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In a widely watched case in Florida, a jury ruled this week that a hospital acted reasonably when it essentially deported a brain damaged undocumented immigrant with no health insurance. The case highlights a rare but growing problem, and it could affect how hospitals treat such patients in the future. NPR's Jennifer Ludden reports.
JENNIFER LUDDEN: In 2003, Martin Memorial Medical Center faced a dilemma: For three years it had been caring for day laborer Luis Jimenez, who'd been hit by a drunk driver and left paraplegic and brain damaged. The hospital had spent $1.5 million treating him. Now it wanted to transfer him to a cheaper, long-term care facility.
Carla Luggiero of the American Hospital Association says hospitals face limited options for patients with no insurance and no legal status.
Ms. CARLA LUGGIERO (American Hospital Association): We could help find a charity bed, or subsidize them at a nursing home, or send them home to relatives. Or we could keep them indefinitely. And in that case, that patient is utilizing a bed that could be used for someone who has a more acute health care need.
LUDDEN: When no other facility would take Jimenez, Martin Memorial turned to another option. Early one morning, against the wishes of Jimenez's cousin and legal guardian, the hospital chartered a plane for $30,000 and flew Jimenez back to his native Guatemala. The government there had said it would care for him in a hospital. But he was soon discharged and now lives with his mother, bed-bound, in a remote mountain-top village.
Bill King is the lawyer for Jimenez's guardian.
Mr. BILL KING (Attorney): He has no medical care there to speak of, and he's having increasing number of seizures and increasing in intensity.
LUDDEN: Jimenez's family had sought damages, plus $1 million to cover the lifetime cost of his care in Guatemala. The Florida jury denied that. Luggiero of the American Hospital Association says this might make hospitals more comfortable transferring patients to their home countries, something she estimates happens once or twice a month. Others believe this whole high-profile case will have another impact.
Mr. LARRY GAGE (National Association of Public Hospitals and Health Systems): What it is mostly likely to do for a lot of hospitals and a lot of patients is have a chilling effect on the front end.
LUDDEN: Larry Gage heads the National Association of Public Hospitals and Health Systems. He says by law publicly funded hospitals must stabilize someone in crisis, but that doesn't always mean admitting them.
Mr. GAGE: Hospitals may well try to define in as limited a way as possible their obligations to the patient that shows up at the emergency room. And I think you'll see hospitals tightening up on their policies to try to mirror the reality of what they're going to get paid to do.
LUDDEN: Something else might make hospitals wary. A state judge originally approved Jimenez's repatriation. But an appeals court later overturned that. It said state judges have no power to decide immigration cases. It was too late for Jimenez, but lawyer Bill King hopes that ruling sends a message to hospitals.
Mr. KING: You can't just decide to remove a foreign national, an undocumented person, and send them into what we contend, of course, was a medical abyss.
LUDDEN: King says he plans to appeal the jury decision denying damages to Luis Jimenez's family.
In a statement, Martin Memorial Medical Center said the most disappointing part of this case is that the issue of providing health care for undocumented immigrants remains unresolved. Unfortunately, the hospital says, none of the health care overhauls being debated in Congress would address it.
Jennifer Ludden, NPR News.
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