All deserve treatment for flu

The swine flu scare may be hype. Maybe not. Either way, it’s reassuring to know that hospital emergency rooms and community clinics are treating anyone who’s sick, including illegal immigrants.

“Swine flu knows no borders,” notes Carmela Castellano-Garcia, chief executive of the California Primary Care Assn., an organization of roughly 700 clinics. “It pays no regard to income or immigration status.”

Hardly a day goes by that I don’t receive at least one e-mail from someone complaining about tax dollars “wasted” on illegal immigrants.

Here’s an excerpt on Friday from Dink: “Thanks to your ‘buddy’ Arnold, I’m paying more taxes so that illegal immigrants can use the nearest emergency room as their primary doctor’s office. . . . “

First, it’s a good bet that Gov. Schwarzenegger does not consider me a “buddy” after all I’ve written about his Sacramento stewardship over the years. But if he had just listened to. . . . Never mind.

Second, the governor has nothing to do with the fact that emergency rooms are forbidden from denying care to anyone, whether they’re in the country illegally or not. That’s federal law.

The nonpartisan legislative analyst figures that so-called emergency services for illegal immigrants cost the state $536 million annually in Medi-Cal funds.

One can argue, as I have, that our borders should be protected and respected. People should come here the right way, legally. And, fortunately, the Obama administration has signaled its intent to crack down on employers who illegally hire undocumented workers.

That said, they are here -- an estimated 12 million illegal immigrants nationwide, nearly 3 million in California. About 90% of California’s share are from Latin America; 65% from Mexico, suspected incubator of the swine flu.

Many e-mailers want to round ‘em all up and truck them back to Mexico. Even if that were logistically possible, only the federal government legally can do it. The feds also are responsible for guarding the border.

But many immigrants, especially those living in Southern California, periodically crisscross the border visiting their friends and families.

Do we really want someone who’s sneezing, coughing and exhibiting flu-like symptoms that are contagious to be trying to ride it out without seeing a doctor? Not if we’re sane and attempting to contain an epidemic.

Treating illegal immigrants -- or anyone else who’s poor and uninsured -- is a practical imperative. Never mind the moral obligation.

Sen. Dean Florez (D-Shafter) put it this way after holding a daylong hearing into California’s readiness for an epidemic: “If clinics are fully funded and prepared, it’s going to save lives, not just the immigrants’ lives through vaccinations, but the lives of non-immigrant Californians who eat the food picked, prepared and served to us every day by immigrants.”

Some nonprofit clinics -- those deemed “federally qualified” for reimbursement purposes -- are legally required to treat all comers.

“We provide care for people with no financial ability,” says Kurt Stauder, chief operating officer at AltaMed, which operates 39 community clinics in Los Angeles and Orange counties. “We charge based on ability to pay. . . .

“Because of the nature of our clientele, which is highly Latino, and the proximity of the border, obviously we have to prepare and are probably on the front line of this swine flu threat.”

There are other local clinics that aren’t legally bound to treat illegal immigrants, but do anyway because they consider it their mission to care for the sick, any sick.

“We serve everybody regardless of immigration status,” Castellano-Garcia says. “We have 4 million patients statewide -- largely low-insured, uninsured, low-income, working poor, Medi-Cal. Over 55% are Latinos. Other than the emergency rooms, we are the safety net.”

Some clinics reported a 25% to 30% increase in patient visits last week, she says, presumably because of swine flu.

That’s fine with state officials, who’d like to steer the uninsured to clinics rather than expensive hospital emergency rooms. Treatment at an ER can cost anywhere from three to 10 times what’s charged at a clinic.

Moreover, says Jennifer Kent, the governor’s point person on health legislation, “in a public health crisis, the number of people going into an ER with a tickle in their throat can crowd out the people with heart attacks, strokes, injuries from car accidents. Not everybody needs to be in a hospital. In fact, in a hospital they could make things worse by just spreading their germs.”

Clinics receive funds from the federal, state and local governments, plus insurers, patients and foundations. Nationwide, community clinics are in line for $2 billion in federal economic stimulus funds. But in California, they’re threatened with state and local budget cuts at the same time the ranks of uninsured are growing because of job layoffs.

A recent statewide survey commissioned by AltaMed and conducted by veteran pollster Ben Tulchin found that two-thirds of registered voters support more public funding for community clinics -- even when told they serve illegal immigrants.

“There’s no significant difference whether you mention ‘illegal immigrant’ or don’t,” Tulchin says. “It’s times like this that people want everyone to have access to affordable healthcare, to get into a clinic and get treated.”

We all benefit from that, no matter how many generations we’ve been legally rooted.

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george.skelton@latimes.com