Antonio Valenzuela Gomez, a retired factory worker who boasts 49 grandchildren, lifts his shirt to show the giant scar where American doctors cut into his chest a year ago.
Gomez, 79, was at his house in the dusty Mexican border town of Naco near here when his heart began to fail. There is no hospital in that part of Mexico, so family members loaded Gomez in a car and drove him a short distance to the U.S. checkpoint.
An ambulance arrived from the Arizona side and rushed Gomez 7 miles to Copper Queen Community Hospital here. Emergency room workers stabilized him and sent him 80 miles north to Tucson Medical Center, where heart surgery was performed.
Gomez, who spent three weeks in U.S. hospitals, thinks the bill was about $20,000—likely a fraction of the actual cost. He offers gratitude along with small monthly payments that will never cover the expense. “They saved my life,” he says. “They treated me well.”
Along the border from Chula Vista, Calif., to Brownsville, Texas, U.S. hospitals serve as a medical safety net for undocumented immigrants and residents of northern Mexico. Each year, their care costs American medical centers, consumers and taxpayers hundreds of millions of dollars. During 2002, 38 Arizona medical centers surveyed by the Arizona Hospital and Healthcare Association reported losses on foreign-national patients of $153 million.
“We had super-deficits the last two years,” says Dickson, who solved his budget crisis by laying off about 35 of the hospital’s 130 employees and eliminating medical services such as the long-term care center. “This has had a very negative impact on our hospital.”
Arizona has been particularly burdened since the mid-1990s, when U.S. border crackdowns in Texas and California began funneling illegal immigrants and drug smugglers to the state’s 350-mile border with Mexico. Last year, Arizona accounted for 52% of the 1.1 million illegals captured by Border Patrol agents in the Southwest.
Hospitals use international collection companies to pursue payments. Some patients such as Gomez pay as much as they can. But most costs go uncollected.
Although public attention has focused on unpaid medical care for illegal immigrants, Pivirotto says four-fifths of the foreign nationals in his hospital entered the USA with legitimate paperwork—visas, 72-hour passes or “compassionate entry” permits granted in medical emergencies.