When Uninsured Immigrants Are Hurt, Who Pays?

“Several of the patients are young adults with families — young children they’re responsible for who are U.S. citizens. How do you say no to them?”

Suzanne Meyer, director of social work, Truman Medical Center

Caesar Sacaries-Barrios is lucky to be alive — and to still be in the United States.

The 23-year-old restaurant worker is an undocumented immigrant originally from Guatemala. He barely remembers a car wreck in November that left him in a coma at North Kansas City Hospital.

He knows nothing about the estimated $250,000 the hospital has spent to keep him alive.

He’s still unaware that the hospital — faced with the possibility of rapidly mounting bills — tried to fly him to his home country in a specially equipped plane while he was comatose.

“That shows you just how expensive this guy’s care is,” said Chuck Chionuma, a Kansas City lawyer who has been fighting a legal battle to keep Sacaries-Barrios in the United States. “They were willing to foot that bill just to get him back to Guatemala.”

Shipping a patient home may be an extreme measure. But it’s a sign of the frustration at many hospitals across the country as they care for growing numbers of poor, undocumented immigrants.

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But when the Florida Hospital Association polled its member hospitals in 2002, it received 700 reports of uninsured non-citizens who ran up bills totaling more than $40 million for childbirth, brain tumors, heart surgery and other care.

In counties that border Mexico, hospitals and ambulance services estimated that they spent more than $200 million in 2000 caring for undocumented immigrants who were uninsured

The problem is reaching deep into the heartland as well.

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Truman Medical Center estimates it spends at least $500,000 a year providing dialysis for eight kidney patients, all undocumented or resident immigrants who do not qualify for public programs such as Medicaid.

Because the patients are uninsured, the hospital has been unable to find any outpatient dialysis clinics willing to care for them.

Rather than force the patients to wait until they are critically ill to receive dialysis at the emergency room, the hospital schedules them for visits three times a week.

“Several of the patients are young adults with families — young children they’re responsible for who are U.S. citizens. How do you say no to them?” said Suzanne Meyer, Truman’s director of social work.

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