California Aflame

11 of 18 in burn unit undocumented; UCSD cases put focus on who pays for care

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By Cheryl Clark and Leslie Berestein

The fact that 11 of the 18 wildfire victims lying in UCSD Medical Center’s burn unit are illegal immigrants with no apparent health coverage highlights the daunting financial challenge hospitals face in providing long-term, intensive care for all those who need it.

“These are the most expensive kinds of cases, but we don’t look at these patients and say, oh, because they aren’t legal residents, we’ll stop providing care or stop changing their bandages,” said Dr. Thomas McAfee, UCSD’s physician-in-chief. “It’s part of our ethic to continue to provide this care no matter what.”

According to the Mexican Consulate in San Diego, the burn victims are from central and southern Mexico, and include one woman. Four are in critical condition. All were rescued north of Tecate last week, said consulate spokesman Alberto Lozano, and it is suspected they had crossed the border illegally before coming face to face with the Harris fire.

Four other people, two men and two women, were found dead Thursday in a ravine off state Route 94. Their badly burned bodies remain unidentified, although authorities suspect they crossed illegally before they died. Those in critical condition may include a married couple from Guerrero, according to the consulate. The others are a 20-year-old man from Guerrero and a man from Chiapas.

With some facing a long rehabilitation, hospital officials said they realize many U.S. taxpayers don’t believe UCSD should provide such expensive hospital care to illegal immigrants. But, by law, that care must be provided “to anyone who comes regardless of their ability to pay.”

Last year, San Diego County hospitals provided $619 million in uncompensated care, and an estimated 10 percent to 17 percent of that paid for treatment for undocumented immigrants, according to the Hospital Association of San Diego and Imperial Counties.

Burn care requires ventilators, multiple surgeries, round-the-clock intensive care and grafts from human cadaveric skin. McAfee said grafts can be grown from patients’ own skin to minimize tissue rejection at $500,000 per patient.

Last year, the average cost of treating a burn patient at UCSD was $45,000 for an average 15-day stay.

When patients need long-term nursing care, said UCSD spokeswoman Leslie Franz, “we make arrangements on a case-by-case basis. This could mean anything from them continuing to receive care from us, or we might transition them to another facility in that person’s home state or another country, if we can expedite that.”

However, appropriate care in a person’s native country is not always available.

Esmeralda Siu of the Coalición Pro Defensa del Migrante, a network of migrant shelters and other services in Baja California, said rules prevent the United States from sending Mexican nationals home before they can travel safely.

“By law, they can’t deport them if they are injured,” said Siu, who is based in Tijuana. “They have to be stabilized, and that they accept leaving, and that they are well to travel.”

Mark Krikorian, executive director of the Center for Immigration Studies, a group that advocates immigration restrictions, said that in the case of the 11 border burn victims, it might make sense to request assistance from the Mexican government or arrange long-term care in their home country.

http://www.signonsandiego.com/news/metro/20071031-9999-1n31burn.html

http://www.wvwnews.net/story.php?id=2223

2007-11-01