Comments on: Immigration and health care

By: Anonymous

Anonymous — Fri, 22 Aug 2008 00:41:00 +0000

Mexico is actually in the top third of countries for wealth and has had a socialist government for nearly 4 generations–they can provide his medical care. This shouldn’t be controversial. They would send me home as soon as I could travel safely.

By: Anonymous

Anonymous — Fri, 22 Aug 2008 00:37:00 +0000

Then New York Medicaid officials are just weak and/or stupid. In my state Medicaid program, they will pay for the emergency treatment only–and are strict about it. As soon as the patient is stable for transport to another hospital in their home county, Medicaid cuts off payment. That is usually within a day or two of admission. Certainly no payment for SNF or Rehab.

Actually with Mexico, the hospitals, authorities, and doctors there are good about taking transfer when contacted–just as I would hope an American hospital would be if I were sick in Mexico.

It is not mean to send people home. If I am ill, I want to be home. Dominican Republic has a medical school. Surely they can handle patients stable to travel. In any case, the person is no worse off than their countrymen who stayed at home.

By: Anonymous

Anonymous — Thu, 21 Aug 2008 11:57:00 +0000

This is a VERY common scenario in NYC, sometimes referred to as "D.R. to E.R." -

patient in the dominican republic gets sick. family puts them on a plane to JFK in NY. They go from the airport to a major academic med ctr ER (e.g columbia, cornell). They get the mega work-up, ICU stay, inpatient rehab, & then SNF for subacute rehab. Meanwhile social workers are getting them emergently enrolled in medicaid, which will be active retroactively.

This whole scenario probably costs $500,000 for that ONE PATIENT, and is a major reason that taxes in NY are about the highest in the country. Hospitals & nursing homes have no recourse, open to lawsuits for premature or inappropriate discharge. And why would patients / families from santo domingo care??? They just see america as a place where "they" must take care of you.

Hospitals need to be given the political / legal teeth to protect their bottom lines from this kind of abuse. And in the case sited, the family should ABSOLUTELY be responsible for the medical bills (duh!)

By: raj

raj — Thu, 21 Aug 2008 05:15:00 +0000

This is something that is of concern. While doing internal medicine rotations, I encountered a patient who came from Haiti solelyfor medical care after a stroke. She had extensive tests and treatment such as PT/OT, CT, MRI. Thought to myself when I went to the doctor after hurting my knee, I hesitated to get an MRI due to the co-payment for my knee MRI. Doesn’t seem right.

By: Anonymous

Anonymous — Thu, 21 Aug 2008 01:25:00 +0000

Yes, the PR issue is a problem because no one can accept that people, or perhaps their families, are ultimately responsible for themselves. A hospital (i.e., a business) that finds a way of ending an otherwise undefined, unending payout for a patient in a coma is considered to be rendering an “injustice” by the family! I’m sure if they had to foot the bill, they would also be making “other arrangements.”