These are the Times that Try Men's Souls
With the 24-hour news cycle, I understand news organizations tend towards the dramatic in order to draw in readers. However, that’s a flimsy excuse when it comes to irresponsible reporting. One article in particular stands out.
This news story is about an undocumented immigrant with end stage renal disease on dialysis. Renal disease is common in the United States and approximately 468,000 Americans are receiving dialysis. Filtering out toxins and excessive minerals from the bloodstream, dialysis is typically performed three days a week to synthesize the action of a functional kidney. Although limited, dialysis is a life-saving procedure, allowing people with minimal or no renal function to survive.
While receiving dialysis, patients usually are set up with an outpatient center such as Fresenius or DaVita. At these clinics, patients receive dialysis and also are followed by a renal doctor and dialysis dietitian. Due to poor renal function, patients have to limit fluid, sodium, potassium, and phosphorus while maintaining adequate protein and calorie intake. It’s a challenging diet to follow and not unusual for patients to eventually decline dialysis, where they pass away within a few days of no treatment.
CNN Story
Going back to the news story, the sensationalized account of Lucia remarks that she is one of 6,500 undocumented immigrants living with end-stage renal disease. The article states that Lucia “must wait to nearly die before she can be revived and brought back to life.” The rest of the article contains similar inaccuracies.
Because Lucia is not documented, she is not eligible for Medicare, Medicaid, or private insurance that would cover dialysis. She can only receive dialysis when symptomatic through the emergency department of her local hospital. Hospitals are compelled to treat patients who are in imminent danger regardless of their citizenship or insurance. Lucia receives dialysis approximately once a week instead of the normal three times a week regimen.
At any given time, hospitals have a number of these patients. In both hospitals where I’ve worked, we’ve had patients who are not citizens and cannot be accepted by outpatient dialysis centers. After being told to follow a strict renal diet with fluid restriction, they are told to come to the emergency department when symptomatic to receive dialysis.
Obviously, this regimen is dangerous and not ideal. We cannot put the blame on our hospitals though. A few points to keep in mind when reading the CNN or similar stories include:
Lucia is not in the United States legally. While our immigration system is a broken one, hospitals and healthcare providers are not responsible for that system.
Dialysis is a prohibitively expensive treatment which Lucia receives weekly. It’s likely that the hospital absorbs the cost of her treatment.
If Lucia had stayed in Mexico, her native country, she would not have received dialysis and would likely not be alive. She recognizes this fact in her interview.
Dialysis centers do have charity spots but they are only available to citizens.
We have great healthcare in the United States but it comes at a cost and there are limited services for uninsured patients. There are minimal services for undocumented immigrants.
Emotional Response
This article is written in such a way to elicit an emotional response. I feel a sense of compassion towards Lucia and her family. I hope we all feel that way. I think we would all consider breaking immigration or other laws to save the lives of our parents or loved ones. We also have to consider Lucia’s predicament in light of our broken immigration system and the problems in our healthcare system. This story, even badly reported as it is, should affect us.
On a more practical note, providing healthcare is expensive and providing low-cost or free services is a burden to our community. Resources are limited and we all contribute to paying for Medicare and Medicaid which is how many people have their dialysis covered. This is a longer discussion that simply can’t be hashed out in a single article but we desperately need to change immigration and healthcare policies.
These are the Times We Live In
These are not easy targets for improvement. However, let’s consider two facts:
People immigrate to the United States illegally every day and we can’t prevent this from happening completely
We have to offer lifesaving medical treatment to all people regardless of citizenship or insurance status- this isn’t simply a moral imperative but also a law
Regardless of your political status, these two facts are a given. By ignoring the reality of our situation, we simply add to the taxpayer burden. Not only do we need to create reasonable paths to citizenship, we need to provide a way for Lucia and others to contribute to the healthcare system that is already providing them services. Not only will this improve her and other’s lives, it will also lessen financial burdens.
I see no reason why reasonable people can’t provide at least a better solution to our current predicament. In the meantime, I guarantee that any hospital in the United States will continue to have multiple patients in the same predicament as Lucia.
