Should illegal immigrants qualify for nursing home care?

[NNguyenMD]

So I'm currently a resident physician at a very large county hospital.

Here is a scenario I am coming across far more often than I expected.

A patient comes in very critically ill, and turns out to have many major chronic diseases that have been left untreated for a long period of time, coronary artery disease, type II diabetes, poorly controlled congestive heart failure, chronic kidney disease, blood clots, severe vascular disease. The family is obviously too overwhelmed to take care of the patient at home, as they are struggling as it is working all hours of the day. The patient is obviously not fit to go home, but because the patient is undocumented, they do not qualify to go to a Skilled Nursing Facility paid under state medicaid.

What inevitably ends up happening is that we send them home to their families, they get worse and end up coming back into the hospital again for the same insult they got them into the hospital in the first place. This becomes a VERY depressing revolving door with no end in sight.

It feels like such a catch-22, either spend lots of money readmitting these patients through the emergency room, or invest in the high cost to pay for skilled nursing care at a rehab facility or nursing home. Either way, someone has to pay somebody.

If anyone is familiar with the NHS system in Europse or Canada, maybe they can shed some light into who pays the medical bill for patients who are chronically ill but are citizens of another country.

[magellan]

1. When I was a legal resident of the UK

...I had an NHS number and access to the entirety of their healthcare system.

edit to add because I ended rather abruptly: illegal immigrants in the UK have access to the NHS but there's a proposal to restrict that to emergency services only.

[NNguyenMD]

3. what if you're someone who is jsut visitng the UK?

and you also happen to be severely ill, are you covered under NHS healthcare system? Or do they arrange for you to be returned to your home country for long term treatment?

[magellan]

4. Generally you're covered, but you may have to pay depending

...on the services you require. It's only "free" for residents of the UK, and as I added to my first reply above, the UK government is proposing restricting illegal immigrants to emergency services access only.

[Selatius]

5. I could be wrong, but I think right wing elements in France wish to restrict access as well.

France, of course, has a single-payer health insurance system that covers everyone.

[magellan]

8. I think the problem is costs to maintain the systems are soaring

My husband told me this morning that Germany -- which probably has the best and most efficient healthcare system in the EU (it's PRIMO) -- is now having funding problems. And Germans are taxed highly to pay for it.

On the other hand, UK taxpayers don't pay near as much as the Germans and this has resulted in the NHS long being plagued by general underfunding. Also, too much of the money is wasted on the bureaucracy to run it. I don't know if that's the source of Germany's creeping problem. But it wouldn't surprise me at all to learn government graft/waste is partly to blame for eroding these systems.

[Lydia Leftcoast]

7. I looked it up the rules before going to the UK last year

The NHS will provide emergency treatment to anyone who needs it, but will provide non-emergency care only to legal residents of the UK or legal residents of the European Union, under a reciprocal agreement. Otherwise, if you're going to require long-term care, you're expected to go home.

Back in the days when I taught on the college level, two faculty members led a student group to London for January Term. One of the students broke her leg, so one of the professors took her to the nearest ER. There was no charge for setting the bone and putting on a cast or for crutches, and the pain pills were cheap.

[WolverineDG]

31. I didn't have to pay 4 years ago

I was just stopping over on my way back from Cairo, but fell ill in London. I fully expected to be billed when I had to be taken to the ER, but I never got a statement. I had caught some weird 24-hour bug, nothing severe, so maybe that had something to do with it.

dg

[Warpy]

2. The system we have is insane and cruel

Only universal single payer health care will actually provide all of us with the necessary CARE.

The policy of sending severely ill patients home to overwhelmed family members because they don't qualify for Medicaid or have long term insurance is pure insanity and maximizes human cruelty on all levels.

[behonest]

6. Mandatory health care

I actually think health care shouldn't just be universal, its should be mandatory.

People should be required to take care of themseleves, for the benefit of society.

You have a very large number of people who do things that make themself sick and then turn around and want to be cared for.

The problems need to be addressed when they start, not when people are at deaths door and all you can do is prolong the agony at great cost.

So I think people should all have to see the doctor twice a year at least. If they have medical problems they should have to take medicine or change their life style. And if they don't they should be forced to.

When I see these armies of obese self indulgent, smoking, hard drinking people waddling down the streets and think of the future of health care its more than alarming.

[Viva_La_Revolution]

11. And those who aren't able (for whatever reason) to buy mandatory insurance...

You won't mind stepping over their bodies on your way about your business. The disgustingly heartless never do.

[ConsAreLiars]

16. Would you use waterboarding to force them to comply with your will?

And maybe sterilize people whose genes are impure? Yeah, a police state is the answer to every problem. You, of course, being a perfect model of virtue, should never have to contribute anything to help the lesser beings.

[MADem]

21. This is a website for progressives. I think, with those views, you've taken a wrong turn. NT

[madfloridian]

9. Well, in Florida they can not get medical care...

except through clinics set up for that purpose....and the right wing will cause problems even then. It's getting very cruel out there.

Time to stop the madness.

http://journals.democraticunderground.com/madfloridian/1706

Thank you for caring and asking.

[NNN0LHI]

10. The term "illegal" immigrant is a wingnut Republican code word used by Dobbs and scum like him

The same people who I hear use it around me in real life also call blacks "colored" people.

Anyone else noticed that?

Don

[earth mom]

15. Bullshit. Those people are ILLEGALLY in this country. They are breaking the law.

As in any crime, the word illegal is used. Illegal lane change, illegal possession, etc.

[NNN0LHI]

18. Oh yes I hear people referring to the "illegal" lane changers constantly

And all them "illegal" possessors too.

All the time.

Come on now people with any sense at all can see right through the bigotry of labeling another human being as "illegal."

Don

[earth mom]

23. No one is saying anyone is an illegal human being. That's just silly.

People have illegally immigrated to this country. Hence the widespread and common coinage: illegal immigrants or illegal aliens.


You know, you might win people over to your "side" if you first stop calling them racist for using a common term. It's extremely offensive and makes people tune out to your message.


Not only that, but just once I would love the pro-immigration folks on this board to acknowledge that the massive influx of people coming through the borders illegally has hurt workers that are already here legally big time. I'd don't think I've ever seen an acknowledgment of that fact on this board from any of you.


Instead, you all freak out and name call at the first opportunity when people don't agree with you. Sorry, but I doubt you will win hearts and minds if you keep up with the name calling.

[earth mom]

27. No reply...not surprised. nt

[High Plains]

33. You can do the research on impact on wages as well as I can.

If I recall correctly, the primary wage impact is a slightly lower (4-5%) wage level among the least educated workers.

So, yes, there is an impact. How do we weigh that against other economic impacts of having a large, undocumented group of foreign workers? Slightly less expensive goods, for instance? Or the economic impact of providing goods and services for that undocumented population. They have to buy shoes and food and gas and cars, too (although not auto insurance, perhaps, because they can't get drivers' licenses).

[High Plains]

32. So if you got a speeding ticket are you an illegal driver?

Does that now define your very existence?

No you are a documented traffic law violator, and that guy who came across the border without papers is an undocumented worker.

But please keep us informed when Dobbs comes up with a new meme.

[MADem]

22. No it isn't. It was popularized in song, years ago, before the GOP got really jerky.

http://www.youtube.com/watch?v=p7q1H3VKdp0&feature=related



An old geezer named Phil Collins had a band that did the tune.

I never heard old Phil use the term 'colored people.'

[EFerrari]

12. Why not just put them out on the curb?

It's obvious that this impoverished country can't absorb the costs of chronic illness from its slave population. Just ditch them and get it over with.

[NuttyFluffers]

28. well, maybe congress will let us spit on them to stave off dehydration...

seriously, it's a crazy, crazy situation we're left in. a better world would have a better usa president work with a better mexico president for a mutually improved economy and national health care reciprocity. but every time i say this people call me out as off in La La Land. i think i want a resident alien visa to La La Land and try to go ex-pat there.

[EFerrari]

29. The plight of undocumented workers and their scapegoating

is the next most perfect expression of the GOP after Blackwater.

They are the prelude and Blackwater, with their torturers recruited from all over the globe, is our future.

[NuttyFluffers]

35. it's another ridiculous divide and conquer

what's the best way to destroy a people? divide them up into manageable and conquerable portions. a nation has a right to its borders, of course. but it also has a responsibility to its citizens to have an intl. policy not go around "union busting." creating hopeless slums, which naturally result in increased immigration, and destroying our organized labor here is obviously the desired result. but as long as it's all about the race card people will be divided. but sadly too many people can only ever see 2-3 links up the chain...

[pop goes the weasel]

13. This is a matter for diplomacy

Seriously, there should be treaties that cover this sort of thing. If Country A's national needs medical care in Country B, and can't afford to pay for it, then maybe Country A should pay the bill or a percentage of the bill, or some other deal that both nations find relatively fair. Leaving it to be worked out piecemeal at the local level is obviously a recipe for medical disaster for local hospitals as well as immigrants, legal or not.

[williesgirl]

14. I know I'll get flamed, but here goes: Why should my tax dollars go to care for folks who came here

illegally in the first place? We all pay for more hospital care due to the huge influx of illegal immigrants who use the hospital rather than doctor's offices. And, please, if you don't live in an area with high illegal immigrant numbers, don't bother to flame. Try waiting for hours in the emergency room behind folks who don't have the documentation to qualify for Medicaid and who therefore can go to doctor's offices instead. Even if we get national healthcare, it won't address this issue cause they won't be eligible for it, not in my opinion, should they be.

I have acquantances who have been waiting for years to come to the US legally and due to quotas, have to wait their turn. I have trouble feeling sorry for those who just walk in. It's sure unfair to those who do the right thing.

None of us could go to another country, especially entering illegally, and expect free health care. Why are we providing it?

[NNN0LHI]

19. Why are we providing it?

Because many of us don't want sick and dying people being denied basic health care for any reason.

Someones immigration status is the last thing on my mind when any man, woman or child is in need of medical care.

I guess its the way I was brought up.

Don

[ConsAreLiars]

20. Yeah, why help anyone. Being human is certainly not enough to deserve humane treatment.

The have to have the proper documents.

Your house is on fire? "Show me your papers."

You're bleeding to death or have leukemia? "Show me your papers."

You want to use the streets for free? "Show me your papers."


And maybe only landowners or people who earn enough to pay taxes or maybe just whites should have those papers. Certainly, asking people like you to contribute to the well-being of others who don't have money or haven't paid their share is asking too much. God forbid "you" should ever be expected to contribute anything to the common good. Clearly, it is against your nature to do so.

(edit typos)

[Bluebear]

25. Right, just put the oldsters in the street and let them rot.

:crazy:

[judaspriestess]

30. well I guess I'm going to get flamed too

but why should my tax dollars go to smokers who know damn well the risk they are taking, then become seriously ill and I'm stuck footing the bill. Why should my tax dollars go to people who are severely obese knowing full well that it causes heart disease, diabetes just to name a few symptoms. And why should my tax dollars go to irresponsible people out their just breeding away bringing so many unwanted children into to world and I'm stuck footing the bill???

sorry on edit: we cannot deny healthcare to anyone period. Instead of getting pissed off at undocumented immigrants, smokers and everyone else. We need to stop these for profit insurance companies. CEO's get bonuses in the millions every year. How much health care could that provide?

[JCMach1]

17. IT should be like a passport... all countries that offer free and universal health care

should be reciprocated... at least for acute care.

[flordehinojos]

24. in answer to your question,

WHY THE HELL NOT?
one day, all of these antihuman sentiments that so many are feeling and expressing from lou dobbs to the dogs who follow his leash, i mean, lead ... one day, every damn thing they are serving humanity with, will come back to haunt them..here or in the other world.

[Hekate]

26. Should we dump people on the street and let them die there?

It actually has happened in Los Angeles (photos and security tapes available courtesy of the Rescue Mission and the LA Times) when no one will claim an elderly and/or disabled -- and very much still convalescing -- patient being released from a hospital. More than one has been transported from the hospital to Skid Row and dropped off on the sidewalk. One old woman wandered around in her hospital gown. A paraplegic man with a colostomy bag crawled into a gutter. No one said what their citizenship was, so by default these were fellow-Americans.

A national single payer health plan would benefit every human being within our borders, and we could pay for it handily with a fraction of a percent of what's currently going to the Masters of War.

Hekate

[Mz Pip]

34. A slightly different perspective

If we provide "free" health care to people in the country illegally, what possible motivation would the country of origin have to get its own house in order? Someone is sick the reponse from that country would be "Just go to the U.S. They'll take care of you for free."

Why should the United States be responsible for the failure of other countries to do the right thing. Maybe the citizens of these other countries need to start a revolution in their own country and demand what we are demanding for our own citizens.

Mz Pip
:dem: