On Aug. 3, 2008, the New York Times ran a front page feature story chronicling the apparently widespread practice by U.S. hospitals in dumping illegal (and sometimes legal) immigrants abroad in order to avoid the high cost of treatment and maintenance in the United States. The feature, “Deported by U.S. Hospitals,” written by Deborah Sontag, largely follows the medical and legal passage of one Luis Alberto Jiménez, a Guatemalan illegal, who was working as a gardener in Stuart, Florida when he was struck by a drunken Floridian, suffering severe traumatic brain injury.
Martin Hospital, a community hospital, provided life saving care to Mr. Jiménez twice but was unable to find a long term care or rehabilitation facility willing to accept Mr. Jiménez without insurance. He existed as a ward of the hospital for several years at a cost of approximately $1.5 million before the hospital decided to return him to Guatemala.
A guardian appointed to represent Mr. Jiménez objected to the transfer because of a concern about the lack of adequate facilities in Guatemala. Guatemala is not known for its brain injury rehabilitation programs. Its national Hospital for Orthopedics and Rehabilitation operates on an annual budget of $400,000. The cost of an air ambulance rental to take Mr. Jiménez to Guatemala Aurora Airport is about $30,000.00.
In Court, in Florida, the trial judge sided with the hospital which itself operates on a thin margin of 3.6% to 3% over cost. Mr. Jiménez’s attorneys asked the judge to issue a stay pending appeal and he gave the hospital a period of time within which to respond to the guardian’s request. Four hours before the hospital response was due, Mr. Jiménez was wheels up at the airport.
The Florida appeals Court overturned the trial court’s ruling and held that non-consensual deportation was exclusively within the prerogatives of the federal government. Mr. Jiménez’s attorneys have filed a false imprisonment lawsuit against the hospital seeking actual and punitive damages, which if successful may permit him to pay his bills at the hospital.
No part of this story wears well. While Mr. Jiménez’s circumstance as an illegal immigrant and the efforts to save his life certainly temper outrage at his vigilante removal to his home country, efforts have also been made to dump legal immigrants, including a comatose woman, into a situation of probably terminal result. What about the homeless? Can we offer them a free private jet ride to a tropical paradise to get them off our hospital rolls? Then what about the obese? They are expensive to care for and should be eating more tropical fruit anyway? Perhaps the hospital will also pop for Spanish lessons. And Medicaid, how about let’s cut a deal with Cuba? The Medicaid dollars will go much further in Cuba, and overall perhaps they will receive better care. Medicare patients can’t be too far behind. Let’s call it medical tourism. We will get you down there, you figure out how to get back. With a dysfunctional healthcare safety net like ours, who needs Jack Kevorkian?
It is a good posting. I like it. It's pretty much impressive.
Posted by: Nick Matyas | January 04, 2010 at 10:39 PM