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Hospitals cannot continue to hemorrhage. For the country as a whole, medical insurance premiums include a surcharge that pays for treating the uninsured. However, if the proportion of uninsured indigent patients exceeds a certain figure, a hospital has no choice but to close. In California alone, the heavy cost of free medicine for foreigners forced no fewer than 60 hospitals to shut down between 1993 and 2003; many others were on the verge of collapse. From 1994 to 2004, the number of hospital emergency rooms in the country as a whole dropped by more than 12 percent.
In May 2010, Miami’s health care system was so strapped, it was considering closing two of its five public hospitals. This would mean laying off 4,487 employees and the loss of 581 acute-care beds. Experts explained that treating uninsured patients had stretched the system to the breaking point.
Houston is a good example of a city whose hospitals are barely making ends meet. In the nation as a whole, about 15 percent of the population has no medical insurance, but Texas, with its large population of Hispanics, has the highest percentage at 24 percent. In Houston, the figure is 30 percent. The safety net cannot accommodate so many people who cannot pay. “Does this mean rationing?” asks Kenenth Mattox, chief of staff at Ben Taub General Hospital. “You bet it does.”
There is such a crush at Houston’s emergency rooms that ambulances often wait for one or two hours before they can even unload patients. The record wait is six hours. Twenty percent of the time, hospitals end up sending patients to other hospitals, and some have died after being diverted. Politicians and businessmen pull strings so friends can cut in line.
Americans who fall sick in Mexico do not get free treatment. The State Department warns that Mexican doctors routinely refuse to treat foreign patients unless paid in advance, and that they often charge Americans for services not rendered.
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