Doctors cannot turn illegals away

The loud arguments about health insurance coverage for illegal/undocumented aliens overlooks important issues. We are dealing with two problems: immigration control and health care.

Our borders do have to be made secure, and illegal aliens must be identified, and then a decision made as to what to do with them -- can they stay or will they be deported?

The second problem is that illegal aliens do get sick, and when they seek health care, usually in an emergency room, they are very sick. They get this way because they do not seek preventive care, or early care for illness. They avoid health-care providers because they are poor (most of them work at minimum wage) and uninsured, and because they fear contact with "the system." They are concerned that physicians will turn them in to the Immigration and Naturalization Service.

Well, what do we do with these people? They are sick, often critically so. We cannot turn them away. So they are treated, and hospitals and physicians absorb the loss (No, we don't pass the costs on to paying patients. Most of our payments are predetermined by Medicare or HMOs or similar contracts). After discharge, they can't afford to fill prescriptions, and they can't afford follow-up care. So the cycle repeats.

The problem of illegal immigration is a major one, but it is not the same as financing health care for illegal immigrants. Stating that no new health-care financing system will cover these people is just passing the buck. We cannot turn them away to die.

Melvyn L. Haas, M.D., FAAN.

Aiken, S.C.

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