Immigrants Cling to Fragile Lifeline at Safety-Net Hospital
Source: New York Times

Hospital officials estimate that two-thirds of the outpatient clinic??s roughly 90 patients are illegal immigrants. They do not qualify for Medicare, which covers dialysis regardless of a patient??s age, and they are excluded in Georgia from Medicaid and other government insurance programs. Legal immigrants face a five-year waiting period before becoming eligible. That leaves Grady to absorb costs of up to $50,000 a year per dialysis patient, some of whom have availed themselves of the thrice-weekly treatments for years.

This outpatient dialysis clinic at Grady Memorial Hospital is closing because it has bled money year after year. Essentially 60 out of the 90 patients are illegal immigrants and cost the United States an annual $50,000 per patient which equals $3,000,000. Lets compare that to the 30 legal patients’ cost of $1,500,000. Assuming, just for a second, that these numbers have been roughly the same over the past 5 years, the cost to treat just illegal immigrants would have been $15,000,000 compared to $7,500,000 for legal patients. In other words, the dialysis clinic could have stayed open approximately 10 more years to treat America’s own even if none of the patients were capable of paying a cent — based on what has already been spent.

However, legal patients can qualify for state and federal programs which defray the costs to a facility. Sure, it may take five years, but some percentage of the existing dialysis patients at this clinic probably had state or federal funding. Taking this fact into consideration, this dialysis clinic may have lasted considerably longer than ten more years if it had not taken on the challenge of treating illegal immigrants. In this case, as in many other cases, the policy to treat everyone failed the legal patients of this country by short changing them and their communities. This is not to say that all people don’t deserve healthcare. However, resources are scarce for even America’s own poor and uninsured. I cannot fathom why we, as a country, attempt to care for the citizens of every sovereign country in the world. Why do we welcome, with open arms, every foreign visitor who, legal or illegal, lands on our soil and beelines to our emergency rooms in the pursuit of free or subsidized health care?

Lastly, as any primary care physician or nephrologist will tell you, it is the rare patient on dialysis who didn’t do it to themselves either through ignorance of their disease or wanton disregard. There are far more out-of-control type II diabetics with end stage renal disease on dialysis than people who just happen to be born with failed kidneys. Too often, “being sick is not my fault” is utter nonsense. All the alcoholics with cirrhosis and upper GI bleeds, all the smokers with cancer and COPD, all the gluttons with heart disease, all the blind diabetics on hemodialysis. Who is to blame? The healthcare system? God? That’s all bull. There is no manual for life. At the end of the day, whether you knew it or not, you did it to yourselves.