Posted on August 30, 2006

Illegal Immigrants Drive Up ER Costs

Michael Arnold Glueck, M.D. and Robert J. Cihak, M.D.,, August 30, 2006

In one of a series of hearings occurring in 13 states over the month of August, a panel of the U.S. House of Representatives was told that TennCare pays about $15 million yearly in emergency care for illegal aliens. TennCare pays only for illegal aliens who would otherwise qualify for the program; the remainder of the burden falls on hospitals. So notes The Association of American Physicians and Surgeons Inc. in a statement on August 26, 2006.

Gary Perrizo, director of accounting at Vanderbilt University Medical Center, estimates that his facility incurs $3.8 million in unreimbursed costs annually because of illegal aliens, a fraction of the more than $74 million total.

Republican Representatives Marsha Blackburn and Nathan Deal, both from Georgia, are concerned that many illegal immigrants are receiving care with forged documents. No evidence concerning the actual amounts was presented at the hearing (Tennessean, 8/11/06).

In general, hearings have been poorly attended, and activists complained that citizens were given no opportunity to speak (Houston Chronicle, 8/25/06).


Compounding the current higher ER, hospital and environmental costs is the fact that nearly a quarter of U.S. births are to immigrants. This, according to a study in 2005, is a record higher than at the peak of the previous great immigration wave in 1910. Nearly 42 percent of those births are to mothers in the country illegally.

Do the math, and this means that 10 percent of U.S. births are to illegal aliens.

“We are heading, if you will, into uncharted territory,” said last year’s study author, Steve Camarota, director of research at the Center for Immigration Studies. “In the past, immigration was significantly reduced when it reached a similar level, but that’s not happening today.”

Comments noted historian Philip Gold, Ph.D., of Seattle, “This whole situation sounds like an excerpt from an Ayn Rand novel.”

To which we add that to allow this absurdity to happen we must be either the most foolish people on earth, delusional, or as a country have a latent wish for destruction.

Centinela Freeman HealthSystem is considering closing the emergency room at its Memorial campus in Inglewood, a step health experts and patient advocates say could further destabilize Los Angeles County’s fragile emergency care network.

The health system said it is reviewing a plan that would shift the patients treated in Memorial’s emergency room to its Centinela campus, also in Inglewood, about 1 1/2 miles away. A decision is expected within 30 days.

Memorial, formerly known as Daniel Freeman Memorial Hospital, treated about 38,000 patients in its emergency room last year. Centinela treated about the same number, but it has room to handle more, officials say.

If the Memorial emergency room is closed, it would mark a major turning point for the 358-bed hospital, which has had three owners in the last five years. Earlier this year, the health system moved obstetric services from Memorial to 370-bed Centinela.

“These are tough decisions,” health system President and Chief Executive Michael A. Rembis said in an interview. “We are losing a lot of sleep over this. We’re going to do what we believe is best for the community.”

But Carol Meyer, director of Los Angeles County’s emergency medical services agency, called the prospect “devastating.” She noted that nine emergency rooms had shut their doors in the county in recent years, but said: “This is going to be the biggest one yet.”

“I want the public to know that their healthcare system is in jeopardy,” she said.


But community leaders say they feel betrayed by the news.

“It’s a good business model but it’s very bad for healthcare,” said Lark Galloway-Gilliam, executive director of Community Health Councils Inc., a consumer advocacy group. “I am so angry. The sad thing is we don’t have any control over this situation.”


The health system said it had hired the Camden Group, a consulting firm, to analyze its options and the potential effect of closing the Memorial emergency room. The study found that nearly two-thirds of the emergency room patients at Memorial and Centinela were treated for non-emergency and non-life-threatening conditions, the system said.

Data submitted by Memorial to the Office of Statewide Health Planning and Development showed that Memorial treated 16,000 patients last year that it characterized as “severe,” representing about 42% of all emergency room patients.


Emergency rooms can be a financial drain on hospitals because, by law, they are required to screen and stabilize any patient who comes to them, regardless of insurance status.

By comparison, hospitals without emergency rooms can offer only those services with acceptable profit margins and screen which patients they admit.