According to the New York Times, hospitals have taken the problem of what to do with seriously ill (i.e., renal failure) and/or "catastrophically injured" (i.e., brain injured) patients. Spend $30,000 for a flying ambulance and send them back to their country of origin.

So, what's wrong with that? Well, for one thing, it's against federal law for a hospital that receives Medicare or Medicade money to release a patient onto the street. If the patient needs longer term care and/or rehabilitation, the hospital must transfer the patient to an appropriate facility.

The problem with that appears to be that most secondary care facillities won't take uninsured patients. They are for profit while most hospitals are not for profit organizations. So the hospitals have taken it on themselves--pack 'em up and ship 'em out.

The question then becomes a legal one. Are cross-border repatriations--done without control or over-sight--legal? Or is it 'patient dumping?'

Interesting story, as much for what it doesn't say as for what it does.


"Country of origin?" Huh? Is there a wee itty bitty part of this story that is somehow getting left out of the account here? Hmmm?

No, not unless you think I deliberately left out that a lot of the patients are undocumented. I did that because not all of them were undocumented. One was a sick baby, born in the US and, therefore an American citizen, who was going to be shipped to Mexico before the police stopped the flight.

Are the hospitals following any legal procedures? No, because there are none.

So, Liz, if there is no legal procedure can we assume the hospitals in question are not in fact breaking the law?

For the record, most hospitals are indeed "for profit" organizations and they have an obvious vested interest in ensuring the service hey provide is actually paid for...

I might also point out that you are misrepresenting the anti-dumping laws. They do not, generally speaking, require a hospital to transfer a patient to a secondary care facility. If a patient is stable and not in need of immediate life saving treatment the hospital can quite legally discharge that patient.

I think what we have here is a creative pre-emption of future uncovered expenses by the hospitals in question. By transferring their uninsured and undocumented patients back to their country of origin they not only avoid the likelihood of having to treat that patient again in the near future but they also generously the opportunity for that patient to enjoy the benefits of the socialized medical system of their home nation...After all, most of those countries have socialized medicine. Thats what the left tells us all the time when it says the US is almost the only nation that fails to provide free health care.

Bingo! That is precisely what was being left out of the story. And I'm rather skeptical about the "sick baby" story, but I'll let it go. The point is, these hospitals are seemingly trying to hold down their un-reimbursed expenses by trying NOT to end up getting stuck providing long-term care for non-U.S. citizens.


Indeed. This remarkable plus side of the story escaped my notice entirely. If we could just expand the program to be a medical option for U.S. citizens we'd be killing two birds with one stone: Even with the transportation costs, we could end up lowering health care costs over-all. And think of all those Americans who would get the opportunity to enjoy the health care they envy so much in other countries.

Hey, in Mexico you don't even need a doctor. You can just walk into your local pharmacy and buy all the pain killers you want.

So I'm with you on this one.

A funny thing happened on the way to the forum, tonight. I may talk about it, I may not.

Anyway, here's a part of what I found. Not all of the patients are undocumented and not all of them come from south of the border. A Chicago hospital admitted to repatriating patients to Lithuania and Poland, as well. And how do you define socialized medicine or universal health care, as it's also called? Many countries have 'some form' of universal health care but the definitions and extents of that care vary widely.

Guatemala, the country to which the test case patient was repatriated, doesn't. Futhermore, there's only one rehabilitation facility in the entire country. It has 32 beds and doesn't offer the specialized treatment needed for brain-injured patients.

Please don't get me wrong, I'm not dissing the hospitals. They, for the most part, can and do spend hundreds of thousands of dollars every year caring for un-insured patients, documented or not. Luis Jimeniz, the brain-injured patient, was kept as a ward of Martin Memorial Hospital in Florida to the tune of over a million dollars. No secondary care facility would take him although the release coordinators tried to find a place for him.

That really isn't the point. The point is that hospitals are being forced to do the work of Immigration with no guidelines, no oversight and no legal procedure to go by.

This is, to me, why the lawyers have now stepped in, in an effort to force the establishment of the needed guidelines, oversight and procedures.

And Law, please don't try to draw me away from the subject.

LOL...I would need to see the regulation that stated what you claim, Liz. This would not be the first time you said something that was not entirely in accordance with the facts. Which federal regulation requires hospitals to arrange post hospital care for patients who need it? On more than one occassion, I or family members, have been discharged from the hospital with instructions to make specific follow up appointments. The hospital did not arrange to have me transferred to a secondary care facility...where they violating your interpretation of federal law?

The Emergency Medical Treatment and Active Labor Act (EMTALA) only requires that a hospital stabilize a patient until the patient can be discharged or transferred to the nearest facility that will accept the patient.

So, what you are telling us, CG, is that Liz's opening post was in error? Federal law does not require what she claims it requires? How interesting...

What exact;y is the subject as you see it, Liz?