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3/1/2005 - (Houston) Hospital district struggles with burden from beyond its border: (Use the taxes they PAY or refund their taxes and make them pay)

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  • Al Soto
    ... Hospital district struggles with burden from beyond its border: Funds fall short even as the cost of caring for those outside the county and nation soars
    Message 1 of 1 , Mar 2, 2005
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      >Houston Chronicle
      >
      >March 1, 2005, 9:22AM
      >
      >
      Hospital district struggles with burden from beyond its border:
      Funds fall short even as the cost of caring for those outside the county and nation soars
      >By BILL MURPHY
      >Copyright 2005 Houston Chronicle
      >
      >After he was caught illegally crossing the Rio Grande in November,
      Ricardo, >a 43-year-old Honduran with six children to feed, was taken to a
      detention >center in the Valley.
      >
      >He suffered a heart attack in late December and was treated at a
      Harlingen hospital. But immigration authorities balked at paying for heart
      surgery and released him, advising him to seek treatment on his own, he says.
      >
      >Still weak, he made his way to Houston and eventually to Ben Taub
      General Hospital, where he underwent heart surgery in January.
      >
      >As the cash-strapped Harris County Hospital District operates on a
      budget
      >that can't keep up with the needs of the county's poor, almost a third
      of
      >its admitted hospital patients are coming from outside the county and
      even
      >outside the nation.
      >
      >Over the past 10 years, the district has provided $510 million in
      >unreimbursed care to illegal immigrants, the district says. Another
      $101
      >million was spent on unreimbursed care for residents of surrounding
      >counties.
      >
      >"I think we have an obligation to provide care," Commissioner Steve
      Radack
      >said of treating immigrants. "There is a public health issue. When you
      have
      >a population that hasn't received preventive care, they are at risk of
      >infecting the population at large. But the federal government needs to
      help
      >us provide such care."
      >
      >Radack and others are less enthusiastic about providing free care to
      >residents from other counties.
      >
      >The district last
      year spent 10.4 percent of its budget on
      unreimbursed
      >care for illegal immigrants - $80 million out of a $770 million
      budget, a
      >Radack aide found while researching district spending.
      >
      >Federal law requires hospitals to treat everyone who comes to
      emergency
      >rooms. Passed by Congress two years ago, the Medicare Modernization
      Act was
      >supposed to provide some relief by funneling $1 billion over four
      years to
      >hospitals providing emergency care to illegal immigrants.
      >
      >
      >Left out of funding
      >Texas was to get $47.5 million a year. The hospital district assumed
      it
      >would be in line for some of the money and that it would help offset
      other
      >cuts in Medicare, said Clifford Bottoms, the district's chief
      financial
      >officer.
      >
      >
      >But state officials decided the money would go to private hospitals
      that
      >provide care to illegal immigrants,
      not charity hospitals such as Ben
      Taub,
      >Bottoms said.
      >
      >Money has become so tight at the district that its officials are
      >contemplating severe measures to balance the upcoming annual budget,
      to be
      >considered by Commissioners Court on March 8. These include limiting
      >patient prescriptions covered by the district and cutting available
      beds at
      >Ben Taub and Lyndon B. Johnson hospitals.
      >
      >Even though demand for the district's services has risen 8.2 percent
      >annually since 2000, the district is expected to be given an annual
      budget
      >next month calculated on a 1.3 percent increase in patient demand.
      >
      >Not everyone agrees that the district should feel compelled to provide
      >treatment for undocumented immigrants.
      >
      >"It's going to break all of us. There's no way we can provide health
      care
      >for illegal aliens," said J.C. Hernandez, founder and president of
      >Houston-based Americans for Zero Immigration.
      >
      >County officials don't buy the argument that the county ought to
      refuse
      >treatment to illegal immigrants.
      >
      >"It's a moral issue; it's a public health issue," said County Judge
      Robert
      >Eckels. "This is how we do things in America."
      >
      >Radack said the federal government should increase funding for such
      care
      >because it has the mandate of keeping people from crossing the borders
      and
      >isn't doing enough to prevent illegal immigration.
      >
      >Advocates say illegal immigrants would have few places to turn if the
      >district closed its doors on them.
      >
      >Mark Zwick, who runs Casa Juan Diego, a nonprofit Houston shelter for
      >immigrants, said that in the past year, four illegal immigrants fell
      from
      >scaffolding while working for low wages on construction sites in
      Harris
      >County. The accidents left three
      of the workers paraplegics and the
      fourth
      >a quadriplegic, he said.
      >
      >Casa Juan Diego cared for them while they recuperated in one of its
      >Heights-area homes or paid for them to be cared for elsewhere.
      >
      >Ricardo lives in one of the homes and hopes to regain his strength
      >following his heart surgery. When he does, he will work as an
      electrician
      >or painter and begin to send money back to Honduras, where his wife is
      >trying to care for their children, he said through a translator.
      >
      >"They depend on me," he said. Ricardo said he is grateful for the care
      he
      >has received at Ben Taub. "They attended me very well."
      >
      >Ricardo asked not to be identified fully because he is in the country
      >illegally.
      >
      >"If they are building our houses, mowing our grass, watching our
      children,
      >the least we can do is to take care of them when they are sick," Zwick
      >said. "To abandon people when they work very inexpensively is
      >unconscionable."
      >
      >County officials don't take issue with that but do complain about
      another
      >strain on the district's budget - providing unreimbursed care to
      residents
      >from surrounding counties.
      >
      >Last year, the district spent more than $15 million on such care.
      >
      >Radack said he will ask County Attorney Mike Stafford to see if civil
      >action can be taken against out-of-county residents who don't pay
      their
      >bills and will ask District Attorney Chuck Rosenthal whether criminal
      >charges could be brought.
      >
      >"This money is coming straight out of the pockets of the Harris County
      >taxpayers. This is a theft of services," he said.
      >
      >Intended to provide a safety net for the county's poor, the district
      now
      >serves as a regional safety net, Bottoms said.
      >
      >Trauma patients
      from around the region are taken to Ben Taub because
      it is
      >a top facility. And residents from surrounding counties turn to the
      >district because fewer services are offered to the poor in most nearby
      >counties, Bottoms said.
      >
      >
      >False residency claims
      >Some out-of-county residents falsely claim to live in Harris County
      because
      >it is easier to qualify for indigent health care than in most
      surrounding
      >counties.
      >
      >
      >"You have to be dirt poor now before we'll take you," said County
      >Commissioner Tom Stavinoha of Fort Bend County, where a family of four
      >earning more than about $4,000 a year doesn't qualify for free care.
      >
      >State Sen. Royce West, D-Dallas, has filed a bill that would allow a
      >regional hospital that serves as a draw to surrounding counties to
      recoup
      >some of the costs of treating out-of-county residents.
      >
      >The bill would
      require all counties to pay for health care for people
      with
      >annual incomes as high as 200 percent of the federal poverty level.
      That
      >poverty level is $19,350 for a family of four.
      >
      >Harris County Commissioner El Franco Lee said more federal funding,
      not
      >state or county money, is needed to pay for health care statewide.
      >
      >"You aren't going to get anything from small counties with one
      bulldozer,"
      >he said.
      >
      >
      >bill.murphy@...
      >
      >       RESOURCES
      >       OUT-OF-COUNTY PATIENTS
      >       More than 1,000 patients from other counties were admitted to
      Harris
      >County Hospital District facilities
      last year. They're often drawn by
      the
      >county's better facilities and easier eligibility requirements:
      >       . Harris County: A family of four making up to $19,350 a year
      >qualifies for free care, and those making up to twice that pay on a
      sliding
      >scale, often with minimal fees.
      >       . State standard, applied by many surrounding counties: A
      family of
      >four qualifies only if it earns less than $4,064.
      >
       
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      The government and the NEWS should reflect, not determine, the desires of the people.The news is to be reported not to sway opinion. Stop the melodrama and constant trivia on news time. The founding fathers knew that government is always corrupt, that is why they gave us civil liberties.  The people must lead to survive corrupt governments. Read the constitution. (In accordance with Title 17 U.S.C. Section 107, this includes information for research and educational purposes.)  Al Soto (c) 2005


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