Entrants costly to hospitals, patients

Scope of crash injuring 29 unusual; bill passed on to consumers routine

By Brady McCombs Arizona Daily Star Tucson, Arizona Published: 04.09.2008

The costs to four Tucson hospitals that treated 29 illegal entrants injured in a rollover crash Monday near Benson will be sizable and largely unreimbursed. The medical-care costs not covered by a federal reimbursement program will eventually be passed on to consumers, officials at the hospitals said Tuesday. The incident — which resulted in the death of one Guatemalan woman and has three men in critical condition — was extraordinary in the number of people involved and the severity of their injuries. But it's just the latest example of Southern Arizona hospitals' being forced to treat illegal border crossers with no assurances of reimbursement. "It's a daily event for us," said Kevin Burns, University Medical Center's chief financial officer. "This one gets attention because it's such a large number of people and such a catastrophic event, but we deal with this day in and day out." Of the four hospitals, only University Physicians Healthcare Hospital at Kino has estimated the cost of this crash. The hospital, which treated 11 of the 29, estimates it cost between $44,000 and $55,000, spokeswoman Sarah Frost said. The faith-based Carondelet Health Network, which runs St. Joseph's, St. Mary's and Tucson Heart hospitals in Tucson and Holy Cross Hospital in Nogales, takes its duty to "care first and worry about payment later" seriously, but it doesn't mean the costs don't add up, said Bill Pike, director of public policy at Carondelet. Four of the illegal entrants landed at St. Joseph's. "In the big picture of things, when health-care organizations provide a lot of charity care, those dollars are billed into or carried over to people who do pay for care," Pike said. "You and I, we all pay for care for the uninsured." Burns echoed that: What doesn't get reimbursed eventually gets covered by consumers because the hospital needs to operate at a reasonable profit margin to stay in business. UMC treated seven of the injured border crossers and is still caring for two Guatemalan men in critical condition. "Effectively, not getting these costs covered by the federal government means we end up passing that cost on to consumers in insurance premiums," Burns said. Treating foreign patients without medical insurance costs UMC about $5 million a year, Burns said. The hospital is reimbursed about $1.5 million a year through a federal program designed to pay hospitals for emergency care given to illegal entrants. It costs Carondelet about $4 million annually to care for illegal entrants, Pike said. Tucson Medical Center, which treated nine of the injured, and Kino didn't have yearly cost estimates available Tuesday. Records from the Arizona Hospital and Health Care Association show that in 2006, the federal program reimbursed Arizona hospitals $24.7 million for treating illegal entrants. Tucson hospitals received about $4.5 million: ● Carondelet: $1.85 million. ● UMC: $1.76 million. ● Tucson Medical Center: $917,398. The program reimbursed ambulances statewide in 2006 a little more than $2 million and physicians $1.7 million. Burns and Pike are in Washington, D.C., this week advocating for the extension of the federal reimbursement program, known as Section 1011. It's set to expire in September. The program pays hospitals at a rate of about 15 cents on the dollar, they said. "This is very much a largely unfunded mandate," Burns said. "It doesn't just affect us; it affects every hospital in the state of Arizona." The impacts aren't just financial. Treating the uninsured, who include many U.S. citizens as well, takes time and resources away from treating paying customers, Burns and Pike said. "We have a very busy ER department, and this really tends to tie up our ER and trauma," Burns said.

Rollover under investigation
The crash occurred at about 5 a.m. Monday on Interstate 10 near Empirita Road, about 10 miles west of Benson. A van loaded with illegal border crossers tried to evade the Border Patrol and rolled. Ambulances and helicopters transported 29 illegal entrants. The cause of the rollover is still under investigation and may take investigators several days to determine, said Officer Quent Mehr, state Department of Public Safety spokesman. A 21-year-old Guatemalan woman died at the scene. Officials with the Guatemalan Consulate in Phoenix have notified her family, said Oscar Padilla, the Guatemalan consul general in Phoenix. Three Guatemalan men remain in critical condition, two at UMC and one at Good Samaritan Hospital in Phoenix, Padilla said. In total, at least 20 of the 31 involved in the crash were Guatemalan. Those who have been released from hospitals are in the custody of the Border Patrol, he said. Vincent Picard, spokesman for Immigration and Customs Enforcement, said there also were eight from Ecuador, two from Mexico and one from El Salvador. The two Mexican men were arrested and referred to the U.S. Attorney's Office on suspicion of being the smugglers. No charges have been filed yet, said Sandy Raynor, spokeswoman for the U.S. Attorney's Office. The Ecuadorean consul general in Los Angeles, Eddie Bedón, flew to Tucson to visit with the Ecuadoreans in hospitals and at detention facilities. ICE officers will hold some of the illegal entrants involved as witnesses for a possible criminal trial, Picard said. They'll be given parole and allowed to work, because it can take a long time for a criminal trial, he said. The rest will be set up for formal removal proceedings and held in detention centers in Eloy and Florence. The removal process can take several weeks to several months, Picard said. ● Star reporter Dale Quinn contributed to this story. ● Contact reporter Brady McCombs at 573-4213 or bmccombs@azstarnet.com.

Submitted by EGH in El Paso.