Arizona Hospitals Fund Mexican Healthcare

Facing an avalanche of unpaid bills from Mexicans who cross the US-Mexico border solely for emergency healthcare, desperate hospitals in southern Arizona have taken to making capital investments in Mexican hospitals hoping to keep sick Mexicans in Mexico, where the chances they will pay their bills is somewhat better. The Arizona Republic reports that the US government recently issued a $365,000 grant to a Mexican hospital in hopes of improving conditions there so that the Mexican hospital could treat patients instead of "routinely sending them to Tucson emergency rooms."

For the Mexican hospitals, this has been a very good deal:

Dr. Enrique Contreras Duarte, who has worked at the Mexican hospital for seven years, said the program has changed the way administrators handle serious cases and even some routine injuries. The triage unit now includes two operating rooms, an obstetrical-care area and an intensive-care nursery. The hospital also bought incubators, neonatal monitors and surgical instruments.

"In the past, we had to send a lot of patients to Tucson. Now that very seldom happens," Contreras said in a recent interview. "We can take care of them here or send them on to Hermosillo," the capital of Sonora, which has a higher-level trauma center. By Mexican law, the hospital in Nogales provides low-cost or free services to all patients from Mexico.

For Arizonan hospitals, on the other hand, it's the lesser of two evils:

Federal law requires U.S. hospitals to treat all patients needing emergency care, regardless of their citizenship or ability to pay. In Arizona, the cost of caring for foreign patients has increased substantially over the past decade as the U.S. government cracked down on illegal immigration in California and Texas.

The number of undocumented immigrants crossing through Arizona has increased exponentially, and hospitals have footed bills for their emergency-room care.

Dickson, who runs a 15-bed hospital in Bisbee, said that in 1998 the hospital had $30,000 in unpaid bills for foreign patients, some who entered the country legally with visas and others illegally. Last year, the cost topped $400,000, roughly the amount it would cost Dickson to replace increasingly outdated equipment.

...

Patrick Walz, interim chief financial officer for Yuma Regional Medical Center, said investing in Mexico is "definitely the right approach."

"We can't turn patients away," said Walz, whose hospital had about $1.9 million in charges for undocumented immigrants last fiscal year, "so the alternative would be help them out, to provide as good of health care (in Mexico) as they can get up here."

Of course, the real problem for Arizona's healthcare system (among many other things) is the failure of the US government to control the southern border and federal laws that force US medical institutions to treat foreign nationals without even the chance of repayment. At a minimum, the US government might attempt to collect the fees owed to US hospitals by Mexican nationals from the Mexican government. But the Washington hasn't the slightest intention of doing that. US citizens, therefore, must bear the financial costs of subsidizing Mexico's collapsing heathcare system, raising healthcare costs for Americans. This is the direct result of the Bush administration's policy of border neglect.

But some administrators question why the U.S. government would invest in Mexico while U.S. hospitals are struggling. Hospitals along the Southwestern border paid about $190 million for the emergency care of undocumented immigrants in 2000, according to a study commissioned by the nonpartisan, Washington, D.C.-based United States/Mexico Border Counties Coalition, the most recent information available.

"We see our system being decimated, and we see that services are diminishing in the area, such as closing down maternity units, closing down skilled-nursing facilities," said Jim Dickson, chief executive officer of Bisbee Copper Queen Hospital in southeastern Arizona. "And then people want to put money on the Mexican side? So it's kind of like, you put all that money over there but what about here?"

Don't look to Washington for any answers. No one in either party cares.