Hospital Falters as Refuge for Illegal Immigrants

This topic was the subject of an earlier 9-24-09 post entitled "Ground zero Grady clinic: An illegal immigrant from Honduras said she could only hope to make it “back to my country to die.” -- Start packing."

Today there is a follow-up article in The New York Times that reads in part:

[A]t a cost of about $50,000 a year [each, illegal immigrants have relied on Grady Memorial Hospital for dialysis for years.]

Every Tuesday, Thursday and Saturday morning, the 15 or so patients would settle into their recliners, four to a room, and while away the monotonous three-hour treatments by chitchatting in Spanish.

That all changed on Oct. 4, when the strapped public hospital closed its outpatient dialysis clinic, leaving 51 patients — almost all illegal immigrants — in a life-or-death limbo.

For Grady, which has served Atlanta’s poor for 117 years, it was an excruciating choice, a stark reflection of what happens when the country’s inadequate health care system confronts its defective immigration policy.

Like other hospitals, particularly public hospitals, Grady has been left to provide costly treatments to nonpaying illegal residents who most likely could not have obtained such care in their home countries. American taxpayers and health care consumers have borne the expense.

Over time, the mounting losses have compromised Grady’s charitable mission, forcing layoffs, increases in fees and the elimination of services.

“Years and years of providing this free care has led Grady to the breaking point,” said Matt Gove, one of the hospital’s senior vice presidents. “If we don’t make the gut-wrenching decisions now, there won’t be a Grady later. Then, everyone loses.”

Officials at Grady, which will provide more than $300 million in uncompensated care this year, estimate that as many as a fifth of its uninsured patients are illegal immigrants.

Some of the Grady dialysis patients have chosen to return to their countries, encouraged by the hospital’s offer of free airfare, cash payments, three months of paid dialysis and assistance in seeking insurance or other long-term remedies. Others are trying their luck in states where Medicaid policies may be less restrictive.

But most remain in Atlanta, taking full advantage of a last-minute offer by the hospital, in response to a lawsuit, to pay for three months of dialysis at commercial clinics. They are hopeful that the reprieve will buy time for the lawsuit to progress or for private dialysis providers to take them as charity cases.

What they fear, however, is that their already fragile lives will soon be reduced to a frenzied search for their next dialysis, most likely in an emergency room after a descent into crisis.

[I]llegal immigrants are not eligible for Medicare, and legal immigrants must wait five years to qualify. A few states use emergency Medicaid programs to cover ongoing dialysis for certain illegal immigrants, but Georgia discontinued the practice in 2006.

Two years ago, the Grady board, then dominated by political appointees, undercut its chief executive’s plan to close the dialysis clinic. The new board, now led by business leaders, hopes to save the hospital by convincing corporations and other potential donors that its fiscal discipline is worthy of support.