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OUSTON, Aug. 11 — With other states grappling with the issue of
providing services to illegal immigrants, the Texas attorney general is clashing
with many of the state's largest public hospitals over whether the hospitals are
permitted to provide illegal immigrants with free or discounted nonemergency
services like prenatal care.
For years, public hospitals and clinics in Houston, Dallas, San Antonio, El Paso and other Texas cities have offered preventive medical care to illegal immigrants. These hospitals usually do not ask patients if they are citizens but require proof only that they live in the county.
Last month, though, the attorney general, John Cornyn, declared in a written opinion that federal law prohibited hospitals from using tax dollars to provide such nonemergency services. The decision infuriated many hospital officials, who called it both a misinterpretation of the law and bad public health policy. In particular, the officials said, blocking access to preventive care will only push patients into already crowded emergency rooms, where care is far more expensive.
"We think the attorney general's opinion is in error," said Dr. Ron Anderson, president of the Parkland Health and Hospital System, the public hospital district in Dallas. Of nonemergency care for illegal immigrants, Dr. Anderson said, "Our rationale is that not only is it the right moral thing to do, but it's prudent fiscal policy."
The most recent estimate is that as many as 700,000 illegal immigrants live in Texas. Hospital districts do not maintain precise information about how many illegal immigrants receive care or at what cost to local taxpayers, but officials say they spend millions of dollars. The 29 largest public hospitals in Texas provide about 70 percent of all charity care in the state.
Several states are approving a range of benefits for illegal immigrants, like laws in North Carolina and Tennessee making it easier for such immigrants to qualify for driver's licenses. But the trend toward expanding benefits has drawn criticism from groups who say it rewards people who break immigration laws.
The Texas attorney general's opinion on medical service is nonbinding and does not carry the weight of law, but it opens hospitals to legal challenges and seems likely to become a major topic for the Texas Legislature when it convenes in 2003. Some lawmakers had suggested a special session should be called to consider the issue, but Gov. Rick Perry declined to call one.
The issue is already eliciting conflicting responses from public hospital districts in Texas. In Dallas, Dr. Anderson said the public hospitals would continue providing the services. But in Montgomery County, a suburb of Houston, hospital officials this week voted to cut services to more than 400 illegal immigrants. In Nueces County, which includes Corpus Christi, hospital administrators are cutting services to 311 people.
Officials in San Antonio said they would continue the services, though the public hospitals in Fort Worth stopped in 1997.
The biggest conflict is in Houston, where the Harris County district attorney, Chuck Rosenthal, has begun an investigation to determine whether the hospital district has violated state laws against the misapplication of public money. Mr. Rosenthal, who called it "a very complex issue," said he opened the investigation in response to requests from residents and at least one county commissioner.
"I felt it was my obligation to look into it to see whether there has been a law violated," Mr. Rosenthal said.
Rusty Hardin, the lawyer for the Harris County Hospital District, said a criminal investigation was not the appropriate response to a legal debate over access to health care.
"It's one thing to have this policy argument," Mr. Hardin said. "It's another to have somebody come in here from left field and say it's a criminal matter."
Mr. Cornyn issued the opinion in response to a request in January by hospital officials in Harris County for a legal assessment of changes in welfare laws, passed by Congress in 1996, before setting a policy on care for illegal immigrants.
Mr. Cornyn said that federal law required that illegal immigrants receive emergency room care, immunizations and treatment of communicable diseases. But he said the law prohibited all other care unless states enacted laws to provide it. He said that the Texas Legislature had enacted no such law and that state hospitals could lose millions of dollars in federal aid if they continued offering the services.
But Mr. Cornyn's opinion is coming under legal attack from the hospitals. The National Association of Public Hospitals and Health Systems contended that Texas enacted a law in 1999 that met the federal requirement for continuing care.
Meanwhile, Mr. Hardin argues that the federal law merely states that illegal immigrants are not entitled to such benefits, not that states or localities are not permitted to provide them.
Dr. Kenneth L. Mattox, chief of staff at Ben Taub Hospital, Houston's leading public hospital, said that eliminating preventive care for illegal immigrants was bad medicine and bad economics.
A patient who might be treated for asthma during a routine examination at a hospital clinic would not get such care if service was stopped, Dr. Mattox said. But eventually, he said, that patient's condition would worsen and require a visit to the emergency room, where federal law requires treatment.
"They come into the emergency room and they are supersick," Dr. Mattox said, "and I have to put them in intensive care and the cost is 4 to 10 times as much."
ping
The Attorney General carries the big stick in Texas, more so than the Governor. It's good to see he's waking up from a long nap.
.
I would love to know the total national cost for providing health care to illegal aliens.
I'd like to present the bill to Mexico which should be happy to pay for health care for its 'heros.'
In fact, maybe this money can best be spent on helicopter shuttle services to the nearest mexican hospital where illegal aliens can be deposited on their steps pronto.
"They come to the emergency room and they are super sick", Dr. Mattox sais, " and I have to put them in intensive care and the cost is 4 to 10 times as much."
Well Doc, how about having President Fox's beeper number posted on the emergency room wall, and trying to get these sick people on the plane with Fox on his home bound flight after his latest visit sticking his nose in our business, trying to get us to finance his business.
Where the hell does Fox get off sending his problems to us, after all the jobs for our own unskilled citizens have been sent to Mexico? Why do Americans who still have jobs and pay taxes despite the illegal alien invasion, have the responsibility of financing Foxes empire in Mexico? Why must Americans be punished for the actions of every ruling tyrant in third world countries. To hell with FOX! and to hell with our own politicians who are too dimwitted to see through his transparent lies.
An ambulance to the border would be cheaper and dump them over. My relatives who worked as Customs inspectors at the San Ysidro crossing by Tijuna, said there was a steady stream of ready-to-pop any minute pregnant gals racing for a hospital on our side of the border. The reward? Free hospital care, and the baby is born an American, and then the whole family gets to come in. What a country! I like your helicopter idea too.
As for the argument that we would be forcing them into emergency rooms... hey whenever I've had to go in, before I was ever looked at, the first question I was asked, was not what my name was, but how was I going to pay...so..no pay, then please jump on the shuttle to the border...
That knowledge would just upset you, it's Friday night, no one should be upset on Friday night.
Ummm, it's Saturday night!
Already? Gee, I have been having a good time.
Lets hand the bill to President Fox and see what he has to say about it. They want to take over the country and they want us to pay for it too.
"But the trend toward expanding benefits has drawn criticism from groups who say it rewards people who break immigration laws.".....that and the fact that all services are swamped with people who pay no taxes. As more of us are stuck in minimum wage jobs, we resent the free ride! We can't get these same services-why should they?
The following is an article written recently about the problem of free health care for illegals. Obviously the writer must be a flaming racist who hates Hispanics....(except he is a Hispanic):
Porous border penalizes United States
Raul Amaya Special to the Times
On June 5, I attended "La Frontera: A Day On The Border," a panel discussion sponsored by Time magazine and UTEP. On stage were a moderator and six panelists.
I thought the most interesting comment was made by the only panelist who lives in Mexico, Mexican-born musician Pepe Mogt. The moderator, Maria Hinojosa, a correspondent for CNN in New York, said she did not understand the need for a wall along the U.S./Mexico border. Mogt said he thought the wall is good because it keeps many Mexicans from crossing a dangerous and sometimes deadly border without guarantees of a better life in the U.S.
Mogt said many more people were hurt and exploited when the border was more open.
I think many Mexican-American El Pasoans would agree with him, but for different reasons. Why? Because El Pasoans are burdened financially by a porous border.
My beef is not with the Mexican people or their government. It's with the U.S. government, which I believe has deliberately kept our border with Mexico porous. This serves to protect the interests of American corporations with businesses in Mexico. They don't want their investments in Mexico jeopardized by the political instability that would result from an impoverished populace unable to go elsewhere to survive.
A porous border serves the pecuniary interests of the U.S. agriculture, construction, manufacturing, restaurant and lodging industries that hire undocumented immigrants.
El Pasoans pay the costs of illegal immigration in higher school and hospital taxes. One reason Thomason Hospital faces financial difficulty is because it doesn't have enough payers to cover the cost of the many non-payers, many of whom are here illegally from Mexico.
El Paso's students and teachers are shortchanged because of the money spent on educating children from Juárez, whose parents don't pay school taxes or tuition but have their children educated in El Paso's schools, funded by El Paso's property taxpayers.
El Pasoans make less money because of a porous border. In communities far from the border, skilled tradesmen such as plumbers, carpenters, masons, electricians, welders, and auto mechanics earn good wages, but not in El Paso.
All these problems are the fault of the U.S. government and the politicians who do the bidding of the campaign contributors who own the industries that profit from a porous border.
Finally, a porous border ensures that the U.S. will continue to lose its drug war.
We ought to bring back home the U.S. troops in Western Europe and the Asian Pacific and station them along the U.S./Mexico border. They could conduct their military exercises there with unarmed tanks and armored personnel carriers running back and forth along the border.
Every Border Patrol agent would be assigned several soldiers who would carry only stun guns or some similar type of equipment, but not loaded weapons.
Border Patrol agents and the INS should be making regular checks of businesses that traditionally hire undocumented immigrants. Employers should be required to thoroughly check the backgrounds of the people they hire. Employers caught hiring undocumented immigrants would not only pay big fines, they'd also get jail time.
These measures would seal the border more tightly and force the Mexican government and its business community to make the changes necessary to make Mexico a country where its people can stay because they can prosper there.
If our federal government is unwilling to protect our community from the harmful effects of a porous border, then it should reimburse El Pasoans for the financial burdens it creates for our community.
Raul F. Amaya, a personal financial consultant who lives in East El Paso, writes often for the El Paso Times.
Here's another racist concerned about the ever increasing cost of illegal immigrants' health care:
Statement from Congressman Silvestre Reyes Regarding the Need to Reimburse Hospitals for Treating Undocumented Immigrants
"During the 106th Congress I cosponsored a bill that would have amended the Balanced Budget Act of 1997 to assure that additional funds were provided for State emergency health services to specifically reimburse hospitals that treat undocumented aliens. Thomason hospital is not being fully reimbursed for the services they provide to many undocumented immigrants. This bill would have alleviated some of the financial burden they continue to carry. Although this bill was never considered by the House of Representatives, I plan to introduce it during the 107th Congress.
The omnibus spending bill that was passed at the end of the session included $300,000 for the United States-Mexico Border Counties Coalition to continue to conduct a study that will determine the unreimbursed costs incurred to treat undocumented aliens for medical emergencies in the Southwest border states, counties, and hospitals. The Coalition is due to report their findings to Congress on March 1st. It is my hope that this study will increase everyone's awareness to the fact that hospitals along the border must be reimbursed for the increasing numbers of uninsured and undocumented patients they serve.
During the last several years, I have worked closely with Sentators Hutchison and Gramm to make sure that the border is compensated for the extra financial burden it must carry. Border states, counties, and localities are among the poorest in the country. They simply cannot afford to bear the burden and the cost of what is a federal responsibility. We have increased funding for the State Criminal Alien Assistance Program which reimburses states and localities for costs incurred by incarcerating persons who are illegal. We have also had to fight to receive reimbursement for our border prosecutors. While some of these problems have been improved, we still have a lot of work to do during the 107th Congress."
We are having problems here in Dallas. Parkland Hospital refuses to stop non-emergency care to illegal aliens. The doctors could care less what the law says.
As far as I am concerned, they can shut Parkland down and put anyone that has given medical care to these parasites in jail.
The costs are out of hand. New York has a system of community health centers which are being overwhelmed by illegal aliens from all over the world.
>> As for the argument that we would be forcing them into emergency rooms... hey whenever I've had to go in, before I was ever looked at, the first question I was asked, was not what my name was, but how was I going to pay<<
It is against the "law" to fail to provide emergency services to anyone who cannot pay. (How it is possible for Congress to requisition hospital and physician services without it being an illegal taking is unclear, but there it is).
When the Feds have been moved by adverse publicity to enforce this "law", they have been very harsh-recently in Texas they tried (outcome unknown) to get a hosptal administrator and ER doc to do time over this issue.
>>New York has a system of community health centers which are being overwhelmed by illegal aliens from all over the world.<<
Patients arrive at Kennedy airport every day, sick, often with a note pinned to their chest from a doctor in some third world hellhole with a tentaitve diagnosis.
They are evacuated to an NYC public hospital, usually Kings County but sometimes Coney Island or Bellvue, for free treatment. I think (but I am not sure) that they bypass La Migra at teh airport because of their condition.
Kings County Hospital is now known as the Mayo Clinic for the third-world.
Contact California Coalition for Immigration Reform...They have a WEB site.
This will be the catalyst that rips this country apart. A person in Mexico, jumps the border. He works here at a wage that undercuts an americans, so the american is finacially destitute. He typically shares a dwelling with 5 other like him so he pays no property taxes, He is typically paid in cash, and he sends his money out of the country without paying any state, federal, or local taxes. When he gets sick, he shows up at an emergency ward and is treated for free, ( fantastic expense), and then he goes back to work somewhere else and the cycle continues.
This is the optomistic outlook. Many of our "undocumented aliens" are driving around in vehicles that they purchase, (again for cash), for almost nothing, from folks who have long ago worn them out to the point of being dangerous. They have no car insurance, or permit to drive. Many have had accidents that send more people to the hospital. Others were criminals in Mexico and they find the prey here to be even better. They continue their crime career here until they are caught, or killed. Still others get together and form gangs to get even more of what they feel they are entitled to. When this happens, it is the youth of America that is drawn into the web of crime and family destruction.
All the while this is going on, somebody has to pay the bill, this is typically the average racist american, (me) who is paying the bill with half of everything I make going to taxes, where it it sent to hospitals and jails for these people. Now, before you folks flame me, I will state here and now, that I have personally witnessed each and every one of the above things happen.
Well put, John, I can vouch for the fact that everything you said is true.
I'd like to present the bill to Mexico which should be happy to pay for health care for its 'heros.'
These "heroes" should be presented to Fox, Hernandez, and Castaneda along with the bill.... accompanied by a stern warning that their continued failure to keep their "new American pioneers" out of here could likely result in a prolonged visit by a real Army.
Mexico still has not paid their water bill t the U.S.
As for the argument that we would be forcing them into emergency rooms... hey whenever I've had to go in, before I was ever looked at, the first question I was asked, was not what my name was, but how was I going to pay...so..no pay, then please jump on the shuttle to the border...
First of all, every ED in the country that gets a single dollar of Federal funds ( Medicare, Medicaid, construction, research etc.) is obligated to follow EMTALA the "Emergency treatment and labor act". This law states that ANYONE who presents to an Emergency Room is required to have a screening exam and "stabilization". This must occur BEFORE any questions regarding payment or insurance can be asked.
Over time this screening and stabilization have expanded to cover any specialty on call at the hospital, any service available at the hospital on a regular basis. The Feds have successfully prosecuted hospitals for patients admitted and treated for weeks THEN TRANSFERRED. What the law has in essence mandated is free care to anyone who presents to an ED. The penalty is a PERSONAL fine for the physician of 50,000 dollars an occurrence, the hospital also suffers a huge fine and loss of the ability to receive any federal funding for a year ( a death sentence). Not to even mention the subsequent vulture like action that then ensues on the "Tort" side of the legal system.
This law is slowly strangling EDs around the country, as more and more "free" care is given. Hospitals that are hemorrhaging thru the ED are closing the EDs, thus causing remaining ED's to get more congested, doctors who are obligated to give increasing free care are taking themselves off "call" not available to the ED therefore also not available to anyone who comes in the ED, paying or not. This causes the ED to "back up" as the ED doc scrambles to find SOMEONE to admit the patient. In addition the EDs get more and more frantic making the work harder especially on the nurses, but with "free" care the Hospitals are unwilling to sink more resources into the hole, thereby making it harder and harder to get adequate staffing. So we slowly spiral down.
If anyone here doubts me go and walk into the waiting room of any medium sized or larger hospital (esp urban) at about midnight on Saturday.
Three out of four patients giving birth in the county hospital here are women from Mexico. The hospital is in so much debt, it wants to raise the local property tax portion that pays for it four times what it is now. I pay many times more for the care of illegals now than I pay for my entire families health care costs, if they raise the tax, I won't continue living here, one less taxpayer in an area that is losing taxpayers very very fast.
The most recent estimate is that as many as 700,000 illegal immigrants live in Texas.
This is why hospitals in Houston occasionally have to go on "drive-by" status, meaning there is no more room and not enough personnel on hand to treat any new patients. The ambulances are told to "drive on by" unless it is extremely critical. I like Kitten's helicopter idea. Works for me.
I won't continue living here, one less taxpayer in an area that is losing taxpayers very very fast.
Some of the candidates running for Mayor are talking about raising NYC taxes - for the children of immigrants! If Bush gets his wish to legalize millions I'm out of here - let some other suckers pay for this nonsense. New York is required to pay for welfare and Medicaid for all legal residents. I can't even imagine how much this will cost.
"Texas attorney general is clashing with many of the state's largest public hospitals over whether the hospitals are permitted to provide illegal immigrants with free or discounted nonemergency services like prenatal care".
Oh come on people. Lets give them free and reduced medical care. Does it really matter if you or you're children are waiting behind 10 or 15 criminal illegal aliens? No is doesn't. You're kids will live. We are a nation of illegal aliens, like it or not. And if the damn hospitals get to full we can just build some more and just raise the taxes on the people that work.
So get in line and shut up...
"This is why hospitals in Houston occasionally have to go on "drive-by" status, meaning there is no more room and not enough personnel on hand to treat any new patients. The ambulances are told to "drive on by" unless it is extremely critical".
So this is why Texas is now known as Texico.....
Where is your compassion - you mentioned that they should get reduced price medical care. Don't you know that these poor illegal alien criminals have to send money back to their homelands to enable their families to pay the alien smugglers? We must support family reunification for these criminal illegal aliens!
"Don't you know that these poor illegal alien criminals have to send money back to their homelands"
To the tune of an estimated $8 BILLION in 2000 alone.
That figure is for Mexico - I wonder what it is for all countries. England was trying to measure the outflow to China and the figure was stupendous.
If you build (provide) it, they will come!
This is not a hard call at all.
If I was a Texan, I would be outraged at providing free medical care for the equivalent of criminals.
If I was a Texan, I would be outraged at providing free medical care for the equivalent of criminals.
We are, believe me. By "we," I mean a large majority of the state's LEGAL population.
Oh come on people. Lets give them free and reduced medical care.
That's being done here, they get free medical care, the taxpayers paying for the county hospital they use can't use it or have to put a lien on their homes unless they have insurance, but then are better off going to a more affordable private hospital. Of course taxes are going sky high, people are leaving the area along with doctors tired of treating people who never intend to pay their bill.
But our government, that is supporting and encouraging this massive illegal alien invasion is giving us $300 of our money back. Yippeeee.
If I was a Texan, I would be outraged at providing free medical care for the equivalent of criminals.
The equivalent of criminals? They ARE criminals. Each and every one of them.
Meanwhile in Los Angeles the city council is considering expanding their rules to allow all garages to be used for living.
Meanwhile in Los Angeles the city council is considering expanding their rules to allow all garages to be used for living.
You've got to be kidding!
They get it free but we have to pay. Charming.
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