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HOME > ABOUT > PRESS > ILLEGAL IMMIGRANT CARE A HOT ISSUE
Article published - October 1, 2009
Credit: PETALUMA 360.COM
Illegal-immigrant care a hot issue
by Dan Johnson
Treatment provided for illegal immigrants has become a hot topic in the discussion about national health-care problems and reform, and local leaders voiced opinions and clarified some misunderstandings about the issue.
The major current health plans being considered specify that illegal immigrants are ineligible for subsidized benefits, although they might be able to use their money to buy coverage through an insurance exchange, without subsidies, as they can now.
“I don’t think illegal immigrants need to be included if there is a national, public option,” said Kathie Powell, executive director of the Petaluma Health Center. “If we subsidized coverage for them, this could encourage more illegal immigration.”
Despite claims to the contrary, studies have shown that the vast majority of illegal immigrants are relatively young and healthy, and generally don’t need as much health-care treatment as U.S. citizens. They apparently account for less than 2 percent of national medical spending, although precise statistics are unavailable because hospitals and community clinics don’t ask about patients’ legal status.
“Seventy percent of national health-care money is spent on chronic diseases, including preventable illnesses, and I don’t see undocumented patients having a lifestyle that causes chronic diseases — they tend to be very healthy people,” said Powell.
“The Latino population in the county is younger in relation to the whole population,” added Mary Maddux-Gonzalez, director of the public health division for the Sonoma County Department of Health Services. “It’s primarily made up of young, healthy, adults. Health costs, in general, are lower for Latino immigrants. They generally have good, healthy outcomes with pregnancies, and although many of them live in poverty, they have lower birth rates and fewer premature babies than people of similar income levels.
“They also have a lower rate of chronic diseases in several other health-care areas.”
Daymon Doss, the executive director of the Petaluma Health Care District, says that illegal immigrants generally do not have expensive operations.
“It’s a myth to think that undocumented individuals are receiving expensive things such as heart transplants, kidney transplants and new knees,” Doss said. “This is a myth perpetuated by people who don’t want health-care reform.
“The cost of taking care of undocumented people is minor compared with the money we are putting into paying insurance companies, pharmaceutical companies and health-care systems.”
Many of these companies and systems are encouraging people to blame illegal immigrants for the current crisis, he says.
“They are trying to get people to focus on something other than themselves,” Doss said.
He advocates greater access to health care for illegal immigrants.
“It’s a matter of social justice,” he said. “It’s a privilege to take care of one another, to serve all who need help whether they are documented or undocumented.”
The Pew Hispanic Center in Washington, D.C., estimates that 59 percent of the country’s illegal immigrants are uninsured, compared with 25 percent of legal immigrants and 14 percent of U.S. citizens. The center estimates that illegal immigrants comprise some 15 percent of the nation’s 47 million uninsured people, and around 30 percent of the rise since 1980.
The California Health Interview Survey, conducted by UCLA in 2007, showed that 21 percent of the uninsured people in the state are undocumented.
“It’s likely that the percentage is about the same in Sonoma County, and throughout the state,” said Maddux-Gonzalez.
The survey also found that there are 38,000 uninsured residents in Sonoma County, although citizenship information was not included.
Due to financial difficulties and health-care access problems, many illegal immigrants do not seek medical attention until their situation becomes emergent. They generally aren’t eligible for regular Medi-Cal, and most can’t afford to buy health plans.
“They also can go to local private physicians, if they’re willing to accept them as patients,” Doss said.
“Any time people put off receiving health care, this creates a danger to themselves, and raises the risk of communicable diseases spreading,” Doss said.
Petaluma Valley Hospital and Santa Rosa Memorial Hospital together provide about one-half of all treatment given to uninsured and underinsured people in Sonoma County. Undocumented people are able to obtain health care in the emergency departments of both hospitals.
“The Emergency Medical Treatment and Active Labor Act (passed by Congress in 1986) is a federal law that mandates all hospitals to provide emergency medical stabilization to people, regardless of their ability of pay, and without delay,” said Wendi Thomas, the nurse manager of emergency services at PVH.
The EMTALA requires hospitals to screen each patient, and to treat them or direct them to an appropriate source for treatment.
But emergency rooms are not the only places where undocumented immigrants can receive treatment.
The Petaluma Health Center offers health care to everyone.
“We don’t ask for documentation. We don’t refuse treatment to anyone,” Powell said.
“Even if you’re not eligible for Medi-Cal because you’re not a U.S. citizen, you can get Emergency Medi-Cal,” Doss said. “This isn’t the best type of coverage, and it’s not preventive, but anyone can go to a federally qualified health center, such as the Petaluma Health Center, and receive care.”
Undocumented women are able to obtain health coverage for pregnancies through Medi-Cal.
“A pregnant woman is eligible for services at the Petaluma Health Center and at other federally qualified health centers during her pregnancy, and then the coverage ends,” Doss said.
St. Joseph Health System-Sonoma County’s mobile medical and dental clinic also offer health-care services to pregnant, undocumented women.
This mobile clinic, which is set up four days each week, in different county locations, is an outreach project that SJHS created to provide access to people who have difficulty receiving health care, including low-income children and their families, seniors and undocumented people. Both clinics are open on Wednesdays in Petaluma, with the medical clinic stationed at the Mary Isaak Center and the dental clinic available at St. Vincent de Paul Church.
Another program, Healthy Kids Sonoma County, which is managed by the Sonoma County Department of Health Services, provides health care for children of low-income families, including families of undocumented children.
“This program provides access for children, regardless of their immigration status,” said Maddux-Gonzalez.
Kathy Ficco, executive director of community health for SJHS of Sonoma County, feels that some undocumented people are unaware of the health-care services that are available to them.
“At our clinics, we seek to educate the uninsured to let them know about what services are available. We want them to stay connected to the health-care system, and work collaboratively with other social-service agencies,” she said.
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