Weak immigrant sent home after free treatment in Ariz. (Arizona Republic)

Weak immigrant sent home after free treatment in Ariz.

Chris Hawley
Republic Mexico City Bureau
Mar. 17, 2008 12:00 AM

ECATEPEC, Mexico - When the motorcycle that illegal immigrant Laura Velázquez was riding slammed into a concrete wall, it cost a Phoenix hospital $478,000 to save her life.
The hospital is footing the bill. But Velázquez's life in America is finished after hospital officials sent her back to Mexico.
Velázquez's story is an example of what happens when uninsured illegal immigrants need medical care, a problem that costs American hospitals and taxpayers millions of dollars each year. It's a critical issue, because a federal program aimed at reimbursing hospitals is scheduled to disappear at the end of this year.
But Velázquez's case also shows how innocent people can get ensnared in the illegal-immigration controversy. Velázquez, now 22, never asked to come to the United States; she was brought as a child. She wasn't driving the motorcycle; she was only a passenger.
Her journey home has attracted the attention of Mexico's national media. Government officials in Ecatepec, her hometown on the outskirts of Mexico City, say she should have been allowed to recover in Phoenix, and they have accused the United States of indifference.
Velázquez, meanwhile, lies in a dim, windowless room in a relative's home in Ecatepec and thinks about how things used to be.
"I want to walk again," she said, her voice a whisper because of a tracheotomy tube. "I want to go home."
Twist of fate
When Velázquez was 11 years old, she and her mother climbed into a car trunk in Nogales, Sonora, and emerged again in Arizona.
They moved to Laveen with her father, a landscaping worker. Velázquez learned English, attended Summit High School and had two children with her high-school sweetheart. She worked off and on at a furniture store, processing credit applications.
On Jan. 26, a neighbor invited her for a ride on his motorcycle.
What happened next is unclear. The Maricopa County Sheriff's Office, the Arizona Department of Public Safety and the Phoenix Police Department have no record of the crash. Velázquez remembers little, her family says.
But whatever happened, it was violent. When an ambulance brought her to St. Joseph's Hospital and Medical Center in Phoenix, her upper spine was snapped, her left lung was collapsed, and her left leg and arm were broken.
Paramedics reported that the motorcycle had hit a concrete wall, said Margaret McBride, the hospital's vice president of mission services. The driver escaped with minor injuries, said Velázquez's mother, Estela Loera.
For days, Velázquez fought for her life.
"The patient has been medically unstable," doctors' notes said. "Surgery has been canceled multiple times."
In all, Velázquez underwent three operations to repair her spine, mend her bones and install breathing tubes.
Costly care
No one is sure how much uninsured illegal immigrants like Velázquez cost the United States, according to a 2004 report by the U.S. Government Accountability Office. That's because hospitals usually don't ask patients about their immigration status.
But a study by the Border Counties Coalition estimated that illegal immigrants accounted for more than $200 million of the $845 million in unpaid medical and ambulance bills in 2002 at hospitals along the U.S.-Mexican border.
By law, hospitals must treat emergency medical patients until they are healthy enough to be discharged.
The cost is a serious burden for hospitals in border states. Some have had to cut back on other services.
"I've had to close my OB department down, I've had to close my long-term-care facility down, because the drain on the resources doesn't allow it," said Jim Dickson, administrator of Copper Queen Community Hospital in Bisbee. "We're into rationing because of the uncompensated (care)."
Under pressure from lawmakers in border states, in 2003 the federal government set aside $250 million a year to reimburse hospitals for illegal-immigrant care.
But the program applies only to the first two or three days of care, and the program expires at the end of this year. Hospital trade groups are lobbying to get it renewed.
As Velázquez's tab grew, hospital officials knew they would never get the money back, McBride said. So they declared her a charity case, essentially forgiving her $478,000 bill.
Last year, St. Joseph's spent $17 million on such charity cases, immigrants and U.S. citizens alike.
"Ultimately, it does cost the community," McBride said. "It affects the programs we can offer, the technology we can buy, the raises we can give employees."
Hospital officials knew another problem was on the horizon: Velázquez would need long-term care. Without insurance or legal residency, no U.S. hospital would take her. Mexico, however, has government-run hospitals and a free, if rudimentary, socialized medical system.
Coming home
Velázquez arrived in Hermosillo, capital of the northern Mexican state of Sonora, in an aircraft chartered by St. Joseph's. In her immigration photo, blue-and-white breathing tubes cover her face.
Relatives went to the Ecatepec government for help bringing Velázquez the remaining 1,000 miles home. That's how the Mexican press learned about her case.
"Woman deported in vegetative state," read a headline in the newspaper El Universal. "Hospital that treated her reported her as illegal," read one in El Gráfico. "(Mexican) federal authorities did nothing," El Milenio added.
The stories exaggerated. Velásquez wasn't in a vegetative state, her family says. She can talk a little and move her head, arms and toes. She wasn't deported, either: McBride said St. Joseph's never had any contact with immigration officials.
But at a time when the United States is building border fences and cracking down on illegal immigrants, the story of the comatose woman kicked out by the Americans quickly spread around Mexico. None of the articles mentioned the free medical care.
The Ecatepec government looked into flying her home, but no airline would take a patient in such grave condition, said Osmar León, a city councilman who chairs the health committee. A chartered jet was out of the question: It would have cost $40,000, one-tenth of the city's entire health budget, he said.
And so Velázquez was loaded into an ambulance for a 26-hour ride across Mexico.
She arrived in Ecatepec on Feb. 21, her 22nd birthday, with an infection. Three days later, she stopped breathing. The family gave her CPR and rushed her to an Ecatepec hospital.
"She should never have left Phoenix. She needed more time to recover," León said. "The United States of America has intervened in other countries in the name of human rights but is incapable of respecting the human rights of its own immigrants."
Loera said she had hoped Velázquez could go through rehabilitation in Phoenix. León said he was asking Ecatepec's congressmen to try to get her into a rehabilitation program at a federal neurological hospital in Mexico City, but there has been no progress.
McBride said St. Joseph's doctors believed Velázquez was stable enough to travel when they discharged her. They also said it is unlikely she will walk again.
For now, Velázquez spends her days in0 a bed in her aunt's small house in a poor, unkempt neighborhood in Ecatepec. A bare light bulb lights the room. A picture of the Virgin of Guadalupe hangs over her bed.
"I know the doctors did their best up there," Loera said. "I just wish she could have stayed longer."