Not a Healthy Choice

Posted: Sep 20, 2004 12:00 AM

 Advice is cheap, take it from me. So here?s a tip for anyone who lives in Los Angeles. Or anyone who might soon be traveling to, near or through that city: Eat your vegetables, take your vitamins and whatever you do don?t get sick. Or injured. Or shot.

Why? Because it?ll soon be harder than ever to get the medical care you?ll need to survive.

 Last month, officials announced two emergency rooms in L.A. County would close by the end of this year. That makes six shuttered facilities in the last two years. ?We cannot stand any more closures in an emergency system capacity in Los Angeles -- this system is on the brink of absolute chaos,? announced Jim Lott, executive vice president of the Hospital Association of Southern California.

 We?re about to find out what?s beyond ?the brink.? This week, the county?s health services agency announced it would pull the ?trauma? designation at King/Drew Medical Center. Last year, that facility treated (or failed to treat, depending on your viewpoint) some 2,100 trauma patients; most were shot or involved in traffic accidents. The county says those patients will now be taken elsewhere. No doubt some will die on the way.

 The problems at King/Drew involve long-term mismanagement. But they?re also financial. About one third of the elderly patients treated there have no insurance; one in five children seen is uninsured.
Other facilities are plagued by this same problem. Officials at Good Samaritan Hospital told the Los Angeles Times they?re losing $10 million per year because of uninsured patients. The paper also reports that Downey Regional Medical Center loses $2 million annually covering the uninsured, and may soon start turning away 5,000 ambulances each year.

 All right, so we?ve identified the problem: Too many people without insurance swamping the health-care system. But before we can solve that problem, we must figure out where these people are coming from. And that one?s easy: Many are illegal immigrants.

 ?Every day, nay, multiple times each shift, I?m treating people who willingly admit they?re here illegally,? an Orange County E.R. nurse told me. ?They laugh at the ease of crossing the border and of obtaining treatment (they have related that there are groups in Mexico telling them U.S. hospitals must care for their every ailment). They cheerfully present their admittedly false IDs with no guilt with respect to what they?re doing in breaking so many laws, to people in their community, or everyone?s insurance prices, or anything else.?

 And those Mexicans are certainly well informed. According to federal law, ?A participating hospital may not delay providing an appropriate medical screening examination ? or further medical examination and treatment ? in order to inquire about the individual?s method of payment or insurance status.?

 That?s great as far as it goes. We certainly can?t have E.R.s turning away gunshot victims because their Blue Cross might be expired. However, the system clearly won?t work unless the federal government is also doing due diligence to keep illegal aliens -- who, among other things, lack health insurance -- out of the country. And in that, it?s dropping the ball.

 ?The U.S.?s borders, rather than becoming more secure since 9/11, have grown even more porous,? TIME magazine reported on Sept. 20. In fact, the magazine estimates, ?the number of illegal aliens flooding into the U.S. this year will total 3 million ? It will be the largest wave since 2001 and roughly triple the number of immigrants who will come to the U.S. by legal means.?

 Just as we can all agree that hospitals ought to treat all patients who come through their doors, we all ought to be able to agree that the government must crack down on illegal immigration. As the great California congressman Sonny Bono once put it, ?What?s to talk about? It?s illegal.?

 The state of Arizona seems like a good place to start. More than 4,000 people illegally cross its border every day. This November, the state will consider Proposition 200, which compels the government to enforce immigration laws that are already on the books.

Like Rep. Bono?s comment, that seems simple enough. After all, if the lawmakers don?t like the immigration laws we?ve got, they should change them. Otherwise, they ought to insist the laws be enforced. That, after all, is what laws are for -- not merely to be passed and then ignored. Polls predict up to 75 percent of Arizona?s voters will say yes to Prop 200.

It?s a start.

As my friend in Orange County puts it, ?There needs to be respect of the law, and it needs to be uniform. I don?t blame poor immigrants for coming here, I blame us, as in the federal, state and local governments, for making it ridiculously easy to get here and stay here.?

The dominos are falling in California. It?s time to crack down on illegal immigration, before our whole health-care system tumbles, too.