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Tuesday, January 22, 2008

Ethnicity, visa status are not cost concerns, say Vanderbilt and St. Thomas hospitals

"The more expensive patients in the Hispanic community are the same as the ones in the Caucasian community"

St. Thomas Hospital and Vanderbilt University Medical Center spokesmen bucked the implication that Hispanic Nashvillians and/or visaless Nashvillians hurt their overall missions of healing, according to this Tennessean article on the intersection of immigration and health care:
A patient's legal status doesn't matter at St. Thomas Hospital in Nashville, where spokesman Paul Lindsley said the main mission is to care for the poor. "We treat all persons, regardless of their situations," he said.

For five years, the hospital has operated the St. Thomas Family Health Center South in south Nashville, and Lindsley said about 80 percent of the clients there are Hispanic.

On payments, "we have a sliding scale," he said. "We serve those who are uninsured and underinsured."

At Vanderbilt University Medical Center in Nashville, the concern isn't illegal immigrants. It's uninsured patients, regardless of their citizenship.

"I would say the more expensive patients (to VUMC) in the Hispanic community are the same as the ones in the Caucasian community," hospital spokesman John Howser said. "Those are the ones that are uninsured and critically injured."

Article cites "hate group" report without further comment

A cite of questionable origin slipped into the article, raising the issue of a broader problem not raised by the Tennessean: the influence of extremism in the nation's immigration policy debate. One sentence after describing as "sketchy" the available data on health care costs to underground expatriates, a report is cited on the subject without any mention by the Tennessean that the sponsor of the report was recently added to a list of hate groups.

Denouncing scapegoat approach to health care

In a previous Tennessean report in August 2006 TennCare director Dr. Darin P. Gordon is said to have testified before a Congressional hearing that a small percentage (an estimated 0.2%) of the TennCare budget is spent on underground internationals. The Tennessean said that Gordon "rejected the idea that illegal immigrants are sneaking onto the TennCare rolls for regular medical care, saying the program has always required various types of documentation for enrollment." Shortly after the hearing in which Gordon appeared, the Tennessean published an editorial denouncing legislators' finger-pointing at illegal immigrants and their failure to propose broader health care solutions. The editorial tracked the sentiment of a 8/16/06 letter to the editor from Nashville ER emergency physician Michael Hasty.

Legislative attempts to inject visa status and citizenship checks into the hospital setting have been rejected by various Middle Tennessee health care providers, even when it would cost them federal funds. The providers and their associations who have come out on record against immigration-based health care decisions are HCA, Vanderbilt (story here), the Tennessee Hospital Association, and the Bedford County Medical Center in Shelbyville (story here).

Rather than constricting its pocketbook to shy away from health care for underinsured and international patients, HCA and the HCA Foundation donated $1.5 million (story here) to the Siloam Family Health Center, which serves primarily refugees and immigrants. The Memorial Foundation, the Cal Turner family foundation and other local organizations have given substantial support to Siloam (story here).

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