Should illegal immigrants with end-stage renal disease (ESRD) receive the dialysis treatments they need to survive? Atlanta’s Grady Memorial Hospital has been struggling with that question for several years after the community’s safety-net hospital closed its dialysis clinic to show Atlanta’s philanthropists how fiscally responsible it is.
Without dialysis or a kidney transplant, end-stage dialysis patients die, sometimes within as little as two weeks.
While Grady receives direct appropriations from both Fulton and DeKalk Counties, it remains Atlanta’s hospital of last resort and has been losing money for years.
Kevin Sack and Catrin Einhorn, writing for the New York Times, report the closing of Grady’s dialysis clinic “displaced about 60 uninsured illegal immigrants who depended on free thrice-weekly treatments at the clinic to survive.” Grady offered to pay to ship the illegal immigrants to other states or their home countries and three months of dialysis. Thirteen took the offer; five died.
After a patient lawsuit and media attention, Grady contracted with Fresenius Medical Services for one year that expired this week.
Under a new agreement, Fresenius, DaVita, and Emory University would take a small number of illegal immigrants as charity and Grady would contract with Fresenius to treat the rest. As Sack and Einhorn write, “The patients in Atlanta have gambled that American generosity, even at a time of hostility toward illegal immigrants, would prove a surer bet than uncertain care in their home countries. Several said that the fates of those who returned home had reinforced their fears about leaving Atlanta.”
The agreement does nothing to resolve the issue of how to care for illegal immigrants, for whom health insurance is banned by the federal government under the new healthcare law. Similarly, the agreement (and the federal healthcare law) do nothing to resolve the issue of how to pay for hospital emergency room visits in which hospitals must treat patients under federal mandate.
As Jim Galloway writes in the Atlanta Journal-Constitution, “If you’re a preacher stuck for a Sunday sermon topic, look no further. You can’t make up a moral dilemma like this one.”
Sack and Einhorn also report, “Fresenius and DaVita are the country’s largest commercial dialysis providers, with combined net income of more than US$1.3 billion last year.”
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