...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....