After working as a translator in a U.S. hospital for the past two years, I have seen and experienced many things. Among the most disturbing is the outright plundering of the system by those who the system was never designed to cover, namely illegal immigrants.
Julia
Julia is an expectant mother who has been in the U.S. for less than 4 months. She has received no prenatal care and shows up at the Emergency Room of her local hospital here in the U.S. when she begins to have contractions. She arrives with no identification and a vague idea of her street address here in the U.S.
Her baby girl is subsequently delivered at the hospital and, during the three days following the birth of their daughter, both Julia and her daughter receive around-the-clock medical care in the Family Birthing Center of the hospital. A translator is contacted by the hospital and is provided to Julia and the father of the little girl because they cannot speak English.
Amongst other things, the little girl receives an application for a social security number & birth certificate, a variety of injections, and her first Hepatitis B vaccine. The mother is offered a free car seat - courtesy of the hospital - and a free smoke detector for use in the house because of the family’s perceived low-income status.
On the third day, a woman from the hospital arrives and, with the help of the hospital’s translator, files the necessary paperwork so that the mother and father can successfully enroll their baby on Medicaid. After the completion of the necessary paperwork, a nurse escorts the new mother & father and their baby out the front door of the hospital to their well-appointed Pontiac minivan.
A hospital bill that has reached upwards of $6,000 is never mentioned by anyone at the hospital to the mother or father. Ironically, the nurse who has escorted the new family out the front door and helped deliver the baby is pregnant herself. She pays for health insurance on a monthly basis and will later have to pay a $600 deductible in order to deliver her baby in the same facility as Julia.
This is just the first of a series of tremendous expenditures that will be absorbed into the great federal and state government largesse known as uninsured health care. Upon enrolling the baby on Medicaid, Julia’s baby will be eligible for baby formula, diapers, $15 well child check-ups until the baby is 4 years old - of which there are 8 check-ups with a highly-trained Pediatrician- and at least 10 different vaccinations, several of which are being rationed because of a nationwide shortage. All of this will be paid for by a combination of state and federal tax dollars. Head Start programs at the local elementary school are also paid for. All of this is provided to the baby because the baby is an American citizen by virtue of being born on American soil, regardless of the mother’s immigration status.
Ramon
Ramon is a day laborer at a local greenhouse. He has arrived in the U.S. on a temporary basis approximately two months ago to work at a greenhouse during the seasonal harvest. Ramon was diagnosted with diabetes two years ago in Mexico. He has never given himself an insulin shot and admits he has no idea how to check the level of sugar in his blood. He is 51.
After working in the greenhouse for three weeks, Ramon slips and sprains his ankle. He does little to treat his ankle and later arrives at the Emergency Room at his local hospital with a swolen right foot that is made even worse because of his diabetes. After examining his right foot, the doctor decides that the pinkie toe on said foot needs to be removed. This is a fairly complex surgery with a high risk of infection because of the size of the remaining open wound that will be left after the surgery has been completed. As such, 8 hours after belatedly walking into the Emergency Room, Ramon has had his right pinkie toe removed and is resting on the 5th floor of the hospital. He will remain in the hospital for a total of 6 days as the wound is cared for and cleaned by a variety of nurses and physical therapists.
On the 6th day, Ramon is transferred to a hospital-managed outpatient facility. He has a hand-held device called a wound-vac that is attached to his foot so that the 2 inch surgical wound along the side of his right foot will close faster. This wound-vac requires fairly constant medical attention and was the reason why Ramon was moved to the $350 per night outpatient facility rather than sent home with instructions on how to use the wound-vac himself.
While in the outpatient facility, the doctor checks daily on Ramon’s foot in order to assess whether the wound-vac has successfully closed the wound. Once closed, Ramon will be transported back to the hospital via ambulance where he will once again undergoe surgery. A portion of the skin on his hip will be taken in order to be used as a skin graph on his right foot. The total time Ramon will be in the hospital or at an outpatient facility is approximately 21 days.
By law, a hospital-contracted interpreter is present to explain every step of this process to Ramon. During the many conversations the interpreter has with Ramon over this 21 day period, it becomes clear that Ramon has engaged in absolutely no preventative care for the past two years subsequent to him being diagnosed with diabetes. Ramon admits to regularly drinking 6 to 8 beers several nights a week while in Mexico. The only reason Ramon stops drinking is when his body tingles all over. This is how Ramon crudely checks the level of sugar in his blood. This is how Ramon knows it is time to stop drinking for the night.
After Ramon’s second surgery to graph the skin from his hip over the wound in his foot, Ramon is released from the hospital with a bill that is over $14,000. He is given a variety of insulin for his diabeties and testing supplies and told to schedule a follow-up appointment with a physical therapist where, by law, a hospital-contracted translator will also be present. He is also directed to an uninsured discount clinic that is a satelite office of the hospital where he will receive a vision test as a result of his diabetes coupled with tri-monthly doctor consultations about his diabetes.
Ramon has no assets to speak of inside of the United States. He crossed the border with his brother and approximately 30 other Mexicans from central Mexico to specifically work at the aforementioned greenhouse.
Upon being released from the hospital, Ramon has two options. One option for Ramon is to return to Mexico early where he is a proud grandfather and where his large family - he is one of 11 brothers and sisters - are available to care for him. The second option is to remain at the greenhouse and continue to try and work while attending hospital-arrainged physical therapy sessions for his healing foot. The greenhouse’s need for Ramon’s labor lasts another 5 months, at which point Ramon plans to return to Mexico anyway to be with his family and enjoy the warmer weather.
As for Ramon’s $14,000 bill, a hospital administrator who arrives one day in Ramon’s room to quiz him about his U.S.-based assets admits that the hospital will likely collect absolutely nothing from Ramon. Ramon is blissfully unaware of this fact as the hospital makes virtually no attempt to collect funds from someone they deem unable to pay such a bill. Apparently, the hospital has dealt with the Ramon’s of the world before and has decided that the collection of such a debt is a loser’s game.
Whlie Ramon and Julia entered the same hospital for different reasons, the outcome of each person’s treatment is strikingly similar. Like Julia, Ramon will be escorted out of the hospital by one his nurses at the end of his 16-day stay in the hospital. Like Julia, he will have a bill that numbers in the thousands which he won’t be held responsible for. Like Julia, the hospital is left holding the bag as they are required to treat the Ramons and Julias of the world who need urgent medical care even if that person can’t pay their bill. Like Julia, Ramon can return to Mexico whenever he would like and leave any semblance of responsibility behind him in El Norte.
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