Citizenship often determines medical care - Kidney dialysis is a case in point

[okarol]

From the Los Angeles Times

Citizenship often determines who gets medical care
Kidney dialysis is a case in point: Some states won't treat illegal immigrants, but California and a few others believe not treating them is far more costly.

By Alan Zarembo and Anna Gorman

October 29, 2008

Roughly 2,000 times over the last 17 years, Marguerita Toribio, an illegal immigrant from Mexico, has climbed into a cushioned recliner for the three-hour dialysis treatment that keeps her alive.

She has never seen a bill.

U.S. taxpayers have covered the entire cost of her treatment in California: more than $500,000 and rising, not including a kidney transplant in 1993.

The kidney failed when Toribio briefly moved to North Carolina, which refused to pay for her anti-rejection drugs. She needed to go back on dialysis three days a week to clear toxins from her blood, but North Carolina didn't cover that either.

The best a social worker could offer was a prepaid plane ticket back to California.

"When I came back here, I said, 'There is no way I'm leaving for another state again,' " said Toribio, now 29, before a technician poked two needles into her arm at the St. Joseph Hospital dialysis center in Orange.

Health services and other benefits available to illegal immigrants can vary by the state. Welfare, prenatal care or in-state college tuition might be available in one place and inaccessible across a state line.

The disparities reflect the nation's conflicting attitudes toward its estimated 12 million illegal immigrants. With limited federal guidance, states often are left to make their own decisions, frequently shaped by political winds.

Dialysis offers a striking example of the dilemmas -- and the occasional absurdities -- that result.

The number of patients is not large. In California, illegal immigrants account for about 1,350 of the 61,000 people on dialysis. Their treatment cost taxpayers $51 million last year.

But dialysis stands out because it is often a lifetime commitment. The investment in a single patient over time can easily top $1 million.

Many states draw the line at illegal immigrants. But officials in California, New York and a few other states figure that not treating patients whose kidneys are failing costs more.

That is because patients without regular dialysis frequently end up in emergency rooms, on the brink of death. At that point, federal law requires that they receive dialysis until they are stable enough to be released -- usually only to deteriorate again within weeks and return to the ER.

It's like "rescuing a person from drowning, giving someone a good meal and then pushing them over the side," said Dr. Laurence Lewin, a kidney specialist in Orange County.

Repeated rescuing not only threatens patients' long-term health, it generally costs more than routine care, some experts argue. In Texas, where illegal immigrants generally can't get routine care, some have cycled through the emergency room at El Paso's Thomason Hospital more than 100 times for life-saving dialysis, said kidney specialist Dr. Azikiwe Nwosu.

Such patients are at increased risk of heart attacks and infections.

"Its heartbreaking," said Dr. Claudia Zacharek, a kidney specialist who until recently worked in Galveston, Texas. "Your hands are tied."

In grappling with what services to provide for illegal immigrants, some states tip toward the need to care for the sick. Others see free healthcare as a de facto endorsement of their presence.

Congress tried to establish a balance. In 1986, it barred illegal immigrants from the federal health benefits generally available to the poor, with one notable exception: emergencies. The federal government agreed to share the cost of caring for poor illegal immigrants through state-run Emergency Medicaid programs.

The problem is that the federal definition of an emergency is open to interpretation: an acute condition that, without immediate care, would seriously jeopardize a patient's health or impair bodily functions, parts or organs.

When does an emergency start? When does it end?

Debates have flared over chemotherapy, life-support and dialysis. In 2002, Arizona Sen. John McCain, the Republican presidential nominee, cosponsored a bill to provide dialysis and other chronic care needed to prevent expensive ER visits.

It failed. What's left is an ambiguous policy that the federal government itself has struggled to clarify.

"We do not pay for chronic care for illegal immigrants," Mary Kahn, a Medicaid spokesperson, said when asked about the issue in early 2007.

If California and other states were using federal funds to help provide routine dialysis, she said, they were mischaracterizing it as an emergency treatment.

More recently, she acknowledged that the federal government has knowingly been sharing the cost in California for years. It has long been left to the states to decide whether to provide routine dialysis, she said.

Many states, including Texas, Colorado and New Mexico, take the position that kidney failure does not automatically qualify as an emergency because patients can survive for weeks without dialysis before toxins accumulate to fatal levels.

Other states have wavered. North Carolina, for example, now provides routine dialysis for illegal immigrants. Conversely, the Georgia Medicaid program stopped paying for dialysis in 2006 amid rising sentiments in the Legislature that illegal immigrants were a financial drain.

"Georgia ain't California or New York," said Mark Trail, head of Georgia's Medicaid program until last month, noting a strong conservative tradition.

The courts haven't cleared up the issue.

A group of illegal immigrants sued Arizona in 2002 after the state attempted to cut off their dialysis. Heeding arguments that sporadic emergency treatments would jeopardize lives, a judge told the state to keep treating them while the case was decided. In a settlement last year, the state agreed to restore its policy of providing routine dialysis, but the settlement applies only to Arizona.

California's dialysis policy is largely an economic calculation, said Stan Rosenstein, the administrator of Medi-Cal, the state healthcare program for the poor that covers dialysis for illegal immigrants.

The cost of one routine treatment is about $250. The cost of providing it in the emergency room can easily climb into the thousands of dollars, especially if the patient has to be admitted to the hospital.

To advocates of stricter immigration controls, such comparisons miss the point.

"Taxpayers are on the hook for people who aren't supposed to be here," said Mark Krikorian, executive director of the Center for Immigration Studies.

The fear in many states is that offering routine dialysis will simply lure more sick people from other countries.

"We cannot provide dialysis to the world," said Ramiro Valdez, a Dallas social worker and medical consultant.

Teresita Aquino, an illegal immigrant from the Philippines, hadn't intended to stay in the United States, but being rushed to the emergency room with kidney failure eight years ago changed her mind. Now, a free transportation service picks her up three days a week for her dialysis in Torrance.

"If I go home, I won't be able to afford this," said Aquino, 56. "No way am I going home."

In general, however, California's recent experience does not suggest that free routine dialysis will become an open invitation to illegal immigrants with kidney failure. The number of undocumented immigrants on government-funded dialysis jumped from 835 to 1,327 between 1998 and 2001 but has remained fairly steady since.

Social workers and doctors in Texas and other states said patients may be vaguely aware of the services in California, but they are often too sick to move by the time they understand the gravity of their plight.

Some hospitals in Texas quietly encourage illegal immigrants to move to Houston, where the public hospital district uses local taxes to pay for routine dialysis even though the state Medicaid program does not.

Dr. Karla Vital, a kidney specialist at University of Texas Medical Branch in Galveston, said her hospital encourages Mexican nationals to return to Mexico. Some hospitals pay for plane tickets back.

Mexico offers dialysis to those who can afford it, but access is far more limited for the poor.

Delia Lopez, a 42-year-old illegal immigrant who recently started dialysis in Los Angeles, said she would rather be with family in Mexico. But she can't afford the treatment there, she said.

"I have friends who have died because of lack of dialysis," said Lopez, a longtime diabetic who arrived in the U.S. four years ago while her kidneys were still functioning.

The only alternative to dialysis is a kidney transplant, a procedure California and a few other states provide to illegal immigrants. Last year, 52 of the 1,912 kidney transplants in California were for illegal immigrants.

Several studies show that a transplant pays for itself in three dialysis-free years. Critics, however, say that dipping into the organ pool is a greater outrage because so many citizens are waiting.

"It's not like you go to Costco and pick up a kidney," Krikorian said.

Toribio is now seeking a second transplant.

She said she is grateful for the care she has received in California. But Toribio, who works in a textile factory for $8 an hour attaching tags to blankets, towels and bathmats, believes the United States should accept it as the price of a cheap labor pool.

As much as she would like to visit her parents and grandparents in Mexico, she has never returned.

It is not worth the risk of leaving California: She might not be able to get back.

Gorman and Zarembo are Times staff writers.

alan.zarembo@latimes.com

anna.gorman@latimes.com

http://www.latimes.com/news/local/la-me-dialysis29-2008oct29,0,4485373,full.story

[okarol]

L A Times - COMMENTS related to story
Discuss
Should the funding of dialysis for impoverished illegal immigrants be left up to states?

1. Amazing! In the meantime, Medi-Cal treats American citizens with AIDS and other serious diseases like garbage. My monthly share-of-cost is $579.00 per month, while my monthly SSDI is less than $1200.00. If I lied and said I was an illegal, my healthcare would be absolutely free. I'm being penalized for working and paying taxes in California all my life.
Submitted by: Amazed
5:42 AM PDT, October 29, 2008
2. We treat illegal immigrants better than US citizens. We should enforce the laws as written and treat them exactly as Mexico would treat an American who crossed the border without permission. If Mexico is so unable to care for its own people with medical care and jobs, perhaps the Manifest Destiny bunch I read about in high school were RIGHT.
Submitted by: Jim
5:28 AM PDT, October 29, 2008
3. Lets get the word out that California is a pro-illegal state with free food stamps, free medical care, college and everything else needed to live a healthy live. The state will even supply nannys and mid-wifes for those in need. Illegals move to California and send for your famlies in Mexico. The sunny state of California welcomes you along with the MS-13 members and drug dealers.
Submitted by: budswisr
5:27 AM PDT, October 29, 2008
4. Those who are angry should 1) call Barbara Boxer and Diane Feinstein, and your congresspeople. The number for Congress is 202-224-3121, and then just ask for your senator or congressperson by name and tell them what you think about illegal immigration. Don't just call them once. Call them repeatedly. 2) go to numbersusa.com, and join. They will email you when Congress is debating an issue of importance in the fight against illegal immigration.
Submitted by: David
5:25 AM PDT, October 29, 2008
5. Treating hard working "illegal" immigrants is the moral thing to do as they serve us here doing jobs others will not. Most of them I know work with fake SS numbers and pay taxes but never can collect. They are much better than the millions of native born that live off of welfare and other public programs while they have good income "off the books" and never pay any taxes. I have met several people that brag that they work in construction and have never even filed a tax form while living in their own big home and drive new cars. The IRS encourages this by letting the contractors pay off the books.
Submitted by: USCitizen
5:06 AM PDT, October 29, 2008
6. We have no obligation to provide non emergency care to Mexican nationals. We should bill the Mexican goverment or withhold and payments to the Mexican government for all of the unfunded care we provide to Mexican Nationals or they should reimburse us with free Mexican oil. Do you think a US citizen would get free medical care in Mexico, I don't think so. We as a nation are already strectched to point to considering a socialized system like England or Canada where there are age limits for dialysis for their own citizens. We don't have enough money to service our own citizens how can even begin give free services to non citizens.
Submitted by: Bill the Mexican Government
4:52 AM PDT, October 29, 2008
7. A friend of mine, an African-American male, is on dialysis awaiting a kidney transplant. Now, why should illegal aliens be able to get one before he does, or before ANY citizen or legal resident?
Submitted by: Ali
4:49 AM PDT, October 29, 2008
8. States should give them a treatment and then turn them over to ICE for deportation.
Submitted by: Karen S
4:35 AM PDT, October 29, 2008
9. How can illegal immigrants sue a state?? Did I read that right?? Illegals sued Arizona??!! We are giving this country away little by little..
Submitted by: Mike
4:29 AM PDT, October 29, 2008
10. The Times just ran the story of an American truck driver from Pine Mountain Club, CA who needs a liver transplant. His life is in jeopardy yet he must come up with the funding himself for any possible transplant that could save his life. The state of California isn't there for him yet it has been for illegal alien Marguerita Toribio and has been since 1993. The irony is appaling. Send Marguerita Toribio and everyone like her back to where they came from and help Americans who really need it.
Submitted by: Just a citizen
4:25 AM PDT, October 29, 2008
11. The simple question begs to be answered: why aren't illegals deported?
Submitted by: confused
3:56 AM PDT, October 29, 2008
12. So let me get this straight, California has a multi-billion dollar budget deficit, and we are voluntarily paying to treat the citizens of another country who break our laws, while the rest of us do without enough funding for essential services like roads, schools, etc.? The leaders of our state should be impeached.
Submitted by: Brian
3:36 AM PDT, October 29, 2008
13. How can this nation be so foolish ? We let our own citizens suffer, declare bankruptcy because of extremely high hospital and medical coverage, argue with balky health insurers to cover necessary medical costs. and fight while we are sick and our coverage is suddenly cancelled, while we deal with a whole host of other problems as the cost of being responsible citizens. We're not done there however we need to pay for longterm care and transplants for people who are here illegally as well. Stabilize them and deport them. EMERGENCY CARE ONLY:
Submitted by: Kate
3:09 AM PDT, October 29, 2008
14. Treating illegal immigrants at the expense of legal American citizens and tax payers is putting an undue burden on already strapped Americans who are struggling to pay their own bills and stay afloat. Perhaps the answer is that they should go home to their native countries for treatment. It is an insult to law abiding, legal U.S. citizens to have to foot the bill for their medical and other expenses while they send money home to their relatives in their native countries.
Submitted by: Stretched to the limits!
1:09 AM PDT, October 29, 2008
15. From the parents of legal migrants, I can't believe this is happening. Why do I have to play by the rules when others aren't? Maybe I should just pretend to be an illegal the next time I'm at the hospital.
Submitted by: tireddude
12:21 AM PDT, October 29, 2008
16. once again we see the abuse of our system rewarding law breakers, i lost my job in construction and tried to get help from the government dream on
Submitted by: mexical
12:09 AM PDT, October 29, 2008
17. How can we even consider offering illegals care when US citizens are going bankrupt or facing financial catastrophe during their hour of greatest need (e.g. when they're battling cancer or any other debilitating illness). If you bleeding heart liberals want to offer these illegals care do it with your own pocketbook, set up a private fund to pay for their health care, college tuition, etc. Either that or stabilize the illegal aliens and send them back home.
Submitted by: Stretched out on the Rack
11:56 PM PDT, October 28, 2008
18. we are in a recession and we are paying for illegal immigrants who are violating the federal laws by being here without proper documentation These people knowingly entered the states unlawfully. I think we need to stop giving them any services at all paid for by federal or state money. I cant get food stamps and I need them I cant get free health care and I need it I am a native to california and a legal us citizen who pays taxes this seems very unfair to me think about all the americans you know who need aid and are being denied thats the crime dening americans benefits they pay for and giving it to ilegal immigrants.
Submitted by: harrassed daily by latinos
11:46 PM PDT, October 28, 2008
19. This is ridiculous that we assume every human life is precious. People need to die as part of the life cycle and for the U.S. to spend money to keep the unnecessary labor force alive is a gross misuse of the taxpayer trust. Gather illegals in the dialysis room and send them home.
Submitted by: Chris
11:00 PM PDT, October 28, 2008
20. The answer is simple. Until those who are receiving treatment become legal citizens; continue to treat them and bill their county of origin.
Submitted by: Juan
10:30 PM PDT, October 28, 2008
21. If health costs could be covered magically by the wave of a hand, I'd say go ahead. Unfortunately, it's the taxpayer who must foot the bill for illegal alien healthcare. This will eventually lead to the bankruptcy of the entire healthcare system for every Californian. Sadly, they must be turned away for any problem that involves long-term healthcare. Our first responsibility must be to our own citizens.
Submitted by: Tom
10:23 PM PDT, October 28, 2008
22. Free dialysis is absolutely a magnet for illegal immmigrants in renal failure. They are an enourmous drain on an already broken system. Socialized medicine (ie rationing)is a certainty in the next ten years.
Submitted by: buz
10:09 PM PDT, October 28, 2008
23. Your a sneaky and underhanded paper, putting this article in the paper right before election! that's right take the focus off that video of Obama!
Submitted by: Marie
9:39 PM PDT, October 28, 2008
24. Thats right blame it on Mc Cain right now right before elections! we know your pro Obama!
Submitted by: Marie
9:36 PM PDT, October 28, 2008
25. NO!! And again NO! Send them back to their own country. Give them a prepaid ticket to where they came from.
Submitted by: Ann
9:36 PM PDT, October 28, 2008
26. First, federal law should be enforced -- they should not be here. Second, since that's not happening, let states decide -- illegals are already going to states that provide it and leaving those that don't. Third, illegals are already experienceing what we will get if we want "free" healthcare in this country -- states deciding what is an emergency and what is not...who gets care now and who has to wait.
Submitted by: John
9:34 PM PDT, October 28, 2008
27. why are they NOT being deported?
Submitted by: karin
9:31 PM PDT, October 28, 2008
28. As a citizen who was UNABLE TO GET HEALTHCARE IN HER OWN STATE, THIS IS APPALLING! GIVEN THE ISSUE OF HUMAN RIGHTS I CAN SOMEWHAT UNDERSTAND, BUT WHEN OUR OWN PEOPLE CAN'T GET INSURANCE, THIS IS REDICULOUS! OUR VETERANS ALSO DESERVE THE BEST!!!! FURIOUS IN CA! PS: I AM A DEMOCRAT!
Submitted by: Gabi532
9:18 PM PDT, October 28, 2008
29. It's a tough call, but they are human beings and we need to save them in these emergency situations. It's too bad their own countries(wherever they are from) cannot take care of them.
Submitted by: Lilly Ann
9:09 PM PDT, October 28, 2008
30. WHAT CAN I SAY?!?!?! THIS IS ABSOLUTELY UNBELIEVABLE. THE U.S (NAMELY CALIFORNIA) HAS OPENED ITSELF UP TO BEING TAKEN ADVANTAGE OF BY BLOOD SUCKING ILLEGAL-IMMIGRANTS. OUR RESOURCES ARE ALREADY DRAINED BEYOND REPAIR (AT LEAST NOT IN THE NEAR FUTURE). OH... AND BY THE WAY, HAVE YOU HEARD OF THE THOUSANDS OF ILLEGALS WHO WENT (AND ARE GOING) BACK TO MEXICO BECAUSE THE GOOD OL' U.S.HAS FALLEN ON HARD TIMES? PLEASE TRY TO PERSUADE THE OTHER MILLION TO GO BACK WITH YOU. THEY'LL TRY TO COME BACK ONCE WE ARE HIGH ON THE HOG AGAIN. SO U.S.A., IN THE MEANTIME SHUT THE DOOR AND BUILD UP THE GATES.
Submitted by: AVRIL
9:05 PM PDT, October 28, 2008
31. an accurate portrayal of why we should not provide health care to illegals. when they come in for treatment, we should deport them. if you love illegals, you love the decline of california. if you love illegals, you should give half of YOUR income to support them. to suggest that we should all share in the cost is ridiculous.
Submitted by: steve
8:50 PM PDT, October 28, 2008
32. There are thousands of Americans that have contributed to America all of their lives. When they retire, instead of rewarding them with free medical care, they pay large co-payments and deductibles, and often can't afford the medicine that is prescribed to them. They take half-doses, or go to other countries on-line pharmacies to survive. Meanwhile we spend millions on lawbreakers to "keep them alive". This is an American disgrace. The most we should do is give them dialysis and a one way ticket to where they came from.
Submitted by: Taxpayer
8:43 PM PDT, October 28, 2008
33. Nice! This lady gets free medical treatment courtesy of the U.S tax payers. Some Americans went/are going bankrupt due to medical bills. Some chose(will) not seek medical treatment and died (will die) because they don't to pass the burden to their family and others.The government is willing to help non-citizens. Something is wrong with this picture. Do you think if I was in their country, I would get the same treatment?
Submitted by: Proud American
8:40 PM PDT, October 28, 2008
34. My mother had type 1 juvenile diabetes, and was on Peritoneal Dialysis for 6 years before she died. Our family had insurance, but the deductible, out of pocket expenses, and home health care aide costs were more than $1000 a month, just for dialysis, her other hospital bills were astronomical. It appalls me that American citizens can be driven bankruptcy paying for health care that is given for free to foreign nationals that shouldn’t even be here Illegals w kidney failure should be stabilized & sent home, give them Peritoneal dialysis supplies if they must. Illegals should NOT get free health care, nor should qualify for transplants.
Submitted by: Kathleen
8:37 PM PDT, October 28, 2008
35. "but California and a few others believe not treating them is far more costly." So, how is it more costly? Ship these deadbeats back home to where they came from. Californians shouldn't have to pay for illegals. Who says it's more costly?
Submitted by: Rachel Cohen
8:37 PM PDT, October 28, 2008
36. "If I go home, I won't be able to afford this," said Aquino, 56. "No way am I going home." Ship her back! How on earth does she think that total strangers should pay for her care?
Submitted by: Rathbone
8:34 PM PDT, October 28, 2008
37. This story makes it very obvious why Ca. is going broke. This is not fair to legal residents of Ca. Send their bill for U.S.A care to the country they came from or deduct it from the financial aid that we give that country. Then maybe their own country will start taking care of them, and they can go back to their homeland!
Submitted by: Mary
8:34 PM PDT, October 28, 2008
38. If you want to pay for illegals medical treatment I don't care just do not expect my tax dollars to do it . It is your policy then you should pay for it not me with my taxes here in Pa If your liberal policies cost your state to go broke, as i have read, oh well. You choice your way. Now deal with it. Like Ford said to New York "drop Dead"dead"
Submitted by: dingoman
8:31 PM PDT, October 28, 2008
39. Why is this article about what the US taxpayer will or won't provide? The person in the article is From A Country..a Citizen..why not write an article about that Country dumping ill citizens on the US taxpayer..Why is it the responsibility of the American Taxpayer rather than the taxpayers and government of this person's country of origin? That is the Real Issue
Submitted by: X
8:22 PM PDT, October 28, 2008
40. As our governor continues to advocate tax increases this article is a reminder of how taxpayer money is being squandered in California. Dialysis and transplant are extremely expensive treatments that should be reserved for American citizens only. As a taxpayer, kidney transplant recipient, and former dialysis patient the fact that illegal aliens can tap scarce organs, treatment, and funding all of which are in short supply is an outrage.
Submitted by: liveccam
8:20 PM PDT, October 28, 2008
41. Once discovered as an illegal immigrant, one treatment should be provided for free, with a free tattoo or embedded microchip to identify them, then provide them with an INS officer to accompany the person back to their own country ASAP (also for free). Call it God's mysterious plan. If the individual is well enough to sneak back into the US again, let them pay for their treatment or get turned away at the hospital door.
Submitted by: bb
8:08 PM PDT, October 28, 2008
42. This is insane. One illegal alien alone costing California half a million dollars, while the State is going broke. Umm... why are these people not being deported???
Submitted by: DTS
8:01 PM PDT, October 28, 2008
43. Give me a break. My family went a long time without insurance, but we worked hard and finally got it. There is no way that illegal aliens should get "free everything" and taxpayers get stuck with the bill. My family came to America LEGALLY, then worked hard,I put myself through college with no assistance and paid for my own insurance. California will go broke trying to pay for free medical and then go begging for nationalized care or more money from real taxpapers.
Submitted by: Ginny
7:55 PM PDT, October 28, 2008
44. I read today that the Governor is going to short education two to four billion dollars in an effort to close the State's budge defecit. How can we afford to spend large sums of money on health care for illegal immigrants? Who's State? Who's money? What next?
Submitted by: tarwater
7:50 PM PDT, October 28, 2008
45. Providing hemodialysis to illegal immigrants is economic suicide for most states. States like California, New York and New Jersey do NOT have the financial resources to cover indigent care, much less hemodialysis. As a physician and a nephrologist, I see this everyday. If you provide free hemodialysis, illegal immigrants will come. Where is the limit? Those who argue that the government should cover dialysis should find the money to pay for it. Our compassion should not overwhelm our reason.
Submitted by: a kidney doctor
7:39 PM PDT, October 28, 2008
46. I love contributing tax dollars to pay for care to immigrants. I love paying high premiums each month for my health insurance. It should up to the citizens of each state to decide whether or not to pay for impoverished illegal immigrants free health care. They made the decision to come here and work for cheap wages. It is not a "given" that the state pay for this type of costly care.
Submitted by: msnidc
7:35 PM PDT, October 28, 2008

[Rerun]

Sorry Karol I didn't read the second article yet because I'm so p*cking outraged at the first!  Dialyze them and deport them.  NO wonder California is broke!

This is the most outrageous!:  "The only alternative to dialysis is a kidney transplant, a procedure California and a few other states provide to illegal immigrants. Last year, 52 of the 1,912 kidney transplants in California were for illegal immigrants."

I wonder how many illegal immigrants were donors? 

This just pisses me off beyond belief.   

[Rerun]

OK I read the second response letters and I feel much much better!

                                         

You better bet Obama will continue this free dialysis to all the world through the Unites States!  Spread the Wealth (dumb ass)

[paul.karen]

WOW  Thats it WOW....

Im glad i am paying my taxes so the wealth can be spread.
Well until i need help.  I am not illegal so i suppose i wont be getting anything for free.

Maybe i will move to mexico become a mecian citizen, then sneak back here to america and ill do just fine and get everyhting for free.
Right??

[Rerun]

       

That is a good plan Paul!

[Sunny]

I live in California and I'm outraged.
I cannot believe they are provided transplants over law abiding American citizens, much les repeated dialysis treatments.
Maybe the transplants they are receiveing are from family memebrs who wouldn't donate otherwise. I sure hope they are not being given transplants over American citizens waiting on "the list." Maybe they should be stabalized and then given a plane ticket back to Mexico. That would be the cheapest outcome altogether. Until we have National Health care for Americans, I see no reason for giving illigal immigrants conceivably better treatment than our own citizens.

[petey]

This outrages me, too!

About five or so years ago, there was a big stink at Marvin's transplant hospital (Duke Hospital in Durham, NC).  An illegal immigrant (a teenage girl from Mexico -- undocumented, parents undocumented and came to the US for medical care for their sick daughter) received a heart/lung transplant at Duke.  It was the wrong blood type for her.  (Don't know how that ball got dropped, but it was a scary thing for the rest of us listed there, too).  She became deathly, deathly sick, and was bumped to the top of the list again.  A few days later, she got another heart/lung transplant (right blood type this time), but she ended up dying a few days after that.  Her parents (who don't speak any English) sued the hospital, the doctors involved, etc.  I was saddened by this young woman's death, as it was very tragic.  However, I also thought, "Here her parents admitted that they snuck into the US undocumented.  And, she received not one BUT TWO transplants within a matter of days of each other.  Does that mean that two tax-paying, "legal" Americans died waiting so she could have two chances?"  Something's just not right about that.  And, then they sued on top of that!  How twisted is that?

I say put the illegal immigrants at the bottom of the list.  After ALL Americans on the list have a transplant, then the immigrants can have any donated organs that are left over.  They shouldn't come first -- they should come last.  If they don't like this system, go home and try to get a transplant there.  Also, we're paying for their dialysis??  And, then we're being sued because it's not provided as they think it should be?  WTF   Where did they get these "rights"?  They shouldn't have free medical care -- we don't!

I'm pissed.

[pelagia]

You better bet Obama will continue this free dialysis to all the world through the Unites States! 

Isn't California run by a Republican? 

[okarol]

I hope anyone who has a minute will write to the LA Times reporters and encourage them to keep writing about dialysis. Alan Zarembo is the journalist who wrote the story about our search for a living donor in Dec. 2006. Their email addresses are at the end of the article.

[willieandwinnie]

You better bet Obama will continue this free dialysis to all the world through the Unites States! 

Isn't California run by a Republican? 

Sorry pelagia. California Senate is run by Democrats.

[Rerun]

You better bet Obama will continue this free dialysis to all the world through the Unites States! 

Isn't California run by a Republican? 

Sorry pelagia. California Senate is run by Democrats.

Democrat Nancy Pelosi is a California Girl! 

[florence]

First of all, this article is improperly titled ("Citizenship often determines medial care").  Just because someone is not a citizen does not mean they are not in the U.S. legally.  There are many immigrants who may not yet be citizens who are here LEGALLY (i.e. work visas holders, green card holders, asylees, etc.).  While immigration is a tough topic, I'd like to point out that many illegal immigrants do pay taxes (2/3 of illegal immigrants pay Medicare, social security and personal income taxes) and contribute to the American economy in many other ways.  So, perhaps before we take a stand on issues such as these, we should get all the facts straight.  I often see many complaints on this site about people who are ignorant about dialysis issues.

[pelagia]

You better bet Obama will continue this free dialysis to all the world through the Unites States! 

Isn't California run by a Republican? 

Sorry pelagia. California Senate is run by Democrats.

As noted in the article posted by Okarol, Medi-Cal is California's healthcare program for the poor that covers dialysis for illegal immigrants.  Medi-Cal is administered by the California Department of Health Services, part of the Executive Branch, which is controlled by the governor.  Don't know California politics up close and personal, but in our state the governor's office can directly control agency policy, as well as their budgets.

[Rerun]

First of all, this article is improperly titled ("Citizenship often determines medial care").  Just because someone is not a citizen does not mean they are not in the U.S. legally.  There are many immigrants who may not yet be citizens who are here LEGALLY (i.e. work visas holders, green card holders, asylees, etc.).  While immigration is a tough topic, I'd like to point out that many illegal immigrants do pay taxes (2/3 of illegal immigrants pay Medicare, social security and personal income taxes) and contribute to the American economy in many other ways.  So, perhaps before we take a stand on issues such as these, we should get all the facts straight.  I often see many complaints on this site about people who are ignorant about dialysis issues.

I doubt very much that someone on dialysis will then go work in the fields for 12 hours.  And since you are NOT on dialysis you don't really know.  When you say that you see many complaints on this site about people who are ignorant about dialysis issues...... I ask myself (how does she know)

That is not to say you can't have your opinion.   

The lady in the article worked in a Textile Factory?  Where in California?  I'd like to know where she works in a Textile Factory.

[florence]

Interesting attack, but poorly reasoned.  Whatever your views are about illegal immigrants, I want to make two points.  First, your post seems to suggest that people on dialysis cannot perform certain tasks.  People can overcome a great deal and as you can see from this board, people have overcome many obstacles.  So, I do not see why the woman could not continue to work in a textile factory despite being on dialysis.  The tasks she performs do not necessarily have to be physically intensive. 

Second point, I am offended -- and I am sure many others on the board are offended -- that you would insinuate that a person not on dialysis cannot sympathize/empathize with someone on dialysis. A lot of us live every second of our lives feeling the same pain/frustration/heartache of facing these obstacles.   I will not, however, defend my life to someone who makes ridiculous personal attacks. 

[Rerun]

I can have my opinion and I don't care who I offend.  If you have not sat in a chair for 3+ hours with 15g needles in your arm/leg and have not had your blood pressure drop to 70/50 and have not had your legs twist in half with cramps and thrown up on yourself and had to sit in it, or had the person next to you shit their pants etc, etc, etc.......you have no idea.

I'm sure most people NOT on dialysis would have to agree with me.  AND there is no way these illegals go on dialysis and then go to work.  Most of us can't.  Why would you if you get it free.  My point is I worked for 20+ years (6 of them in California) and I don't want to give my tax dollars to illegals.  They can have one treatment and then deport them.

[kidney4traci]

Waiting for a transplant myself - I can't understand someone coming in to US illegally and getting preferred treatment - or any treatment - before me.  That is BS.

[okarol]

First of all, this article is improperly titled ("Citizenship often determines medial care").  Just because someone is not a citizen does not mean they are not in the U.S. legally.  There are many immigrants who may not yet be citizens who are here LEGALLY (i.e. work visas holders, green card holders, asylees, etc.).  While immigration is a tough topic, I'd like to point out that many illegal immigrants do pay taxes (2/3 of illegal immigrants pay Medicare, social security and personal income taxes) and contribute to the American economy in many other ways.  So, perhaps before we take a stand on issues such as these, we should get all the facts straight.  I often see many complaints on this site about people who are ignorant about dialysis issues.

The online article has a different title - I just saw the print version and it's entitled "Dialysis Dilemma: Who gets free care?"

I am curious where "2/3 of illegal immigrants pay Medicare, social security and personal income taxes" comes from. Undocumented workers cannot get social security numbers.
From SSA:
If you are not a U.S. citizen, Social Security must see your current U.S. immigration documents. Acceptable documents from the Department of Homeland Security include your:

    * Form I-551 (includes machine-readable immigrant visa with your unexpired foreign passport);
    * I-94 with your unexpired foreign passport; or
    * Work permit card (I-766 or I-688B).

[petey]

The first line of the article states that this lady is "an illegal immigrant."  That says it all.  She's here illegally, and she's obviously not trying to hide that.

[florence]

Please read this New York Times Article, "Illegal Immigrants Are Bolstering Social Security With Billions."  My point is simply this, before launching blanket attacks at others, please gather and research the facts.  http://www.nytimes.com/2005/04/05/business/05immigration.html.  This article explains how illegal immigrants contribute to social security.

As for your comments Rerun (which my husband -- the one ON dialysis -- finds ridiculous), I think I will go out and get some ice cream with lots of phosphorous and potassium -- in your honor.

[paul.karen]

To many LIBERALS twist the word illegal for there own purpose.

Illegal is being renamed to Undocumented by the liberal left.

Be them illegal or undocumented they SHOULD NOT get better care then an american.
The liberals did the same with the word Terrorist and turned them into insurgents.

But then again liberals also think Illegals should have better care then Americans.  Unitl it is someone in there family in need.  Then they seem to wake up and see they were wrong to begin with.

I am speaking to the hard core liberals not the daily mainstream liberals.

[florence]

This will be my last post, because I actually have to get back to work.  I think the issue discussed in the article is a tough one -- I have mixed emotions about it.  Neither my husband or myself are illegal immigrants, and my husband is in fact in need of a kidney.  My plea has been pretty simple -- accurate information is important, whether the issue involves immigration or some other issue.  As you can see from the New York Times article, illegal immigrants DO contribute to social security -- there's no "liberal bias" here, it's a fact.  I think it's important that information is presented in a balanced fashion.  I have compassion for anyone faced with these dilemmas -- whether illegal immigrants or U.S. citizens.  Compassion is the key word.  It certainly does not mean that some policies might not be in need of reform.

[monrein]

Florence, I appreciate and applaud your support for your husband and the time and energy that you have put into understanding the struggles and the issues that we, as ESRD patients, must face in order to live.  I do not believe that you have to experience the horrors first hand to understand how torturous they can be.  You, a healthy young person, have made the commitment to join your life with someone who is unable to do many of the normal things that others your age take for granted and by so doing you have demonstrated that you are willing to sacrifice some of these things too.  It's not easy to be a patient and it is also not easy to love and care for someone who will never be totally "better".  When someone we love hurts, we do too, and when you love someone whose life is a chronic health roller coaster, you're on that ride too.  The only difference, and it is a major one, is that you CAN get off the roller coaster and we patients cannot.  The fact that you and others, choose to stay and ride the rails with us is an act of great generosity and indeed a sign of significant maturity.

When my husband tells me that he'd take it all from me in a heartbeat and I know he would it makes me cry, really cry, because I like to think I'd be as good and kind but I  honestly don't know if my character would pass the test.

 Obviously, California, or any where else for that matter, can't afford to pay for dialysis for non-citizens but my heart still aches for anyone who has kidney failure and who must face deportation and possibly death.  It's a sad thing in my view.  

Just because tough measures need to be applied in a variety of circumstances doesn't mean that we can't feel compassion for the very real people who get caught in these circumstances which may be quite different from our own, sometimes due to sheer luck.

Many of the immigrants (all legal), at my clinic do indeed work on dialysis.  One guy is an upholsterer and he gets to D exhausted, but he has to work to support his family so he does.  Another works the night shift somewhere and another works for the post office.   They amaze and impress the heck out of me because I have way more advantages in life than them but I'd have a hard time holding down a full-time job right now.  I'm very lucky and I know it.

[paul.karen]

Florence the bottom line is an easy line to see.
I dont care what they are paying
they are simply ILLEGAL and get things handed to them on a silver plater.

Sneak into Mexico and get caught.  See what happens. 

I dont think anyone is saying anything negative about green card holders.