Hospitals Feeling Strain From Illegal Aliens

STUART, Fla.— In the two and a half years since Luis Jiménez arrived at the Martin Memorial Medical Center emergency room with severe brain damage from a head-on car collision, the hospital here has become his home.

In that time, Mr. Jiménez, 30, a former gardener, has emerged from a coma, had two birthdays and accumulated medical bills of almost $1 million. By all accounts, he is well enough to be discharged, but the hospital and advocates for the patient are in a conflict over his mounting medical bills and future care that makes his release unlikely without a court order.

A penniless illegal immigrant from Guatemala, Mr. Jiménez has no health insurance, and his injuries have left him with limited mobility and the mental capacity of a 3-year-old. Martin Memorial wants to send him back to his homeland for any remaining medical care. But Mr. Jiménez's advocates insist that he must remain at the hospital until it can find a suitable place in the United States or Guatemala that is willing to care for him.

The impasse is at the center of a national debate over who is ultimately responsible for illegal immigrants who require extensive medical care but have no means to pay for it. The issue has become an increasing concern for health care providers, particularly in Florida and border states with growing numbers of illegal immigrants.

Federal law requires hospitals to provide emergency care to critically ill or injured patients regardless of their immigration status. But because many illegal immigrants work in low-wage jobs that offer no benefits, and cannot qualify for Medicaid, they use emergency rooms as their primary source of routine and critical health care. As the number of such patients increases sharply in states like Florida, California, Texas and Arizona, so too does the financial burden on health care centers that treat them, hospital administrators say.

''We have people coming to our country in good faith to work, but we have no system in place as a nation as to what to do when these people get sick,'' said Pat Austin, a spokeswoman for Martin Memorial. ''Each hospital is left to kind of figure out what to do for itself.''

The hospitals insist that they are not turning away critically ill or injured people, but they are becoming more aggressive in seeking ways to release them. Some hospitals are going to court seeking permission to discharge patients like Mr. Jiménez. Federal lawmakers are seeking financial aid to reimburse hospitals for treating indigent illegal immigrants, and some hospitals have taken unusual steps, including putting nurses on planes to fly the patients back to their own countries.

Such measures, though, have done little to stem the rising costs, the health care providers say.

''We have tried to work on this for years, but the problem has gotten more acute,'' said Sheri Jorden, senior policy director for the Arizona Hospital and Healthcare Association. ''Hospitals have been writing these bills off with great difficulty.''

According to a study released last month by the National Association of Counties, 86 percent of 150 counties nationwide reported an increase in uncompensated health care expenses in the last five years. Of those reporting an increase, 67 percent cited a growing number of immigrants as a factor in the rising costs for county hospitals and rescue services.

''Most of the counties receive money from the state and federal government,'' said Jacqueline Byers, director of research for the association, ''but it is not nearly enough to meet the growing need.''

According to the Immigration and Naturalization Service, the number of illegal immigrants in the United States increased to as many as eight million in 2000, the last year for which figures are available, from five million in 1996. By some estimates, hospitals are collectively writing off as much as $2 billion a year in unpaid medical bills to treat the illegal immigrants, who, unlike American citizens and permanent residents, are ineligible for Medicaid.

In one case at Martin Memorial that was resolved in February, an illegal immigrant from Jamaica arrived at the emergency room with a sore on his leg and stayed in the hospital for 17 months.

''He said he had a green card but couldn't find it,'' Ms. Austin said. ''The doctors found a serious vascular disease and he had to have both legs amputated.''

''After his surgeries, when he was well enough, we had a great deal of difficulty figuring out what to do next,'' Ms. Austin added. ''We eventually found some relatives and a physician in Jamaica who was willing to accept him, and one of our nurses flew with him to Jamaica. By the time all that happened, it had cost us probably over half a million dollars.''

In the case of Mr. Jiménez, Martin Memorial says it has already incurred nearly $900,000 in expenses for which it has no hope of being paid.

''We feel there needs to be a national program of some sort that would cover these individuals with insurance,'' Ms. Austin said, ''or in the case of catastrophic events, allow the hospital a chance of repayment.''

Martin Memorial has been unable to release Mr. Jiménez because the patient's guardian and the hospital cannot agree on a discharge plan. The hospital has petitioned a judge for permission to send Mr. Jiménez back to Guatemala. No state medical center will accept him, since his immigration status makes him ineligible for Medicaid.

Mr. Jiménez's lawyer contends that the hospital has not provided enough information about where the man will be placed and who will treat him. Mr. Jiménez's family in Guatemala does not have the money to pay for his care.

''The hospital is saying he's occupying a bed and we need to get him out,'' said Michael Banks, a lawyer who has donated his services to Montejo Gaspar, Mr. Jiménez's cousin by marriage and his court-appointed guardian. ''We have made it unequivocally clear that we have no problems sending Mr. Jiménez to Guatemala, but we feel a plan is not in place.''

In Arizona, where hospitals have grappled with similar problems, the University Medical Center in Tucson wrote off more than $3 million in costs between July 2000 and June 2001 that it incurred from treating uninsured immigrants, said John Duval, chief operating officer for the center. ''I don't know that there's a societal solution to the problem,'' Mr. Duval said, ''but we are doing an enormous amount of heavy lifting with no compensation.''

Another Arizona hospital, Southeast Arizona Medical Center in Douglas, filed for bankruptcy and nearly closed in 1998 because of the rising costs of treating illegal immigrants. The problem has become so bad in Arizona that a state program that provided free dialysis and chemotherapy for legal and illegal immigrants will run out of money in a couple of months.

The issue has prompted hospitals in several states to seek assistance from sympathetic lawmakers. Senator Jon Kyl, Republican of Arizona, introduced a bill in January 2001, co-sponsored with Senator John McCain, Republican of Arizona, and Senator Dianne Feinstein, Democrat of California, that would provide $200 million a year for four years to reimburse health care providers in border regions.

Representative Jim Kolbe, Republican of Arizona, introduced a similar measure in June 2001 that would establish a $50 million reimbursement program for hospitals and ambulance services in his state. The Border Hospital Survival and Illegal Immigrant Care Act would guarantee that medical providers are compensated for treating illegal immigrants. Both bills are stalled in committees.

''It is not a top priority for many,'' Mr. Kolbe said. ''It does happen everywhere, but where you see it every day is here along the border.''

Photo: Luis Jiménez in his room at Martin Memorial Medical Center in Stuart, Fla., at the end of a visit with his cousin Juana Gaspar and her son, Lucas. (David Friedman for The New York Times)

Source - http://www.nytimes.com/2002/08/25/us/hospitals-feeling-strain-from-illegal-immigrants.html

Mexican ID Card Gets Illegal Aliens Access to Banks

WASHINGTON – Mexican citizens living in the United States are allegedly being illegally helped by at least one national banking chain that now accepts a card issued by the Mexican government as valid identification for opening accounts. But an immigration reform group says those banks are violating federal law.

"We were approached by the Consulate General of Mexico to help find solutions to the barriers that Mexicans are encountering when trying to open a checking or savings account at a U.S. bank," said Lynn Pike, regional president for Wells Fargo in metro Los Angeles announcing the decision last year. "It became clear that one of those barriers is having forms of identification that are accepted by banks.

Wells Fargo accepts the Mexican "Matricula Consular" - or Certificate of Consular Registration - as a "primary" form of identification in place of other forms of U.S.- or state government-issued identification. Wells Fargo also requires applicants to have a major credit card, department store credit card, or student identification card with a photo to open an account.

Abetting Illegal Aliens

"By removing this barrier," Pike explained, "we want Mexican citizens to know that Wells Fargo welcomes their business and wants to be the financial services company of choice for the Hispanic community."

The Matricula Consular is a photo identification card issued by local consulates to Mexican nationals living in foreign countries. The card is valid for five years, and applicants are not questioned about their immigration status. It costs applicants $29.

"These cards are issued almost exclusively to illegal aliens," charged Craig Nelson, director of ProjectUSA, an advocacy group created "to inform the public" about "mass immigration and overpopulation."

Information published by the Mexican government corroborates Nelson's claim.

"The Certificate of Consular Registry is exclusively for Mexican citizens, independent of their legal stay in this country," according to a translation of the Matricula Consular page of the Mexican Consulate's Web site in San Diego.

"If someone were in the country legally they wouldn't need the Matricula Consular," Nelson explained. "They would have official U.S.-issued identification, and they would use that to open a bank account."

Criminal Act

By "welcoming the business" of illegal aliens, Nelson said banks are breaking the law. He points to Title 8 Section 1324 of the U.S. Code.

The law mandates that: "Any person who ... encourages or induces an alien to come to, enter, or reside in the United States, knowing or in reckless disregard of the fact that such coming to, entry, or residence is or will be in violation of law ... or aids or abets the commission of any of the preceding acts ... in which the offense was done for the purpose of commercial advantage or private financial gain, shall be fined under title 18, imprisoned not more than 10 years, or both."

The implication, Nelson believes, is clear.

"Courts have held that the word 'encourage' there means allowing an illegal alien to stand equally with an American citizen," he explained. "To us it seems plain that opening a bank account for an illegal alien encourages the illegal alien to remain in the United States."

Wells Fargo maintains, however, that it is not the bank's responsibility to inquire about the immigration status of its customers.

"We don't feel that we're breaking the law because we don't bring [aliens] in, nor do we harbor anyone," said Julia Tunis, a spokeswoman for Wells Fargo. "And, the Matricula card does not induce anyone to come to the United States."

Calls to the Mexican Embassy in Washington seeking comment on ProjectUSA's allegations were not returned before the filing of this story for publication.

Source - http://archive.newsmax.com/archives/articles/2002/8/19/150601.shtml

Millions of Mexican Illegal Aliens Endanger U.S. Security

WASHINGTON – The millions of Mexican illegal aliens in the United States endanger national security by creating a demand for false identity documents and smuggling networks that could also assist terrorists, experts said Tuesday.

The three experts, speaking at a panel hosted by Nixon Center and Center for Immigration Studies, also said that amnesty for Mexican illegal aliens in the United States should not be considered until immigration enforcement at the U.S.-Mexican border is strengthened.

Robert Leiken, a guest scholar at Nixon Center, said that Mexican illegal aliens themselves did not pose a terror threat. But operating in the shadow economy, they help to undermine the rule of law in the United States and in Mexico, he said.

"Mexican immigrants are not a direct threat to homeland security," Leiken said. "The real problem is that a large illegal population creates an active market for illegal documents."

Leiken said that helping Mexico guard its borders should be one of the most important items on the U.S.-Mexico foreign relations agenda, especially in light of Sept. 11. Another critical aspect of control should be increased immigration law enforcement within U.S. workplaces, he said.

"Earned legalization must be sufficiently stringent as to discourage illegal immigration, something the 1986 'amnesty' failed to do. That is why the program must be linked not only to shared U.S. and Mexican border responsibility but also to regularly enforced employer sanctions," he said.

George Grayson, a professor of government at the College of William and Mary, said that the Mexican Ministry of the Interior needed to improve the reach and the behavior of its border agents.

His 2001 study of the conditions for illegal aliens at the Guatemalan-Mexican border showed that more than 100 criminal organizations continue to move migrants across the frontier, at times through the assistance of corrupt border officials.

Middle Eastern, African, and Asian aliens are among the many passing through from Central America, creating a U.S. security threat, the experts said. Despite recent enforcement reforms and crackdowns by the United States and by Mexican President Vincente Fox, illegal immigration continues steadily, they said.

'A Sieve Blasted by Buckshot'

"The Mexican-Guatemalan border is a sieve blasted by buckshot. There are more than 200 clandestine crossing points," Grayson said.

Post-Sept. 11 border security has been a major consideration to the Bush administration. The president's 2003 budget contained money to double the size of the U.S. Border Patrol and major increases in Immigration and Naturalization Service.

Under Bush's plan for a Department of Homeland Security, all border and port security would be handled in one agency and the administration anticipates far greater control over who enters or leaves the country. The annual legal quota for Mexican immigrants is 75,000. Before Sept. 11, Fox and other Mexican officials requested that the quota be raised to 250,000, even if the Mexicans were permitted in only as temporary guest workers.

An amnesty program for the millions of illegal Mexican workers in the United States was a key Mexican request at a February 2001 presidential summit between Fox and George W. Bush. But since Sept. 11, amnesty and legalization programs have taken a back seat to border enforcement, the experts said.

In his remarks, Leiken also said he believed more Mexican illegal aliens should receive legal spots in the United States to reduce the pool of illegals.

But Steven Camarota, director of research at Center for Immigration Studies, an organization that is often critical of open immigration policy, said he thought U.S. policy should focus on reducing the number of Mexican and low-skill immigrants.

Taxpayer Subsidy to Cheapskate Employers

His research showed that Mexican immigrants, legal and illegal, were costing U.S. taxpayers millions of dollars a year though their use of public assistance. He thinks their benefit to the economy is small.

"In effect, Mexican immigration acts as a subsidy to businesses that employ unskilled workers, holding down labor costs, while taxpayers pick up the costs of providing services to a much larger poor and low-income population," he said.

Source - http://archive.newsmax.com/archives/articles/2002/8/6/143102.shtml