8.29.2007

Made up name? Made up person?

"I've seen cases and case histories of patients who essentially have come up from Mexico for the express purpose of being treated here, and then leaving to return home," Dr. Rogers said. "I've watched illegal immigrants brazenly demand free, non-emergency health care that was meant for our poorest citizens. I've heard them and their families complain. They feel entitled to it."

...a prevailing culture that has emerged in government: a culture that will not tolerate anyone who dares to draw a distinction between American citizens and illegal immigrants. It is a culture that now pervades police departments, public schools and universities, social services and health care.



***

Interesting. While I think the clinic is a far better place to treat non-emergencies than the ER, for everyone, period; I do hear frustration with allocation of resources 'taken from poor Americans' and given to illegal immigrants frequently. (This brings to mind an interaction I had with one of my PAs...)

There was a PA I worked with. Not long ago his brother was dying of lung cancer, after being a fire-fighter his entire career. He had health insurance, but still, he had to liquidate his assets to pay for end of life medical care. He sold his house, borrowed money from family...you know, that sort of thing. His money ran out before his life did.

The PA vented to me one day how frustrating it was to provide free care to "all of these people" when his own brother, who served the county for 25 plus years, could no longer afford his medications/healthcare costs despite being insured, and a citizen of this 'great' nation. Working at the County, we regularly admit patients (over and over again) to TICU (trauma ICU) who aren't citizens, and are at war with American Blacks in the innercity. People from all around the world having babies here. Referrals from Mexican doctors to 'go to the US' for continued care. Hundreds of thousands of dollars in (free) medical care rendered at (what he believed was) the expense of poor Americans...


...he asked me, what would happen if someone who appeared to be an American Caucasian or American of African descent presented to our ER, and gave an obviously (or not so obvious) fake name, said they were homeless...received treatment...then disappeared. What stops all people from presenting as 'illegal' with no ID, social security card, or proof of residency (either within the county or country). He wondered if his brother could've/should've just presented as a "homeless" unverifiable person to the ER one day...been admitted....and subsequently entered into the system as "Mr. B.S." From then on...treated until death under this alias, thereby able to keep his house, and his family members their money. It was difficult for him to treat poor (and not so poor) Americans losing everything in medical costs when we do provide so much "free" care to those who cannot even show proof of who they are, where they are from, what they are able to contribute, and where to find them. He was very frustrated, and upset with the system.

Perhaps that's what Dr. Rogers was feeling.

For those with an opinion (and maybe better understanding), why can't Americans just make up a persona and receive free medical care? Especially since no one dares check for fear of being called racist? Seems possible...although hardly a 'solution' on a large scale, obviously.

Perhaps for this PA's brother (as an individual) things would have worked out better....

7 comments:

MY OWN WOMAN said...

So, let me get this straight. PA's brother worked his whole life, was a firefighter, paid taxes via income tax and property tax, got sick, reached his maximum benefit allowance and had to sell his personal property until there was essentially nothing left.

Then we can take things one step further and say with some sort of assurity that illegal immigrants or even the poor in this country can get free medical care when needed.

I have a question. If the PA's brother could afford medical coverage in the beginning, and now is poor because he got sick, does that mean we are punishing him now because he worked and paid taxes prior to getting sick? If he is poor now, does that mean he can get medical care or does it mean he can't because at one time he was able to pay for his health care?

And....what's that about Michael Moore stretching the truth?

I just don't get it.

Anonymous said...

As for why Americans don't simply make up a name -- some of us do not lie, even today.

It used to be that being discovered in a lie would cause a person to be excluded from polite society; these days, it's just another box ticked on the list of prerequisites for Congress.

Bleah.

Cheers,
Felix.

leeptalk said...

Did anyone think of hospice? Whether life long worker and tax payer or homeless and broke, the benefit is the same. Meds related to the diagnosis paid by the hospice and all nursing care provided not based on who the world thinks you are, but on the whole person - physical, emotional, and spiritual. Guess this is why hospice has such a low utilization and misperception of services. And no I am not missing the point, but when it come to end of life care why does no one think to help end the emotional suffering by letting the hospices do their job of healing - not curing - but healing the person and family?


Note: Spirituality of Dying Well Course is at http://spiritualityofdyingwell.blogspot.com/

leeptalk said...

Did anyone think of hospice? Whether life long worker and tax payer or homeless and broke, the benefit is the same. Meds related to the diagnosis paid by the hospice and all nursing care provided not based on who the world thinks you are, but on the whole person - physical, emotional, and spiritual. Guess this is why hospice has such a low utilization and misperception of services. And no I am not missing the point, but when it come to end of life care why does no one think to help end the emotional suffering by letting the hospices do their job of healing - not curing - but healing the person and family?


Note: Spirituality of Dying Well Course is at http://spiritualityofdyingwell.blogspot.com/

Anonymous said...

Well, sure, the hospice is nice, but what if the man wanted to live? You know, the reason why he might have gone to the hospital, rather than the hospice. Hey, it was his life, his money, and his insurance, and if he wanted to stretch it out as long as possible, and try every treatment available, that was his right.

Back to the point: do we owe healthcare to non-citizens? Well, if they pay taxes, sure, part of the social contract, you pay your taxes, we take care of you... ..well, sort of. If they don't contribute, we don't owe them a thing. What we give them is charity. Charity is never owed, it's a gift freely given, and there is an obligation on the recipient to try to get to a position where they need no longer rely on charity. The denial of that obligation is a reflection on a loss of shame, coupled with a misplaced feeling of entitlement. Which is not unique to non-citizens...

leeptalk said...

I want beat this horse more after this, but...the comments said:
"There was a PA I worked with. Not long ago his brother was dying of lung cancer, after being a fire-fighter his entire career. He had health insurance, but still, he had to liquidate his assets to pay for end of life medical care. He sold his house, borrowed money from family...you know, that sort of thing. His money ran out before his life did."

Just for the record. Hospice is not a place, it is a service. It can be provided in a hospital or wherever home is. You don't have to give up living - and many hospice patients receive such good care that they are frequently discharged from hospice.

Just don't want someone else doing without care because of a misunderstood view of what hospice truly is.

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