Hospital Attempts Deportation of Woman With Inadequate Insurance

by Cara on May 19, 2008

in action alert, class and economics, courts, discrimination, human rights, immigration, race and racism, women’s health

An immigrant woman from Honduras who has very recently awakened from a coma is being threatened with what can effectively be called deportation, because she does not have the insurance needed to cover her medical bills. (Don’t read the comments in these articles unless you want to lose your lunch.) But here is the real kicker: while it would be repulsive and incredibly inhumane to deport an uninsured/under-insured person with a serious medical condition because of their undocumented status, despite the lack of adequate facilities for their care in their nations of citizenship, it isn’t even the case here. Sonia del Cid Iscoa has a current visa and in the U.S. legally. (All emphasis in quoted text is mine.)

A gravely ill woman at risk of being removed from the country for lack of adequate insurance coverage awoke from a coma Tuesday.

The hospital has been seeking to return her to her native Honduras; her family took the hospital to court.

[. . .]

Iscoa, 34, has a valid visa and has lived in the United States for more than 17 years. She has no family in Honduras.

But St. Joseph’s Hospital and Medical Center sought to have her sent to Honduras when she went into a coma April 20 after giving birth to a daughter about 8 weeks premature. Iscoa has an amended version of Arizona Health Care Cost Containment System coverage that does not cover long-term care, Curtin said. But her family worried that the move would seriously harm her, or, at the very least, prevent her from ever returning to the United States.

Iscoa’s mother, Joaquina del Cid Plasecea, obtained a temporary restraining order to keep her from being moved. Maricopa County Superior Court Judge Carey Hyatt also ordered that the family post a $20,000 bond by Tuesday to cover St. Joseph’s costs of postponing the transfer.

However, Curtin said that the hospital gave the family three more days to come up with the money before a hearing Friday.

If the family can prove that Iscoa would suffer irreparable injury by a move, the bond will be refunded and Iscoa will not be transferred. But if Hyatt determines that Iscoa is not in imminent danger by a move, the family will forfeit the bond.

A stipulation to a court order issued by Hyatt Tuesday evening said that the parties were “actively exploring alternative sources of securing payment for the medical bills of Sonia Iscoa.”

The original story is close to a week old — but a judge has postponed the hearing until this Friday (which would be May 23rd). As I said, the Honduran hospital that St. Joseph’s is looking to transfer Iscoa to has agreed to accept her as a patient but warns that they cannot provide her with the care she needs.

Iscoa went to the hospital on April 16 because of abnormal bleeding, but the hospital sent her home, family members said. The next day, her doctor asked her to return, and when her water broke and she began having contractions on April 20, she was rushed into surgery and did not regain consciousness afterwards.

“They told us that she was bleeding excessively, and they had to do a hysterectomy on her, but they didn’t know why she was in a coma,” said Maria Adame, a family spokeswoman.

Iscoa went into kidney failure. She had two more surgeries and had an ovary removed.

Meanwhile, Adame said the family is having trouble getting medical records from St. Joseph’s.

An independent doctor was scheduled to examine her on Saturday to help assess whether she can or should be moved.

Liliana Flores, a spokeswoman for Hospital Escuela, said that the hospital would accept Iscoa but cautioned that its ICU unit only has four beds and the hospital has no dialysis unit.

There are attorneys and Honduran groups who are desperately trying to help Iscoa and her family.

Suzanne Pfister, a spokeswoman for the hospital, said that as many as eight patients are transferred each month to other countries, mostly to Mexico.

It’s a practice some lawyers are calling into question, specifically whether a hospital has the legal authority to force patients to cross international borders against their will. One attorney in Tucson has twice called police and accused hospital staff of kidnapping to stop the transfers.

“Right now the hospital is exploring with us the alternative means of being able to try to provide a long-term solution to the problem,” said Iscoa’s attorney, Joel Robbins.

[. . .]

The relatives contacted attorneys and got a temporary restraining order.

Judge Carey Snyder Hyatt of Maricopa County Superior Court ordered that the family post a $20,000 bond against expenses incurred by the hospital in the delay.

Robbins said it will be posted by the Arizona Trial Lawyers Association.

Nora Montoya, consul general for Honduras in Arizona, said that Honduran groups here and in Los Angeles and Washington are raising money for her medical care.

Robbins is hopeful that a compromise can be reached to find long-term medical care for Iscoa in Arizona, and he and his associates are talking with other health-care organizations.

[. . .]

Mitchel, who has lived with Iscoa for four years but is not married to her, wondered how they could send her to another country against their wishes.

Hospital representatives were not sure if such transfers had been successfully challenged in court, despite the frequency with which they are carried out. It is the federal government that ordinarily determines who must leave the country.

Fernando Gaxiola, a criminal-defense and immigration attorney in Tucson, said that he has twice thwarted such transfers by calling police and Mexican authorities and reported the transfers as kidnappings.

You know, the question really does seem like a no-brainer. In what rational world does a hospital have the right to send a patient to another country against her wishes? I know that on a day-to-day basis, our shitty health care system seems to have as much if not more direct power over our lives than the government does. But despite the common perception, they are not all-powerful. They are not the government. And they do not have the right to deport anyone, let alone a woman who is in the country legally and in grave medical condition. Gaxiola was entirely right to report previous “transfers” to authorities as kidnappings. And pretty damn smart to have done so.

Furthermore, knowingly and forcibly transferring a patient with kidney failure to a facility that does not have a dialysis unit is nothing short of violence. Plain and simple. Regardless of how we tend to behave, being a citizen of any nation other than the United States does not revoke your status as a human being. This is both racist and classist. This is flat out wrong.

A fund to help pay for Sonia del Cid Iscoa’s medical care has been set up through Wells Fargo Bank. Please help disseminate this information.

Helping Iscoa’s loved ones to pay for her medical care will not solve the bigger problem or help those who come after her. That is why the legal action is absolutely necessary. But we can help one woman receive the care she needs to live and to stay with her family, and loudly voice our opinion that this is in no way acceptable.

Thank you to Jenny for sending me the link.

Cross-posted from Feministe

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{ 10 comments }

1 Jenny Dreadful May 19, 2008 at 2:40 pm

You are wonderful, Cara. Thanks for highlighting this issue. I’ll add the link to the fund to my post. Thanks again.

2 Wendy May 19, 2008 at 4:27 pm

This kind of stuff makes me furious – I work in the medical field as a Physical Therapist. I currently work primarily with adults with developmental delay and find myself in a position of advocacy ALL THE TIME because of discrimination and denying medical care to these under-insured individuals who are not able to advocate for themselves. I have never understood why hospitals in the US are FOR PROFIT. I believe basic healthcare should be available to ALL PEOPLE, whether they once lived in Honduras or anywhere else – and talking about deporting them because their insurance doesn’t cover long-term care is just downright inhumane. You said it was equal to violence to send her where there is no dialysis…I’ll go one step further – it is murder. She will die without dialysis if she is in kidney failure – who makes these decisions? Someone with no compassion, no heart, no empathy…

3 Anna May 19, 2008 at 4:48 pm

I am absolutely, utterly appalled BUT I AM NOT SURPRISED!! I am sick to death of the cheap-minded, cruel American approach to health care. Sick to death of it. How dare we make human survival & compassion for others a matter of PROFIT.

This hospital’s behavior is inexcusable – what happened to the hypocratic oath – do no harm?

We need socialized medicine now – it is the only way to regain our humanity & to overcome our selfishness. I have loved ones living without health insurance who are treated so poorly, who have to make medical decisions based on cost not their well-being.

I am sick of it.

4 patrick May 19, 2008 at 6:55 pm

Wow, that is just…I think I’m gonna be sick. Have American hospitals forgotten their Hippocratic oath? Pardon me for parroting you Anna. Kind makes socialized health care look worthwhile doesn’t it. How long can the Republican narrative about individual choice and responsibility stand up in the face of what Cara absolutely correctly identifies as violence (pre-meditated murder if this woman dies).

5 Jenny Dreadful May 19, 2008 at 7:51 pm

This whole thing kind of lays bare the fallacy of the whole “loving babies” excuse for being anti-choice. This is a Catholic hospital trying to deport a LEGAL IMMIGRANT who just gave birth. There’s nothing that says “I love children!” like condemning a mother of six to a likely death because of her inability to pay. That’s right neighborly of them, that.

6 Renee May 19, 2008 at 10:43 pm

I wish I could say that I am surprised. This is exactly what happens when basic life needs are commodified. Within a capitalist mode of exchange people are not valued only profit is. Her status resisdency status is irrelevant because irregardless without the ability to pay the hospital would still be searching for a way to absolve itself of responsibility for her care. Her race allows them to prey upon the sytemic racism and xenophobia that is rampant in society today. Race in this case is simply a tool used to mitigate social responsibility.

7 sara May 20, 2008 at 2:29 am

The hippocratic oath applies only to doctors, not policy-based hospital decisions. The only oath they take is to their CEO and shareholders.

BTW, the original oath forbade abortion and surgery. I dont think you really want the original oath in play here.

As an aside, I dont know specifically about Honduras, but I’d be shocked if they dont have any dialysis facilities. Its a pretty common commodity, even in 3rd world nations.

I know Mexico definitely has nationalized dialysis facilities, paid for by the government. Mexico has “universal” socialized medicine, so its really not correct to say that if you send somebody to Mexico that they cant get medical care.

That being said, it is outrageous for a hospital to have a policy of deporting patients.

8 ouyangdan May 20, 2008 at 4:29 pm

well, sara, prepare to be shocked, b/c the article, and the parts of it that Cara quoted specifically say that the Honduras hospital has agreed to take her, but they “can’t provide the care she needs” and “have no dialysis facilities”. i also don’t think anyone here said you can’t get medical care in Mexico. there most certainly is very good medical care available.

(no longer @ sara)

this is appalling. even if the hippocraic oath doesn’t apply to policy, there is no way that moving a patient in the condition that this woman is in is ethical in any way, nor in the best interest of the patient. once a doctor/patient relationship has been established the hospital can not just back out and doom this woman for her inability to pay.

this conversation would not even be happening if she were white, i am sure. but she is a WOC so her needs and best interest can be swept aside easily, right? it’s her fault she is in this situation, not enough insurance, an immigrant, and this isn’t her first child. wow, she is just pure evil all over. *headdesk*

i don’t know if there are any Wells Fargo banks around her, but i sure as fuck am going to look.

9 sara May 21, 2008 at 1:42 am

Just another word about hospitals. As the law stands right now, they are under no obligation to hold patients until all their medical problems are cleared, they simply have to hold them until they are deemed “medically stable.”

Whether thats right or wrong, I’ll leave for another debate but I do think that its an important factor to know about.

Take dialysis again for example. Say a patient comes in with new diagnosis of renal failure. The hospital is obligated to provide the first couple of dialysis treatments to get the urea and other toxins filtered out of the bloodstream so it doesnt kill the patient immediately. HOWEVER, the hospital is NOT under any obligation to provide long term dialysis services, which is what that patient will need. Without dialysis 2-3X per week, they will die but the hospital is technically off the hook.

10 SunlessNick May 21, 2008 at 6:52 am

This is a Catholic hospital trying to deport a LEGAL IMMIGRANT

It won’t be long before that bit gets brushed out of the narrative.

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