excess of that of Luis, he was also subjected to medical rendition.

In this case, the hospital learned their lesson. They did not appoint a guardian or get any independent lawyers involved. They put Neptali on a plane to Tijuana and delivered him to his family. The nurse who accompanied him said over 100 family members met Neptali. That may have been an exaggeration. I presume he is now back in Sinaloa, hopefully in good health. ¡Buena suerte, Neptali!

You're an arrogant, condescending, ignorant dipshit. - trhurler

the hospital should sue Guatemala. (none / 0) (#28)
by d0ink on Mon Aug 04, 2008 at 10:30:44 PM EST

fixt (-.-)

assess blame properly (none / 1) (#33)
by postDigital on Thu Aug 07, 2008 at 06:51:55 AM EST

I do not think that Sudogeek published his story with an intent to slam immigrants. At the same time, many who read this story will think that immigrants are the cause of the health care system's woes. Maybe it is instead, for-profit corporatism gone wild in America.

Cara Mia DiMassa, Richard Winton and Rich Connell, "3 Southern California hospitals accused of fraud - Facilities in Los Angeles and Tustin allegedly churned thousands of indigents through their sites and billed Medicare and Medi-Cal for costly and unjustified medical procedures.", Los Angeles Times, August 7, 2008

Anyone who believes this is an isolated instance, found only in LA, is a damn fool.



Immigrants are not the problem. (3.00 / 2) (#34)
by sudogeek on Thu Aug 07, 2008 at 11:07:05 AM EST

The US as a country has a history of encouraging immigration. "Give us your poor ...," etc. And, all of us are immigrants in some way or another; American Indians about 20,000 yrs ago, my family in 1705, and Luis in 1999.

US employers provide a come-on by employing undocumented workers and the message gets back to the family in Mexico or Guatemala. The current US administration turns a blind eye to businesses failing to follow the law while staging highly publicized raids and incarcerating the workers whenever necessary to fan anti-immigrant feelings for political and electoral reasons. Luis's employer walked away scot-free with his increased profits from hiring low wage illegals. The rest of us pick up the tab.

There is plenty of blame to go around but you shouldn't blame the immigrants. Indeed, they should be celebrated. These are highly motivated individuals, willing to leave their families and risk significant hardship in order to work hard and achieve a better life. That's just the type of individuals that built this country.

You're an arrogant, condescending, ignorant dipshit. - trhurler
[ Parent ]

so make the employers liable (none / 1) (#35)
by cronian on Thu Aug 07, 2008 at 11:41:51 PM EST

So, I suppose you could make the employer's liable for everything the illegal alien costs hospitals and taxpayers if they hire an illegal alien. So, the school district, hospitals, and others could sue the employers of illegals for $$$$$. Additionally, we should make sure everyone has health insurance.

Everyone needs to have health insurance, and it doesn't make sense to only provide emergency care to some people, because that is inefficient. The costs of healthcare for the poor need to be subsidized, and this should probably

We perfect it; Congress kills it; They make it; We Import it; It must be anti-Americanism
That's one solution. (none / 1) (#38)
by sudogeek on Fri Aug 08, 2008 at 04:21:57 PM EST

But it does place a significant burden on employers, particularly small business. In our company, health insurance premiums are the third largest line item, just behind salaries and rent. For low margin businesses, this is simply not affordable at current premium rates unless there is a mandate and all competitors are forced to pay for these employee benefits. A national system where employers and/or employees pay into a insurance pool may be better. When people/employees have to spend their own money, it reduces total demand for services.

I don't think this will happen soon. The GOP strongly opposes any employer mandates or expansion of Medicare.

You're an arrogant, condescending, ignorant dipshit. - trhurler
[ Parent ]

Only for illegal aliens (none / 1) (#39)
by vectro on Sun Aug 17, 2008 at 11:12:19 PM EST

I think the original poster was suggesting this as applying only to employers of illegal aliens; that is, employers engaged in an illegal employment agreement. It's an interesting idea, since it would create a private right of interest against employers (generally more effective than government enforcement), but might also encourage more illegal immigration overall (since people would come for the chance of obtaining an insurance tort).

Whether or not this is good policy depends primarily on the relative magnitude of the two effects, which can probably only be determined empirically. Needless to say, the idea has roughly a snowball's chance in hell of actually making it into legislation.

“The problem with that definition is just that it's bullshit.” -- localroger
[ Parent ]

The most important thing to remember (1.40 / 5) (#37)
by daani on Fri Aug 08, 2008 at 01:26:27 PM EST

is that anybody who has legal access to the American/Australian/British/Dutch economy and still can't get ahead far enough that they don't have to be jealous of illegal immigrants eeking out a living IS A COMPLETE FUCKING LOSER. The contributions and opinions of such individuals are not at all valuable.

Immigration, health care, corporate malfeasance, and too many attorneys. | 40 comments (31 topical, 9 editorial, 0 hidden)
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