Hurt, uninsured immigrant workers face repatriation
GILA BEND, Ariz. - Soon after Antonio Torres, a husky 19-year-old farm worker, suffered catastrophic injuries in a car accident last June, a Phoenix hospital began making plans for his repatriation to Mexico.
Torres was comatose and connected to a ventilator. He was also a legal immigrant whose family lives and works in the purple alfalfa fields of this southwestern town. But he was uninsured. So the hospital disregarded the strenuous objections of his grief-stricken parents and sent Torres on a four-hour journey over the California border into Mexicali.
For days, Torres languished in a busy emergency room there, but his parents, Jesus and Gloria Torres, were not about to give up on him. Although many uninsured immigrants have been repatriated by American hospitals, few have seen their journey take the U-turn that the Torreses engineered for their son. They found a hospital in California willing to treat him, loaded him into a donated ambulance and drove him back into the United States as a potentially deadly infection raged through his system.
By summer's end, despite the grimmest of prognoses from the hospital in Phoenix, Torres had not only survived but thrived. Newly discharged from rehabilitation in California, he was haltingly walking, talking, and, hoisting his cane to his shoulder like a rifle, performing a silent, comic, effortful imitation of a marching soldier.
"In Arizona, apparently, they see us as beasts of burden that can be dumped back over the border when we have outlived our usefulness," the elder Torres, who is 47, said in Spanish. "But we outwitted them. We were not going to let our son die. And look at him now!"
Antonio Torres's experience illustrates the haphazard way in which the American healthcare system handles cases involving uninsured immigrants who are gravely injured or seriously ill. Whether these patients receive sustained care in this country or are privately deported by a hospital depends on what emergency room they initially visit.
There is only limited federal financing for these fragile patients, and no governmental oversight of what happens to them.
Instead, it is left to individual hospitals, many of whom see themselves as stranded at the crossroads of a failed immigration policy and a failed healthcare system, to cut through a thicket of financial, legal and ethical concerns.
That creates a burden. "It's a killer," said Brian Conway, spokesman for the Greater New York Hospital Association. But it also establishes the potential for neglectful and unethical if not illegal behavior by hospitals.
"The opportunity to turn your back is there," said Dr. Stephen Larson, a migrant health expert and physician at the Hospital of the University of Pennsylvania. "You're given an out by there not being formal regulations. The question is whether or not litigation, or prosecution, catches up and hospitals start to be held liable."
In October, the California Medical Association, responding to an article about the medical deportation of a brain-injured Guatemalan in The New York Times, passed a resolution opposing the forced repatriation of patients. The American Medical Association is to take up the matter today at a national meeting in Orlando, Fla. 