Will Cuts to Health Care for Indigent Cost Us More in the Long Run?

Last week the County put off a decision on cutting off indigent health services to undocumented residents.  However, the county will have to act on it and it is likely given the fiscal conditions of the county, they will act to cut off these services.

It is greatly ironic that one of the Republicans on the Board of Supervisors, Matt Rexroad seems to get the fact that while it would seem the fiscally prudent thing to do, cutting off health services to indigent patients probably costs more in the long run.

On his blog last week, he writes:

“I understand how and why the county needs to eliminate these services for all kinds of reasons.  However, I still believe that this will end up costing taxpayers/health care premium payers/and emergency room users more than the county is currently paying.

This is what I think will happen.  Instead of people going to the county on a Tuesday with a cut on the arm that needs some simple first aid that even some lame first aid provider like me could do the same person will show up on Saturday in the emergency room with a raging infection that will require the emergency room staff to apply observation and treatment that will cost 75 times what the visit on Tuesday would cost.

No problem you might say.  The taxpayers don’t have to pay for it — all is good.  Not really.

Federal law requires emergency rooms in hospitals to treat anyone that walks in the door with a real emergency.  These people will get treated to the point they can leave.  This person can’t pay the county on Tuesday for the first aid. Do you think they are going to pay the hospital for the treatment, x-ray, and antibiotics they get on Saturday? Not a chance. Instead of paying $100 for visit on Tuesday the hospital bill on Saturday that will be left unpaid will be many times higher.

What will happen is that the hospital will raise their rates a little higher so that my health insurance premiums go up a little more.  Further, when Jenn cuts her hand or Adam has an intensely high fever so I take them to the emergency room at Woodland Memorial I will be waiting for an extra two hours to be seen because ten people in front of me that should have been treated on Tuesday are not in front of me in line on Saturday.

Some of you are going to be cheering the new policy of not providing services to illegal immigrants.  I get that.  I understand it.  I just don’t agree with all of it.

What I think is not being understood by all of you that have been e-mailing me encouraging this outcome is that we are all still going to pay for this treatment at a more critical stage.  The current legal system mandates that care when it is most expensive.

It is my belief that we will actually pay more in the long run for the care of these people than the county pays right now.  This decision is not the end result that many of you desire.”

Mr. Rexroad is correct.  There are other  reasons to consider this policy other than it’s simply the right thing to do.

First, we live around people regardless of whether or not we provide them health care.  The more we allow disease to fester because we fail to allow for things such as health care and possibly even vaccination, the more we put ourselves at risk.

Thankfully, the H1N1 was not as serious as feared but I still think it illustrates the point.  The lack of diagnosis and treatment will lead to unreported cases.  Thus people who are sick will be more likely to transmit it across the population and less likely to be quarantined.  Disease is not likely to distinguish between those here legally and those not.

The county has to cut services, that part is unavoidable.  What they ultimately decide to cut is going to hurt someone who needs their services.  I get all of this.  Our job however is to determine which cuts will hurt us least and while this seems to make the most sense, I think everyone needs to stop and think.  If the Republican gets it, shouldn’t we all?

—David M. Greenwald reporting

About The Author

David Greenwald is the founder, editor, and executive director of the Davis Vanguard. He founded the Vanguard in 2006. David Greenwald moved to Davis in 1996 to attend Graduate School at UC Davis in Political Science. He lives in South Davis with his wife Cecilia Escamilla Greenwald and three children.

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  1. Anon

    The only problem w this argument is the assumption that illegal aliens come in and get essentially “preventative” services, before the health issue gets out of hand and leads them to the emergency room. I think if you talk to the average doctor/nurse, they will tell you most people, and especially illegals, do not come in for care until it has already become an emergency. This happens repeatedly, in every city across the country – indigents use the emergency room as a doctor’s office, and only come in when things are usually pretty bad. They do not come in for minor cuts that could be solved with a bit of antiseptic ointment and a bandaid.

    While I appreciate the “pennywise and pound foolish” argument as a general principle, I don’t necessarily think it applies here. Matt Rexroad should at least do some substantive research on this issue – and not just ask doctors/nurses who practice at the community clinics, who do not want to see their jobs in jeopardy.

    I would also ask Matt, if not this program, what county programs would he cut instead? Some from the DA’s Office, the County Sheriff’s Office perhaps? They all have strong arguments as to why the cuts should not apply to them. Every program probably has good reason to be in place. That is not the question. The question is which ones should we cut, bc we can do without them less – in the long run?

    “Last week the County put off a decision on cutting off indigent health services to undocumented residents. However, the county will have to act on it and it is likely given the fiscal conditions of the county, they will act to cut off these services.”

    This is nothing more than “hand wringing”, much as DJUSD did before they made the decisions to close Valley Oak. I have no patience with this sort of “political theater” as a CYA tactic.

  2. Old Skool Davis

    Hey! Greenwald,

    It looks like you were a no-show for the Davis All Stars Basketball team this evening. FYI, they announced your name from the team roster at the player introductions. It would have been heart warming for me to see you sharing the bench with Rose Conroy, Ted Puntillo, and Bob Dunning.

    Maybe, Ted would have let you carry his gym bag?

  3. Old Skool Davis

    I recognize the seriousness of your candid sincerity.
    We hope whatever troubles you has a peaceful and positive resolution.

    Peace-out. O.S.D.

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