uncompensated care

[Guest guest]

Further comments to the discussion of uncompensated care by Tina, ,

and .

Each contributor to this discussion hit the principal nails, and hit them

firmly. The report on which most of the AMA article was based originally

was completed for border counties of four states (interestingly, one of the

quoted physicians in the AMA article was from Maricopa County [Phoenix]

which is not a border county). First, the Border Counties Coalition report

attributes no more than 23% of uncompensated emergency services cost to

undocumented immigrants. Who is using the other 77%? Any group(s) in

numbers? points that uncompensated care is not just a dilemma for

border counties/states, and not just about immigrants. At a time when

budgets are dismal, separating the vulnerable from the rest makes a remedy

possible, at the expense of the vulnerable.

and are correct about the relation between the uninsured and

usage of emergency services. Arizona ranks among the nation's highest in

number of uninsured. The uninsured often use emergency services.

Interestingly, none of the border states were among those having difficulty

using funds from the Children's Health Insurance Program ('s article

provided by ).

The Coalition report compares border counties with non-border counties from

the same states. Hence, there is the second factor. Arizona and the three

border states are part of the Sunbelt; they attract people from across the

country from all income levels, low and high. Immigrants join internal

migrants and the state's poor in making use of emergency health services.

The researcher in me wants to know if there are patterns in the

uncompensated care. Are certain categories experiencing repeated use of

emergency services? (Eg, single parents with pre-school children,

particular age groups) Are certain time periods more represented? (Eg,

weekends, late afternoon, Mondays) Are certain problems over-represented?

(Eg, lacerations, poisoning, gastrointestinal complaints, or flu symptoms)

Good discussion, overall. Thanks.

V. Bletzer