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Illegal Aliens And American Medicine

Illegal Aliens and American Medicine
insured, “documented,” or able to pay. A woman in labor must
Madeleine Pelner Cosman, Ph.D., Esq.
remain to deliver her child.
The hospital must have specialists on call at all times for all
The Seen and the Unseen
departments that provide medical services and specialties within
the hospital’s capabilities. EMTALA is an unfunded federal
The influx of illegal aliens has serious hidden medical
mandate. Government imposes viciously stiff fines and penalties
consequences. We judge reality primarily by what we see. But what
on any physician and any hospital refusing to treat any patient that a
we do not see can be more dangerous, more expensive, and more
zealous prosecutor deems an emergency patient, even though the
deadly than what is seen.1
hospital or physician screened and declared the patient’s illness or
Illegal aliens’ stealthy assaults on medicine now must rouse
injury non-emergency.9 ,1 But
0
government pays neither hospital nor
Americans to alert and alarm.2 Even President Bush describes
physician for treatments. In addition to the fiscal attack on medical
illegal aliens only as they are seen: strong physical laborers who
facilities and personnel, EMTALA is a handy truncheon with which
work hard in undesirable jobs with low wages, who care for their
to pummel politically unpopular physicians by falsely accusing
families, and who pursue the American dream.
them of violating EMTALA.
What is unseen is their free medical care that has degraded and
High-technology EDs have degenerated into free medical
closed some of America’s finest emergency medical facilities, and
offices. Between 1993 and 2003, 60 California hospitals closed
caused hospital bankruptcies: 84 California hospitals are closing
because half their services became unpaid. Another 24 California
their doors.3 “Anchor babies” born to illegal aliens instantly qualify
hospitals verge on closure. Even ambulances from Mexico come to
as citizens for welfare benefits and have caused enormous rises in
American EDs with indigents because the drivers know that
Medicaid costs and stipends under Supplemental Security Income
EMTALA requires accepting patients who come within 250 yards
and Disability Income.4 , 5
of a hospital. That geographic limit has figured in many lawsuits. 11
What is seen is the illegal alien who with strong back may
Los Angeles County Trauma Care Network, built in 1983, was
cough, sweat, and bleed, but is assumed healthy even though he and
one of America’s finest emergency medical response
his illegal alien wife and children were never examined for
organizations. Consisting of 22 hospitals, state-of-the-art
contagious diseases.
equipment, superior emergency physicians, surgeons, specialists,
By default, we grant health passes to illegal aliens. Yet many
nurses, technicians, it offered 365-day, round-the-clock
illegal aliens harbor fatal diseases that American medicine fought
emergency care for people suffering life-threatening car crashes,
and vanquished long ago, such as drug-resistant tuberculosis,
industrial accidents, urban crime, natural disasters such as
malaria, leprosy, plague, polio, dengue, and Chagas disease. 6 ,7
earthquake and wildfire, or terrorism. Now most trauma hospitals
What is seen is the political statistic that 43 million lives are at
have left the network, and so have many emergency physicians and
risk in America because of lack of medical insurance.8 What is
surgeons.12 EMTALA contributed to the Trauma Care Network’s
unseen is that medical insurance does not equal medical care.
loss of focus and loss of money.13
Uninsured people receive medical care in hospital emergency
Illegal aliens perpetrate much violent crime, the results of
departments (EDs) under the coercive Emergency Medical
which arrive at EDs.1 4 ,1 5“Dump and run” patients, often requiring
Treatment and Active Labor Act of 1985 (EMTALA), which
tracheotomy or thoracotomy for stab or gunshot wounds, are
obligates hospitals to treat the uninsured but does not pay for that
dropped on the hospital sidewalk or at the ED as the car speeds
care. Also unseen is the percentage of the uninsured who are illegal
away. Usually such incidents are connected to drugs and gangs.
aliens. No one knows how many illegal aliens reside in America. If
Even if the hospital is not exclusively dedicated to trauma care,
there are 10 million, they constitute nearly 25 percent of the
EMTALA still governs treatment.1 2
uninsured. The percentage could be even higher.
While most people coming to EDs throughout the United States
are not poor and have medical insurance,16 cities such as Los Angeles
EMTALA
with large illegal alien populations, high crime, and powerful
immigrant gangs are losing their hospitals to the ravages of unpaid
The Emergency Medical Treatment and Active Labor Act
care under EMTALA. In Los Angeles, 95 percent of outstanding
(EMTALA) requires every ED to treat anyone who enters with an
homicide warrants are for illegal aliens, as are 66 percent of fugitive
“emergency,” including cough, headache, hangnail, cardiac arrest,
felony warrants. The notorious 18th Street Gang has 20,000
herniated lumbar disc, drug addiction, alcohol overdose, gunshot
members, of whom 60 to 80 percent are illegal aliens, according to
wound, automobile trauma, human immunodeficiency virus
the California Department of Justice and the Los Angeles Police
(HIV)-positive infection, mental problem, or personality disorder.
Department, respectively. The Lil’ Cycos Gang, notorious for
The definition of emergency is flexible and vague enough to
murder, racketeering, and drugs in Los Angeles’s MacArthur Park,
include almost any condition. Any patient coming to a hospital ED
was thought to be 60 percent illegals in 2002, and the percentage is
requesting “emergency” care must be screened and treated until
higher now. Francisco Martinez of the Mexican mafia ran the gang
ready for discharge, or stabilized for transfer–whether or not
while imprisoned for felonious reentry after deportation.17
6
Journal of American Physicians and Surgeons
Volume 10
Number 1
Spring 2005
Illegal aliens move freely in crime sanctuary cities.1 4 , In
1 7
Los
had been seriously injured, the EMTALA-associated entitlement
Angeles, San Diego, Stockton, New York, Chicago, Miami, Austin,
would provide, as it did for the four-year rehabilitation of a
and Houston, no hospital, physician, city employee, or police
quadriplegic neighbor illegal alien. Rehabilitation costs
officer is permitted to report immigration violators to the
customarily do not fall under the title “emergency care,” but
Department of Homeland Security’s Bureau of Immigration and
partisans clamor to keep paraplegics in America rather than deport
Customs Enforcement (the old INS or Immigration and
them to more primitive facilities south of the border.
Naturalization Service). Los Angeles Police Department Special
My mechanic employs an illegal I shall call Umberto, who said
Order 40, begun in 1979 by Chief Daryl Gates, prohibits police
when I came for my truck, “Dr. Cosman, my children lost their
officers from “initiating police action where the objective is to
shadows! Help me!”
discover the alien status of a person.”
What does this mean? Umberto has five disabled children: two
As many as 10,000 illegals cross the 1,940-mile-long border
are autistic, two have attention deficit hyperactivity disorder, and
with Mexico each day.18 About 33 percent are caught. Many try
one has oppositional defiant disorder, with additional obsessive-
again, immediately. Authorities estimate about 3,500 illegal aliens
compulsive disorder. All take California government-supplied
daily become permanent U.S. residents–at least 3 million
medications, including Ritalin.2 52-8 The autistic children had
annually.19, 20 EMTALA rewards them with extensive, expensive
“shadows” or personal attendants, one per child, under the federal
medical services, free of charge, if they claim an emergency need
Individuals with Disability Education Act of 1975 (IDEA).2 9The
for care. Government welcomes illegal aliens by refusal to police
program provides a shadow, plus an “individual education
our borders, by reluctance to prosecute people who violate basic
program” that cost about $30,000 per year per child. Umberto and
American law, and by fervor to please those who abuse our
his wife dine out alone each week, thanks to California-provided
generosity and cynically ply our compassion against us.
respite-care babysitters.
Illegal aliens have translators, advocates, and middlemen
Anchor Babies
supplied by immigrants’ civil rights groups or by Medicaid.4 , 3 0 , 3 1
MediCal in 2003 had 760,000 illegal aliens, up from 2002 when
American hospitals welcome “anchor babies.” Illegal alien
there were 470,000. Supplemental Security Income is a non-
women come to the hospital in labor and drop their little anchors,
means-tested federal grant of money and food stamps. People
each of whom pulls its illegal alien mother, father, and siblings into
qualify easily. Scams, frauds, and cheats are rampant. In one clinic,
permanent residency simply by being born within our borders.2 1 ,2 2
300 people diagnosed as “mildly mentally retarded” all had the
Anchor babies are citizens, and instantly qualify for public welfare
same translator, same psychiatrist, same symptoms, and similar
aid.2 3 Between 300,000 and 350,000 anchor babies annually
stipend.4 Fraud is an equal-opportunity employer that flouts
become citizens because of the Fourteenth Amendment to the U.S.
America’s generosity to the feeble, the crippled, and the poor.
Constitution: “All persons born or naturalized in the United States,
Illegal aliens have powerful legal facilitators who litigate and lobby
and subject to the jurisdiction thereof, are citizens of the United
for “Open Borders” and for welfare benefits for all who cross onto
States and the State wherein they reside.”
America’s soil. Open Borders proponents imperil America’s
In 2003 in Stockton, California, 70 percent of the 2,300 babies
sovereignty by obliterating distinctions between legal immigrants
born in San Joaquin General Hospital’s maternity ward were
and illegal aliens, and between American citizens and all other
anchor babies, and 45 percent of Stockton children under age six are
people of the hungry world.3 2
Latino (up from 30 percent in 1993).2 4 In 1994, 74,987 anchor
Among the organizations directing illegal aliens into America’s
babies in California hospital maternity units cost $215 million and
medical systems are the Ford Foundation-funded Mexican
constituted 36 percent of all Medi-Cal births. Now they account for
American Legal Defense and Education Fund; the National
substantially more than half.
Immigration Law Center; the American Immigration Lawyers
Consider the story of one illustrative family to show how reality
Association; the American Bar Association’s Commission on
is the sum of the seen and the unseen. The Silverios from Stockton,
Immigration Policy, Practice, and Pro Bono; the Immigrant Legal
California, are illegal aliens seen as hard-laboring fruit-pickers with
Resource Center; the National Council of La Raza; George Soros’s
family values. Cristobal Silverio came illegally from Oxtotilan,
Open Society Institute; the Migration Policy Institute; the National
Mexico, in 1997 and brought his wife Felipa, plus three children
Network for Immigration and Refugee Rights; and the Southern
aged 19, 12, and 8.24 Felipa, mother of the bride Lourdes (age 19),
Poverty Law Center. And there are more.3 3 , 3 4
gave birth to a new daughter, her anchor baby, named Flor. Flor was
Cases of “permanent disability” have burgeoned because its
premature, spent three months in the neonatal incubator, and cost
definition is vague [a 12-month problem that interferes with work:
San Joaquin Hospital more than $300,000. Meanwhile, Lourdes
see Disability Income, 42 U.S.C. 423(d)-(1)(A), and Supplemental
plus her illegal alien husband produced their own anchor baby,
Security Income, 42 U.S.C. 1382c(a)(3)(A)]; 3 5 , flexible,
3 6
thanks to
Esmeralda. Grandma Felipa created a second anchor baby, Cristian.
the Sullivan case;3 7 , 3and
8
individualistic, thanks to government
Anchor babies are valuable. A disabled anchor baby is more
regulations.39-42 Mental, social, behavioral, and personality
valuable than a healthy one. The two Silverio anchor babies
disorders are included. More than 500,000 “mentally disabled”
generate $1,000 per month in public welfare funding. Flor gets
children on psychotropic drugs for ADHD and ODD have
$600 per month for asthma. Healthy Cristian gets $400. Cristobal
incentives to bad, bizarre behavior.3 1 , 4 3 Children’
, 4 4
s disability
and Felipa last year earned $18,000 picking fruit. Flor and Cristian
stipends are called “crazy money,” for crazy behavior.
were paid $12,000 for being anchor babies. This illegal alien
Drug addiction and alcoholism are classified as diseases and
family’s annual income tops $30,000.
disabilities. Disability Code DA&A had in 1983 only 3,000 stipend
Cristobal Silverio, when drunk one Saturday night, crashed his
recipients, but in 1994 exploded to 101,000. In 2003, between
van. Though he had no auto insurance or driver’s license, and owed
250,000 and 400,000 got lump-sum grants of disability money via
thousands of dollars, he easily bought another van. Stockton Police
SSI.4 55- When
0
Linda Torres was arrested in Bakersfield, California,
say that 44 percent of all “hit and runs” are by illegal aliens.2 If
4
Cris
with about $8,500 in small bills in a sack, the police originally
Journal of American Physicians and Surgeons
Volume 10
Number 1
Spring 2005
7
thought it was stolen money.4 It was her SSI lump sum award for her
Chagas disease, also called American trypanosomiasis or
disability: heroin addiction.
“kissing bug disease,” is transmitted by the reduviid bug, which
Immigrants on SSI, including legal aliens, refugees, and illegals
prefers to bite the lips and face. The protozoan parasite that it
with fraudulent Social Security cards, numbered a mere 127,900
carries, Trypanosoma
,
cruzi infects 18 million people annually in
5 4 , 6 7
aliens (3.3 percent of recipients) in 1982.49, 51-53 By 1992 the numbers
Latin America and causes 50,000 deaths.
This disease also
expanded to 601,430 entitled (10.9 percent of recipients).4 In 2003,
infiltrates America’s blood supply. Chagas affects blood
this figure was several million (about 25 percent of recipients).
transfusions and transplanted organs. No cure exists. Hundreds of
6 8
The National Immigration Law Center (NILC) proudly
blood recipients may be silently infected. After 10 to 20 years, up
announced that it garnered for immigrants expensive cancer
to 30 percent will die when their hearts or intestines, enlarged and
6 9
treatments, prenatal care, and critical health services by means of its
weakened by Chagas, burst.
Three people in 2001 received
litigation. Sometimes NILC worked in collaboration with lawyers
Chagas-infected organ transplants. Two died.
from the American Civil Liberties Union and the Mexican
Leprosy, a scourge in Biblical days and in medieval Europe, so
American Legal Defense and Education Fund. Though the 1996
horribly destroys flesh and faces it was called the “disease of the
70
Welfare Reform Legislation reduced all welfare payments to all
soul.” Lepers quarantined in leprosaria sounded noisemakers when
recipients nationwide, NILC cleverly managed to restore to its
they ventured out to warn people to stay far away. Leprosy, Hansen’s
constituency of legal and illegal immigrants: $12 billion in
disease, was so rare in America that in 40 years only 900 people were
71,72
Supplemental Security Income, and more than $800 million in food
afflicted.
Suddenly, in the past three years America has more than
stamps.3 3 ,3 4For many illegal aliens, America is land of the victim
7,000 cases of leprosy. Leprosy now is endemic to northeastern
and home of the entitled.
states because illegal aliens and other immigrants brought leprosy
from India, Brazil, the Caribbean, and Mexico.54,73,74
Contagious Diseases
Dengue fever is exceptionally rare in America, though
common in Ecuador, Peru, Vietnam, Thailand, Bangladesh,
75, 76
When my grandfather came to America, he first kissed the
Malaysia, and Mexico.
Recently there was a virulent outbreak
77
ground of New York’s Ellis Island, then he stripped naked and
of dengue fever in Webb County, Texas, which borders Mexico.
coughed hard. Every legal immigrant before 1924 was examined
Though dengue is usually not a fatal disease, dengue hemorrhagic
fever routinely kills.
for infectious diseases upon arrival and tested for tuberculosis.
Polio was eradicated from America, but now reappears in illegal
Anyone infected was shipped back to the old country. That was
immigrants,7 as
8
do intestinal parasites.7 98- Malaria
2
was obliterated,
powerful incentive for each newcomer to make heroic efforts to
8 38 -6
appear healthy. Today, legal immigrants must demonstrate that they
but now is re-emerging in Texas.
About 4,000 children under age
five annually in America develop fever, red eyes, “strawberry
are free of communicable diseases and drug addiction to qualify for
tongue,” and acute inflammation of their coronary arteries and
lawful permanent residency green cards. Illegal aliens simply cross
other blood vessels because of the infectious malady called
our borders medically unexamined, hiding in their bodies any
Kawasaki disease. Many suffer heart attacks and sudden death. 8 78-8
number of communicable diseases.
Hepatitis A, B, and C, are resurging.8 99-1 Asians number 4
Many illegals who cross our borders have tuberculosis. That dis-
percent of Americans, but account for more than half of Hepatitis B
ease had largely disappeared from America, thanks to excellent hy-
cases. Why inoculate all American newborns for Hepatitis B when
giene and powerful modern drugs such as isoniazid and rifampin. 54
most infected persons are Asians?9 2
TB’s swift, deadly return now is lethal for about 60 percent of those
infected because of new Multi-Drug Resistant Tuberculosis (MDR-
CRAG: A Proposal to Prevent Medical Cataclysm
TB).6 Until recently MDR-TB was endemic to Mexico.55,56 This
Mycobacterium tuberculosis is resistant to at least two major
Tough medicine could end the cataclysm in American
antitubercular drugs. Ordinary TB usually is cured in six months with
medicine.9 I
3 suggest the acronym CRAG for four critical actions to
four drugs that cost about $2,000. MDR-TB takes 24 months with
reclaim America’s EDs; to restore medicine’s proud scientific
many expensive drugs that cost around $250,000,with toxic side
excellence and profitability; and to protect Americans against
effects.57 Each illegal with MDR-TB coughs and infects 10 to 30
bacterial, viral, parasitic, and fungal infectious diseases that illegal
people, who will not show symptoms immediately. Latent disease
aliens carry across our borders.
explodes later.
TB was virtually absent in Virginia until in 2002, when it spiked
Close America’s borders. Prevent illegal entry with fences,
a 17 percent increase, but Prince William County, just south of
high-tech security devices, and troops re-deployed from Germany
Washington, D.C., had a much larger rise of 188 percent. Public
and South Korea. Deport illegal aliens. Homeland Security’s
health officials blamed immigrants. In 2001 the Indiana School of
Immigration and Customs Enforcement has a division of Detention
Medicine studied an outbreak of MDR-TB, and traced it to
and Removal dedicated to deportation. It is hobbled by the
Mexican illegal aliens. The Queens, New York, health department
powerful Executive Office for Immigration Review (EOIR), the
attributed 81 percent of new TB cases in 2001 to immigrants. The
Department of Justice court system that consists of the U.S.
Centers for Disease Control and Prevention ascribed 42 percent of
Immigration Court (USIC) plus an appellate court, the Board of
all new TB cases to “foreign born” people who have up to eight
Immigration Appeals (BIA). The equation EOIR = USIC + BIA
times higher incidence.5 86- Apparently
3
, 66 percent of all TB cases
usually provides amnesty for the illegal alien, plus another level of
coming to America originate in Mexico, the Philippines, and
appeal against deportation in federal circuit court.
Vietnam. Virulent TB outbreaks afflicted schoolteachers and
Internment and deportation are politically incorrect.1 5 , 3 3 But
, 9 3
children in Michigan,6 46-5 adults and children in Texas,6 6 and
America’s inadequate federal border enforcement permits massive
policemen in Minnesota. Recently TB erupted in Portland, Maine,
daily border penetrations that violate the integrity of our medicine
and Del Rey Beach, Florida.
and our national security.
8
Journal of American Physicians and Surgeons
Volume 10
Number 1
Spring 2005
Rescind the citizenship of anchor babies. We must overturn the
illegal aliens is fighting for individualistic America: land of moral
misinterpretation of the Fourteenth Amendment to the U.S.
strength, and home of responsible liberty.
Constitution. The Constitution grants citizenship to all persons
As we fight to reclaim medicine, so we defend our nation.
born or naturalized in the United States and “subject to the
jurisdiction ther .”
eof An illegal alien mother is subject to the
Madeleine Pelner Cosman, Ph.D., Esq., is a medical lawyer, who formerly
taught medical students at the City University of New York. Contact:
jurisdiction of her home country. The baby of an illegal alien mother
MEDLAWMC@aol.com.
also is subject to that home country’s jurisdiction.
When the Fourteenth Amendment was ratified, its purpose was
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6
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8
to
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Journal of American Physicians and Surgeons
Volume 10
Number 1
Spring 2005
9
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10
Journal of American Physicians and Surgeons
Volume 10
Number 1
Spring 2005