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Hospital Attempts Deportation of Woman With Inadequate Insurance

An immigrant woman from Honduras who has very recently awakened from a coma is being threatened with what can effectively be called deportation, because she does not have the insurance needed to cover her medical bills. (Don’t read the comments in these articles unless you want to lose your lunch.) But here is the real kicker: while it would be repulsive and incredibly inhumane to deport an uninsured/under-insured person with a serious medical condition because of their undocumented status, despite the lack of adequate facilities for their care in their nations of citizenship, it isn’t even the case here. Sonia del Cid Iscoa has a current visa and in the U.S. legally. (All emphasis in quoted text is mine.)

A gravely ill woman at risk of being removed from the country for lack of adequate insurance coverage awoke from a coma Tuesday.

The hospital has been seeking to return her to her native Honduras; her family took the hospital to court.

[. . .]

Iscoa, 34, has a valid visa and has lived in the United States for more than 17 years. She has no family in Honduras.

But St. Joseph’s Hospital and Medical Center sought to have her sent to Honduras when she went into a coma April 20 after giving birth to a daughter about 8 weeks premature. Iscoa has an amended version of Arizona Health Care Cost Containment System coverage that does not cover long-term care, Curtin said. But her family worried that the move would seriously harm her, or, at the very least, prevent her from ever returning to the United States.

Iscoa’s mother, Joaquina del Cid Plasecea, obtained a temporary restraining order to keep her from being moved. Maricopa County Superior Court Judge Carey Hyatt also ordered that the family post a $20,000 bond by Tuesday to cover St. Joseph’s costs of postponing the transfer.

However, Curtin said that the hospital gave the family three more days to come up with the money before a hearing Friday.

If the family can prove that Iscoa would suffer irreparable injury by a move, the bond will be refunded and Iscoa will not be transferred. But if Hyatt determines that Iscoa is not in imminent danger by a move, the family will forfeit the bond.

A stipulation to a court order issued by Hyatt Tuesday evening said that the parties were “actively exploring alternative sources of securing payment for the medical bills of Sonia Iscoa.”

The original story is close to a week old — but a judge has postponed the hearing until this Friday (which would be May 23rd). As I said, the Honduran hospital that St. Joseph’s is looking to transfer Iscoa to has agreed to accept her as a patient but warns that they cannot provide her with the care she needs.

Iscoa went to the hospital on April 16 because of abnormal bleeding, but the hospital sent her home, family members said. The next day, her doctor asked her to return, and when her water broke and she began having contractions on April 20, she was rushed into surgery and did not regain consciousness afterwards.

“They told us that she was bleeding excessively, and they had to do a hysterectomy on her, but they didn’t know why she was in a coma,” said Maria Adame, a family spokeswoman.

Iscoa went into kidney failure. She had two more surgeries and had an ovary removed.

Meanwhile, Adame said the family is having trouble getting medical records from St. Joseph’s.

An independent doctor was scheduled to examine her on Saturday to help assess whether she can or should be moved.

Liliana Flores, a spokeswoman for Hospital Escuela, said that the hospital would accept Iscoa but cautioned that its ICU unit only has four beds and the hospital has no dialysis unit.

There are attorneys and Honduran groups who are desperately trying to help Iscoa and her family.

Suzanne Pfister, a spokeswoman for the hospital, said that as many as eight patients are transferred each month to other countries, mostly to Mexico.

It’s a practice some lawyers are calling into question, specifically whether a hospital has the legal authority to force patients to cross international borders against their will. One attorney in Tucson has twice called police and accused hospital staff of kidnapping to stop the transfers.

“Right now the hospital is exploring with us the alternative means of being able to try to provide a long-term solution to the problem,” said Iscoa’s attorney, Joel Robbins.

[. . .]

The relatives contacted attorneys and got a temporary restraining order.

Judge Carey Snyder Hyatt of Maricopa County Superior Court ordered that the family post a $20,000 bond against expenses incurred by the hospital in the delay.

Robbins said it will be posted by the Arizona Trial Lawyers Association.

Nora Montoya, consul general for Honduras in Arizona, said that Honduran groups here and in Los Angeles and Washington are raising money for her medical care.

Robbins is hopeful that a compromise can be reached to find long-term medical care for Iscoa in Arizona, and he and his associates are talking with other health-care organizations.

[. . .]

Mitchel, who has lived with Iscoa for four years but is not married to her, wondered how they could send her to another country against their wishes.

Hospital representatives were not sure if such transfers had been successfully challenged in court, despite the frequency with which they are carried out. It is the federal government that ordinarily determines who must leave the country.

Fernando Gaxiola, a criminal-defense and immigration attorney in Tucson, said that he has twice thwarted such transfers by calling police and Mexican authorities and reported the transfers as kidnappings.

You know, the question really does seem like a no-brainer. In what rational world does a hospital have the right to send a patient to another country against her wishes? I know that on a day-to-day basis, our shitty health care system seems to have as much if not more direct power over our lives than the government does. But despite the common perception, they are not all-powerful. They are not the government. And they do not have the right to deport anyone, let alone a woman who is in the country legally and in grave medical condition. Gaxiola was entirely right to report previous “transfers” to authorities as kidnappings. And pretty damn smart to have done so.

Furthermore, knowingly and forcibly transferring a patient with kidney failure to a facility that does not have a dialysis unit is nothing short of violence. Plain and simple. Regardless of how we tend to behave, being a citizen of any nation other than the United States does not revoke your status as a human being. This is both racist and classist. This is flat out wrong.

A fund to help pay for Sonia del Cid Iscoa’s medical care has been set up through Wells Fargo Bank. Please help disseminate this information.

Helping Iscoa’s loved ones to pay for her medical care will not solve the bigger problem or help those who come after her. That is why the legal action is absolutely necessary. But we can help one woman receive the care she needs to live and to stay with her family, and loudly voice our opinion that this is in no way acceptable.

Thank you to Jenny for sending me the link.


85 thoughts on Hospital Attempts Deportation of Woman With Inadequate Insurance

  1. Um, excuse me, but why isn’t the family suing the hospital’s collective butt off for malpractice? It’s always hard to say whether care was appropriate without knowing the details, but I spotted at least 4 different points where major malpractice may have occurred and transfering a comatose patient anywhere except for a hospital with better facilities is always malpractice, regardless of their insurance or INS status.

  2. I don’t know much about about malpractice lawsuits, but it’s an interesting point. Can they sue for malpractice when the transfer has not yet been successfully made?

  3. That’s what I was assuming too, Jeffrey. Hopefully someone who is certain will come along to verify, but that’s my understanding of what little law I’ve learned.

  4. Okay, I’m not THAT kind of lawyer and I’m certainly not barred in AZ…but I’m pretty damn sure that there’s an intentional infliction of emotional distress claim here already. At least enough to survive the initial motion to dismiss. Although since the “bond” is being posted by the statewide trial attorney’s I’m sure they’ll come up with something.

  5. This sort of bad stuff can never happen in the UK, no way. Now what we got isn’t flashy, we got problems, but there is a underlying humanity on our national health system and no matter how poor you are or anything, u never getting turned away cos health is not about money, it’s about being a civilized country that has proper human values, and we got that in UK and America can learn a little from us maybe (if u want).

  6. Ok, the transfer would only be malpractice if it were completed and if she came to harm. If she somehow managed to survive without harm being done it would not be malpractice. However, I am very suspicious of certain elements in the story. We don’t have the whole picture here. A normal stat c-section, even under general anesthesia, shouldn’t leave someone in a coma. Neither does labor require rushing someone to stat c-section unless something else is going on. Did they miss a clotting disorder? Or even worse HELLP syndrome or an infection that caused the bleeding? Pregnancy related lupus? Also note the difficulty the family is having getting her medical records. Wonder what they show? That the medical team didn’t take her seriously at first because she was hispanic and they assumed that she was just being whiny? Maybe I’m cynical, but I wonder if the threat of deportation wasn’t made to keep her or her family from suing.

  7. I’m genuinely confused as to how this is even possible. Is there anyone in the healthcare field or any lawyers or law students who can give me any hint as to what kind of rules the hospital is going on?

  8. Is there anyone in the healthcare field or any lawyers or law students who can give me any hint as to what kind of rules the hospital is going on?

    I’m in the healthcare field but no, I can’t give you any idea of how this can be going on. I’ve always been taught that if you have a patient who is unstable they can not be moved, no matter what. The ONLY situation where a move is justified is if the hospital genuinely doesn’t have the resources the patient needs and the hospital s/he is being moved to does. For example, if they wanted to transfer her to U AZ’s hospital or something, I might be able to see it. But transfering someone unstable when you have the resources to deal with them is unethical and–I thought–illegal. As is transfering someone because of their insurance status. Once she was accepted as a patient and had a patient/doctor relationship with the staff, they were obligated to treat her until either she was well or she (or her family if she is unable to decide) withdraws from the relationship. It is unethical, as in malpractice, lose your license level unethical, to stop treating a patient because of his or her insurance status.

    I suppose it is remotely possible that the proposed transfer was legal and ethical and the press simply mutilated the story badly, but I’m having a hard time coming up with a scenario where that might be true.

  9. Diane–I know that in the first article, the hospital’s representative said that they weren’t licensed for long-term care. But I don’t understand why they couldn’t transfer her to another hospital here in Arizona. It seems like the hospital in Honduras isn’t equipped to provide the care she needs, either, so I don’t know why they’d go that route. It makes no sense to me.

  10. I’m having trouble understanding this, as well. The article says the hospital she is currently at is not licensed for long-term care. Is that why they cannot care for her? But why does that mean she *has* to go back to Honduras?

  11. And thanks to Cara for covering this. What really frightens me is that the hospital’s rep said that they deport around 8 people a month because of their inability to pay. I wonder how many of them are here on legal visas? Not that I think anyone should be deported because of their inability to pay, regardless of their legal status, but it does set a really scary precedent. What if a child’s family is unable to pay? Will they just send the kid back to Guatemala or wherever, even if they haven’t lived there since they were two years old? This woman has no family in Honduras and hasn’t lived there for 17 years! And the poor woman just had a baby!

  12. Not that I think anyone should be deported because of their inability to pay, regardless of their legal status, but it does set a really scary precedent.

    It only occurred to me after writing this post that I should be somewhat unnerved for personal reasons; my husband is not a citizen. Of course, we’re both white, he’s from an English-speaking country with good U.S. relations, and though we don’t have much money, I’m privileged enough that in a bind I know perfectly well we could go to my parents. They wouldn’t be able to pull $20,000 out of their asses either, but it’d be a hell of a lot easier than this. He’s also a resident. So I know that as far as those at risk go, we’re waaaaaaaayyy down at the bottom of the list. But it definitely does plant an uneasy feeling in the back of my mind. He’s eligible for citizenship fairly soon, and neither of us can wait to no longer have this kind of thing hanging over our heads. If only everyone was so lucky . . . and if only people didn’t have to pledge allegiance to a country before getting a damn shot at being treated like a human being.

  13. Are there no public hospitals in Arizona? Are there no hospitals willing to take patients of this sort with this inadequate state-based “insurance” who need long-term care? What if this woman were a citizen, what would this hospital do then? Why is the answer “Honduras” and not another city or another county?

  14. Is there any fund set up where we can donate to help with the $20,000? (Or names of individuals at the hospital whom we can contact and express our dismay to?)

  15. I know that in the first article, the hospital’s representative said that they weren’t licensed for long-term care.

    She just woke up from a coma and, unless I misunderstood, is still in the ICU. Plenty of time to worry about where she’s going to get her long term care later. And I find it hard to believe that there are no long term beds available in the state of Arizona. Or in the US, for that matter.

  16. Oops, my error. She has just been moved out of the ICU. Usually, one does not move a patient directly from the ICU to a chronic care facility. She has not had a neurological evaluation or (as far as I can tell from the article) any other evaluation of what her long term care needs will be. It is inappropriate to transfer her to a long term care facility at this point regardless of what country the facility is located in.

  17. Daomadan –information as to how you can help financially is linked to in bold towards the bottom of the post. You can walk into any Wells Fargo bank to make a donation to the fund. I imagine that if you don’t live near a Wells Fargo, you can do a wire transfer — just be aware that there can be hefty wire transfer fees for both the sending and receiving accounts, so you’d want to make sure to donate an amount higher than the fee.

    If anyone knows non-financial action that can be taken, or other ways that donations can be made via check or online transfer, I’d be thrilled to add it to the post as soon as I’m told (I didn’t find anything on my own).

  18. Am I reading this right? She has non-functioning kidneys and they want to send her to a hospital with no dialysis unit? Now, I know very little about medicine, but I’m pretty sure that if your blood can’t get cleaned either by your kidneys or dialysis, you end up dead. Good Lord.

  19. Thanks Cara. No idea how I missed that big, bold link you left…that’s what I get for trying to read surreptitiously at work.

  20. How the hell does a hospital have the authority to transfer a patient out of the country against their wishes? I mean, even if the patient was here illegally, wouldn’t that be something that they’d need the INS to do?

  21. Tobe–and this is a Catholic hospital, too.

    That’s what I was going to say. So worked up about the 5-day-old blastocysts, but go into a coma delivering it 8 months later? Too bad for you.

  22. Catholic hospitals refuse to dispense EC, or even to transport the victim of rape to another hospital that will. Now, Catholic hospitals refuse to care for, and attempt to take actions that almost guarantee the death of, someone who can’t Pay. Up. Right. Now.

    So how can these hospitals say that they are guided by Christianity? Because I’m not seeing how.

  23. So not the point (cause it is horrible to do this to anyone), but WHY can’t reporters get immigration stuff right? There’s no way this woman has been here legally on a “visa” for 17 years – there’s no visa that lasts that long. There are other types of legal status that do, but no visas.

    This sort of confusion about how immigration actually works just encourages ignorant anti-immigrant sentiment.

  24. One of the most heartbreaking scenes in Sicko is when all those 9/11 volunteers got free care from doctors in Cuba, even when they were having trouble getting care in America. That’s what I thought of when I read this story.

    This woman, if she had been living in an immigrant-friendly, patient-loving country, would have gotten her needs taken care of regardless of whether she had the money or insurance or even if she was a citizen.

    It’s sickening and depressing that we live in the wealthiest country in the world and we’re willing to turn away and deport the needy. What happened to our compassion? What happened to our open arms? What happened to the melting pot? What happened to the famous quote inscribed on the Statue of Liberty?

    “Give me your tired, your poor,
    Your huddled masses yearning to breathe free,
    The wretched refuse of your teeming shore.
    Send these, the homeless, tempest-tossed to me,
    I lift my lamp beside the golden door!”

  25. What the FUCK? Aren’t there laws against this kind of thing? I thought hospital were supposed to treat anyone no matter what and were just not allowed to rat them out. They generally don’t report illegal activity to the authorities because that would discourage people from seeking badly needed medical attention. This is really, really not kosher in the medical field.

  26. So not the point (cause it is horrible to do this to anyone), but WHY can’t reporters get immigration stuff right? There’s no way this woman has been here legally on a “visa” for 17 years – there’s no visa that lasts that long. There are other types of legal status that do, but no visas.

    No visa lasts that long, but I do believe that there might be a visa you could renew for that long. Or it is possible that she has a green card.

  27. Siduri says:
    May 19th, 2008 at 8:44 pm – Edit

    What the FUCK? Aren’t there laws against this kind of thing? I thought hospital were supposed to treat anyone no matter what

    They are, for emergency care. This probably isn’t technically emergency care. It’s a bit of a gray area. I’ll try to explain (this is an attempt at an explanation; it’s not a defense of the hospital):

    It’s not clear that a hospital is obliged to provide free services that fall into general “care taking.” It’s also not clear that a hospital is required to provide services without medical necessity. And it’s fairly clear that hospitals don’t need to provide most services which are non emergent, in most cases. So, for example: if you show up to the hospital with a sore knee, they may take you into the E.R., and they may do it even if you have no money: but if they figure out that you need knee surgery they will not perform the surgery for free.

    In other words, the legal right to medical care without ability to pay doesn’t include all of the medical care which is available to those with ability to pay.

    This can be true even when the consequences of non-treatment are severe. A hospital is probably not required to give you a heart transplant, even if you’ll die without one. A hospital is also probably not required to give you a kidney transplant, even if it will cure your diabetes.

    So you can distinguish a bit based on immediacy: A hospital is probably not required to plan for your future dialysis needs for free. However, IMO, that same hospital WOULD be required to provide dialysis for free… IF you showed up in the E.R. in renal failure and dialysis was the necessary and recommended treatment. To use the knee example, a hospital is probably not required to perform preemptive knee surgery for free, but that same hospital quite possibly WOULD be required to perform knee surgery for free, if you had a torn ACL.

    The system is set up this way because it seeks to avoid undue reliance on a hospital’s financial system. (again, please remember that i am explaining, not defending.) Providing long term care is hideously expensive; providing ICU care is essentially the most expensive care in the country and American ICU care is probably some of the most expensive care in the world. While the hospitals are obliged to pay for it, if it eventually comes back to the government (as it does) it is unsurprising that the government would not choose to subsidize it long term.

    Anyway, a lot of the ethicists I have read differ on this. There’s a fairly well acknowledged right to “medical care” but that generally extends to things like emergency and palliative (pain relieving) care. There doesn’t seem to be broad agreement that a system is required to provide all life-extending care and/or all advanced care, to everyone who wants it.

    This may be particularly true when the individual in question is not a citizen, and who (in theory) has a right to call on the obligations of her own country. I.e. from a certain perspective, it seems obvious that Honduras as a country is fully capable of acquiring a dialysis machine. That Honduras would choose not to do so, or that it would choose to let its citizens die rather than doing so, is not necessarily viewed as the U.S.’s fault. The culpability of the U.S. (and yes, I think the U.S. is culpable here) therefore lies in the stickier issue of delivering the patient to a “responsible” country who refuses to accept the responsibility. It’s still an ethical issue, but it’s a different one.

  28. Cara- yeah, I assumed she has a green card and they confused immigrant visa (of temporary usefulness) with green card. It’s just sloppy writing and it bugs.

  29. Sailorman: I have several objections to your argument:

    1. Any care that requires an ICU bed is almost by definition a life threatening emergency. This woman was still in the ICU when the transfer was first attempted. Moving a person who is in the ICU is always life-threatening. As simple a move as to radiology for a scan can be life threatening. Certainly a transfer from one hospital to another can only be justified if the first hospital has no means for treating the patient and the receiving hospital does.

    2. The hospital and staff have a greater ethical obligation to ongoing patients than to people with whom they have no doctor/patient relationship. In your analogy, they are not required to treat your damaged knee, but if they do undertake the surgery, they are not ethically permitted to discharge you before the surgery has healed adequately for you to go home, even if your insurance has run out. Or for any other reason other than that you or your family request a transfer or you or the hospital are unable to provide adequate care.

    3. Public hospitals in the US are required to provide care, regardless of the ability of the patient to pay. This hospital is private and they are therefore legally allowed to express their Christian charity by dumping this woman into a dangerous situation. However, there are public hospitals in Arizona to which she could be transfered and they are not allowed to ignore her needs, regardless of her immigration status. As the signs in the NY public hospitals say, “We don’t care about your immigration status. We care about your health.” I wish the oh-so charitable Catholic hospital in question here would take a similar attitude, but they clearly don’t. Therefore they should not receive any further public funds, since they are clearly not acting for the public good.

  30. In the end it comes down to this: This woman’s kidneys are not working. If she does not have dialysis she will die. The hospital staff know that they are transferring her to a facility that does not have dialysis equipment. Therefore, they are murdering her and they know that too. Murdering her for profit, no less. Sometimes I wish I believed in hell because these people deserve it.

  31. I am *so* confused at the moment.

    What really frightens me is that the hospital’s rep said that they deport around 8 people a month because of their inability to pay.

    A hospital has the right to kick someone out of this country? Really?

    Do they, like, work with the INS to weed out the “undesirables” (i.e., the people who can’t pay)?

    I honestly do not UNDERSTAND the concept of the American hospital anymore. I just don’t get it.

  32. “It only occurred to me after writing this post that I should be somewhat unnerved for personal reasons; my husband is not a citizen. ”

    This is absolutely terrorfying. My Nigerian husband is in the process of “having conditions removed” from his temorary residency so he can become a permant resident. We just received a letter from immigration asking for more documents showing the have a “good faith” marriage (many which we’ve already sent). I was trying to be calm about it, “it’s just how things are done” I think to myself, but this is so scary. We do not have health insurance or family with money. This woman’s situation just shows how much the goverment (or whoever) is willing to do to keep people OUT of the U.S. rather than help people stay.

    *really trying not to cry at work*

  33. “So not the point (cause it is horrible to do this to anyone), but WHY can’t reporters get immigration stuff right? There’s no way this woman has been here legally on a “visa” for 17 years – there’s no visa that lasts that long. There are other types of legal status that do, but no visas. ”

    She may have a Residency Visa, commanly known as a green card. A permanant Residency Visa is good for life.

  34. Malpractice is not the issue here. Besides, the decision as to whether this woman is transported to her homeland shall be decided by the courts, not the hospital.

    Everyone here needs to realize that until we go to a Universal single-payer system, this could happen to anyone here, someone born here. The system here in the states is not about care, but about capitalism and profit.

    The French have the best system in the world, and they pay far less in taxes to support their system than do we in just premiums, and then add co-pays, and the uninsured, and we are fools for permitting the pursuit of greed to provide good, humane health care at a price which can be decent. That would mean paying the manufacturers of technology far less than do we, as the French do, and ditto for meds, and the health care workers there see health care as a right for the patient and a basic human right. Try that here.

  35. A Permanent Resident Card (aka Green Card) is a visa. It is valid for 10 years and (usually) renewing it is not much more onerous than renewing a drivers licence.

    I’ve been a legal resident alien for 20 years now. In theory I could have applied for citizenship 15 years ago. In practice I’ve always found the cost to be prohibitive. $290 to renew a green card trumps $675 for citzenship every time.

  36. What confuses me about this is not necessarily the ability of hospitals to deny people certain kinds of non-emergency care, but how anyone can justify sending legal residents of the United States to another country just because they don’t have citizenship here — even if they’re in the process of applying. This is horrifying to me as someone who has relatives that aren’t citizens. Putting the question of the rights of undocumented people to one side for a second, you’d think that at LEAST it would be clear that if our government has agreed that someone has a legal standing to live in this country, we don’t just kick them out because a particular hospital won’t or can’t treat them.

    This may be particularly true when the individual in question is not a citizen, and who (in theory) has a right to call on the obligations of her own country. I.e. from a certain perspective, it seems obvious that Honduras as a country is fully capable of acquiring a dialysis machine. That Honduras would choose not to do so, or that it would choose to let its citizens die rather than doing so, is not necessarily viewed as the U.S.’s fault. The culpability of the U.S. (and yes, I think the U.S. is culpable here) therefore lies in the stickier issue of delivering the patient to a “responsible” country who refuses to accept the responsibility. It’s still an ethical issue, but it’s a different one.

    But the sticky thing is that she may not be a citizen, she may have the resources of another nation at her disposal — but it’s not like she’s just a visitor or a guest here. She’s settled here and intends to live here, from all available evidence, and the US government has agreed that she can do so. She may be in the process of securing citizenship. Why should the US be “delivering” her anywhere if the US has agreed to the continuation of this process? This is what seems absurd to me. We can’t just revoke the legal standing we’ve given her just because she got sick — quite possibly due to malpractice of a US hospital.

  37. Would someone please clarify what her visa status is? How can she be both “undocumented” and have a valid visa and have lived here for 17 years? I used to practice immigration law and would better understand what the legal options are if I knew what her visa status was. This is not to argue against the humanitarian arguments which are all very good. I just want to know what tactics are available to secure justice in this case.

  38. Susan, she’s not undocumented. I don’t know what her status is more specifically, but she has a current visa. She is documented and in the country legally.

  39. I’ve been a legal resident alien for 20 years now. In theory I could have applied for citizenship 15 years ago. In practice I’ve always found the cost to be prohibitive. $290 to renew a green card trumps $675 for citzenship every time.

    Also, even when one applies for citizenship, it can take a decade or more before one finally gets it.

    In my father’s case, it took 17 years after the initial application before he became a citizen due to the byzantine bureaucracy that is the INS…and they attempted to have him thrown out at least once during this period. There is also a class component to this as there is a strong preference for individuals with well-off family members rather than refugees who are poor and without

    With such a slow byzantine bureaucratic process and the INS’ enthusiasm for attempting to deport….the system seems to be geared more towards discouraging immigration…especially those from non-Western European countries.

  40. did anyone read the article? or is it just not as clear as i think it is? it states that this woman has a visa under “temporary protected status” because of safety issues in honduras, a country that is protected through january 5, 2009. i’m not seeing how they could deport her before then regardless of medical nonpayment. what do we do with citizens who can’t pay their medical bills? send them into terrible debt! (it’s the american way!) so why can’t we do the same (awful…) thing for non-citizens here legally?

    “During the period for which a country has been designated for TPS, TPS beneficiaries may remain in the United States and may obtain work authorization. However, TPS does not lead to permanent resident status. When the Secretary terminates a TPS designation, beneficiaries revert to the same immigration status they maintained before TPS (unless that status had since expired or been terminated) or to any other status they may have acquired while registered for TPS. Accordingly, if an alien had unlawful status prior to receiving TPS and did not obtain any status during the TPS designation, the alien reverts to unlawful status upon the termination of that TPS designation.”

    explanation of temporary protected status

    regardless of her status, the equally sucky thing is that even a citizen under her health “care” plan wouldn’t be able to pay for the necessary medical care. damn our dysfunctional health system.

  41. Here’s what the article says about her immigration status:

    Iscoa is legally in the country under temporary protected status. Sharon Rummery, U.S. Citizenship and Immigration Services spokeswoman, said temporary protected status can be granted to people who are in the United States without valid immigration status when a catastrophe happens in their home country.

    Rummery said that there are about 73,000 Hondurans in the United States under temporary protection status.

    It’s still disgusting, no matter what her status is.

  42. Oops, it looks like I messed up the page format – so sorry!

    I also cross posted the mermaidshoes. Again, sorry.

  43. “With such a slow byzantine bureaucratic process and the INS’ enthusiasm for attempting to deport….the system seems to be geared more towards discouraging immigration…especially those from non-Western European countries.”

    I believe this to be absolutely true. When my husband and I first applied for his temporary residency we went to a non-profit immigration resource group to help understand the gazillion forms we had to fill out. Our representative told us the numerous forms, the way they are written and the required documents are designed to trip applicants up so immigration can deny as many people as possible.

  44. The Mission statement of St. Joseph’s says they believe in: “Serving and advocating for our sisters and brothers who are poor and disenfranchised”. They are also pledged to adhere to the “Ethical and Religious Directives for Catholic Health Care Services” which includes this directive: “Catholic health care should distinguish itself by service to and advocacy for those people whose social condition puts them at the margins of our society and makes them particularly vulnerable to discrimination”.

    Once again the Catholic Church is really living up to its values.

  45. Furthermore, knowingly and forcibly transferring a patient with kidney failure to a facility that does not have a dialysis unit is nothing short of violence.

    As a dialysis patient myself, I have to disagree with this statement. “Violence” is too soft a word. Try “execution”.

  46. While I can’t claim to defend the hospital’s decision, everyone needs to realize that this is a bad situation for everyone involved-Iscoa and her family primarily, but the hospital as well. My understanding of public hospitals, which this is not, is that they are required to provide all emergent care regardless of ability to pay. It sounds like she is now either stabilized or near it, but still in critical condition, and therefore not considered in a precipitating emergency. If the hospital does what many here consider the honorable thing and continue to treat Iscoa regardless of cost, they will have to eat the entire expense. There would be no government compensation for her care, which is likely to be extensive and prolonged in nature. Hospitals, though I have no idea for St. Joseph’s, regularly give out millions in free care, and it would not surprise me if all the care for Iscoa alone would rise to $500,000 to $1 million. Where does that money come from? Cross subsidies. They provide less free care to others, charge everyone else more. Hospitals’ pockets are deep, but they turn over large fractions of every dollar they see. That is, there are many and varied expenses taking a chunk out of all the money a hospital bills for, and there’s not a lot left over in the end.

    I can’t claim to have an answer to this tragedy, but remember that it’s not as simple as calling on a large institution to ‘just take care of it’.

  47. If she were a murderer, rapist or terrorist we would pay for her healthcare in prison. Why does AlQueda get better health care than Legal Residents and Citizens?

  48. Why does AlQueda get better health care than Legal Residents and Citizens?

    Eh, if it makes you feel any better, they don’t actually. I’ve read through quite a few of the files that the ACLU got through the FOIA. If you look at the reports of deaths at Guantanemo, most of them show clear instances of malpractice, ranging from ignoring complaints to inadequate coding. Don’t envy the medical care al Qaeda receives.

  49. I can’t claim to have an answer to this tragedy, but remember that it’s not as simple as calling on a large institution to ‘just take care of it’.

    Greg,

    At the very least, they should not be acting in a high handed manner by attempting to deport her when she is here legally as determined by the INS. These are actions that are reminiscent of what I’d expect from tyrannical fascist and communist regimes…..not ones that should be tolerated, much less cheered on in the states.

    As several other commenters have noted, this hospital is certainly not living up to either their religious faith nor the Hippocratic oath….especially when they are acting as an extension of the INS bureaucracy.

  50. This is a horrible situation to happen. US citizens can not stay in a Hospital ICU bed in a situation like this. She should be transferred to a long term facility. If hospital has 10 ICU beds, and ICU is no longer needed–that patient will be moved to a place combatable to her current needs. Hospitals are closing doors because of free care. Medicade, Medicare and other Federal or State insurances do not pay the full amount to the hospital so the hospital has to pay. So this is what is happening. The more the hospitals have to pay, the less care they can give free. It is a sorry state—but true. Instead of complaining about the hospital work with hospital and government to find a way of helping situations like this.

  51. Reading through that second article, am I the only one who’s a little suspicious that the hospital is trying to cover up malpractice by shipping her out of the country? It seems awfully odd that the hospital is simultaneously claiming they can’t provide care for her in her current condition and refusing to provide her medical records.

  52. This settles it for me. I’ll never accept care at a Catholic hospital. That poor woman.

  53. I used to work in a hospital, and there were lots of times that that institution had to move patients, once they were stable, because of financial issues. Of course,in those cases it meant an ambulance ride to the city public hospital (which was dismal, understaffed and underfunded, but was at least in the same city — even though it may have *felt* like it was in a different country)

    To just arbitrarily shift someone out of the country to someplace that cannot care for their condition is just amazing.

    Of course, this is a health-profit system that thinks proper release for indigents is to have an ambulance drop them off in the local skid row, regardless of whether there is any way for the patient to actually *move* on their own legs once there.

  54. My mother works for a large, very well known private rehab hospital in Boston (which is known for it’s excellent health and educational facilities).

    Even though the facility is a corporation, many patients receive public money depending on their health insurance, or lack thereof.

    Because Boston is The Place to Be when you’re sick, they actually get a lot of people in serious conditions flown in from other parts of the country and other countries altogether. They also get locals who happen to be immigrants, legal and illegal.

    Sometimes my mother grumbles that the illegals should be shipped back to their own countries for care, and let “their taxpayers” deal with it.

    In many ways, I can understand how this kind of thinking develops, because, truly, not everyone does think expensive, specialized care is a right.

    Public school systems will accept anyone though (they have to, I think). At least in Massachusetts, citizenship, language, abilities, and other aspects of the student’s circumstances must be taken into account when the school hires faculty and plans facilities. My high school happened to have an excellent ESL program based on a small handful of kids who didn’t speak English when they came to the school. We renovated and put in an elevator (though I think ramps in most places are the affordable option) because one student was in a wheelchair. We had ASL and special needs experts based on a small group of kids as well. And now the school is prepared for anybody who wants to learn, as a public school should be. If the school cannot possibly provide for a student, the town pays for that student to attend area private schools with proper facilities (we have school nearby specially for kids with emotional problems, which are often manifest themselves as learning disorders).

    And I’m proud that my family’s taxes allow for that.

    Should it not be the same with hospitals?

  55. The hospital is providing medical assistance. To receive that assistance, the hospital required the patient to provide truthful information. The patient truthfully reported their citizenship status. That information is patient information.

    The hospital appears to have substantially confirmed the details of a private record. This is inappropriate. The patient has legal standing to sue the hospital for violations of the medical privacy requirements. The patient should file a motion with the court seeking damages in excess of all medical bills.

    The parties are encouraged to settle. If the hospital does not comply with this reasonable request, lawyers are prepared to provide pro bono legal assistance, seeking treble damages against the hospital for infliction of emotional distress, confirmation of protected information, and other punitive damages.

  56. Lindsay: I’m glad for her, but it still leaves the problem of what is going to happen to the next legal immigrant treated at this hospital who finds him or herself running out of insurance. The hospital is so into the claim that they couldn’t treat her and no nearby hospitals could either. What would they have done if she’d been a native born US-American? Why couldn’t they do whatever that was?

  57. Sometimes my mother grumbles that the illegals should be shipped back to their own countries for care, and let “their taxpayers” deal with it.

    Immigrants, legal and illegal, pay taxes. Indeed, they often pay more taxes than they are required because they don’t understand the forms (which many native english speakers find tricky) and don’t want to draw attention to themselves.

    In many ways, I can understand how this kind of thinking develops, because, truly, not everyone does think expensive, specialized care is a right.

    The problem is that, since emergency care is considered a right, not treating people’s conditions properly is actually more expensive than treating it right the first time in the end. People get sicker, end up back in the ER (a very expensive place for medical care) and may end up in the ICU unnecessarily. Which is why the US spends more money and more public money on health care than any other country, and gets relatively poor results. There are two ways that we could make the cost of health care go down: Cover all people for all treatments, emergency or non-emergency, privately insured or not, citizen or not. Or we could allow people to die outside of ERs if they couldn’t show an ability to pay. It just depends on what sort of country we want this to be.

  58. The hospital needs to have the holy living hell sued out of it.

    Isoca went there the day before her emergency c-section with abnormal bleeding and they sent her home. The doctor called her back the next day, her water broke and she had the c-section.

    She not only has the temporary protected status that all Hondurans currently have, but also a valid work visa. And 7 American kids.

    The hospital did not contact the Honduran embassy to facilitate transfer and they didn’t even inform the hospital that Isoca was in a coma.

    This was stupidity of the highest level all around, and since money was the root of it all, they should be sued and pay a hell of a lot of it for their gross incompetence. People should be fired over this.

    The Catholic Church needs to get out of the hospital business. Not only is it wrong to impose their religious beliefs on the public, but they aren’t even following their own guidelines.

  59. Lindsay: I’m glad for her, but it still leaves the problem of what is going to happen to the next legal immigrant treated at this hospital who finds him or herself running out of insurance. The hospital is so into the claim that they couldn’t treat her and no nearby hospitals could either. What would they have done if she’d been a native born US-American? Why couldn’t they do whatever that was?

    Please don’t get me wrong, Dianne- by no means do I believe we should leave this issue behind. It’s horrifying, not only that the hospital did this to her, but that it apparently does it to an average of 8 people a month. Holy hell!! My sentiment was less “well, it’s over now” and more “at least this woman will survive,” you know? I’m sure she’d rather be healthy and outraged than in a good position to force the courts to stop the hospital from killing people. But it is frustrating that without a court in a position to decide the issue, the hospital may feel free to simply do what it wants with impunity.

    The hospital needs to have the holy living hell sued out of it.

    Caren: couldn’t agree more. I’m not in torts, but the hospital’s refusal to disclose medical records to the family set my lawyer-sense a-tingling. As Mnemosyne pointed out, isn’t it very curious that a hospital should be struggling so hard to dump a critically ill patient into a foreign hospital without disclosing critical care-related information to the patient’s family, when the available evidence suggests the possibility of malpractice on the part of the hospital staff? Hmm!

    I hope the lawyers working with the family continue to help them. The hospital needs to be held responsible for this whole ridiculous crock of crap- hopefully in a way that will force them to change their (in my view) illegal policy of forcibly deporting sick people on the hospital’s own initiative.

  60. What did the “hospital” plan to do about her children if they had gotten away with carrying out their plan? Deport 7 US citizens, too? Dump them on the sidewalk? Make them disappear? Pray to the sky fairy to just handle it?

    I agree that a massive civil suit is necessary, and it’d be great if it could be made class-action. (In my total ignorance of law, though, I wonder if the “hospital” would use HIPPA as a shield to protect itself from responsibility regarding withholding records from her family.)

    But, in addition, the “hospital” staff that made the decision to knowingly send her to her death should be indicted for attempted murder, or at the very minimum, criminal negligence. But, of course, that won’t happen, when the staff is most likely white, upper-class, and male, and Iscoa is brown, poor or working-class, and female.

  61. The fundamental question is what right does any private organization to send someone to a foreign country who has a legal right to be in the United States?

    Why isn’t the answer to this ABSOLUTELY NONE?

  62. GallingGala — The hospital is *already* in a heap of trouble over HIPAA disclosures — they have, apparently, disclosed to the public confidential details about this individual’s financial status, diagnosis and treatment

  63. WTF!!!!!!!!!!!!

    Besides the “eight patients transferred to other countries” each month, how many U.S. citizens are being thrown out of this hospital? Or, for that matter, other hospitals in the United States?

    This hurts… doubly since I moved to Mexico in part because I can get hospitalization and medical care if I need it, which even a “lower upper middle class” (highly educated for a low-paying career) can receive medical attention.

  64. Lindsay: I hope my comment didn’t come out sounding critical of you! I agree with you entirely. This mess is so frustrating I’m afraid my anger is spilling over onto allies. I apologize.

    This hurts… doubly since I moved to Mexico in part because I can get hospitalization and medical care if I need it,

    Yeah. As much as people in the US like to pretend that we have the best of all possible medical care, sometimes we…don’t. A colleague of my partner’s, whose child has a congential malformation, was reluctant to come work with my partner in the US because he was afraid his child wouldn’t be able to get proper medical care. It’s embarrassing and should be.

  65. Another aspect of this issue is that, whether public or private, most hospitals built in the US receive some sort of public funding whether it is Hill Burton funds, tax breaks (including status as a non-profit corporation or religious entity), or other local funding, incentives, and subsidies. I will bet that St. Joseph’s benefited or continues to benefit from public largesse. IMHO their acceptance of public support, no matter the nature of it, should place an obligation on them to provide emergency medical treatment to save the life of anyone who needs care.

    Medical care is not a privilege. Even calling it a “right” doesn’t fully describe the nature of urgent medical care. Providing urgent or emergency medical care to anyone who needs it is a basic expression of our humanity. To do anything less is inhumane.

  66. Reverse the situation; if we went to ANY other country, did not speak the language, did not pay taxes, 90% live off welfare illegally, etc. Do you think we would be accomodated? I am sick and tired of getting forms to fill out for my kids’ school and one side is spanish because they are not required to speak english. What a life. They work for lower wages making some careers(construction) wages obsolete. We wouldn’t want to pay unfairly, BS. I work at St. Joseph’s Hospital, I see what goes on from the inside. You are ignorant! I am extremely proud to say I work there, and further more I put up with alot of SHIT as an American citizen that pays taxes, worked two jobs to raise my 16 and 17 year old as a single mother, to have someone come to my desk and ask, ” Habla espanol?” Hell no I don’t, your in America, figure it out. These people have the audacity to get angry because I am not bilingual, and come to find out they choose not to speak english. It’s amazing when I say No all of a sudden out pops english.
    So, I believe no one should be turned away for medical care, but how many millions of dollars should we be accountable for? It’s good that people are collecting money, a debt needs to be payed. If I go to McDonalds and order 100 BigMacs, then say I don’t have any money. Will I get my 100 BigMacs because I’m hungry?

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