Why hospitals are closing

From the NY Times:

Each had crossed the border years before, smuggled across the desert by a coyote, never imagining the journey would lead to a drab and dusty clinic on the ninth floor of Grady Memorial Hospital in Atlanta.

Some knew before the crossing that they had diabetes or lupus or high blood pressure, but it was only after they arrived that their kidneys began to fail. To survive, they needed dialysis at a cost of about $50,000 a year, which their sporadic work as housekeepers, painters and laborers could not begin to cover.

And so they turned to Grady, a taxpayer-supported safety-net hospital that would provide dialysis to anyone in need, even illegal immigrants with no insurance or ability to pay. Every Tuesday, Thursday and Saturday morning, the 15 or so patients would settle into their recliners, four to a room, and while away the monotonous three-hour treatments by chitchatting in Spanish.

That all changed on Oct. 4, when the strapped public hospital closed its outpatient dialysis clinic, leaving 51 patients — almost all illegal immigrants — in a life-or-death limbo.

For Grady, which has served Atlanta’s poor for 117 years, it was an excruciating choice, a stark reflection of what happens when the country’s inadequate health care system confronts its defective immigration policy.

Like other hospitals, particularly public hospitals, Grady has been left to provide costly treatments to nonpaying illegal residents who most likely could not have obtained such care in their home countries. American taxpayers and health care consumers have borne the expense.

Over time, the mounting losses have compromised Grady’s charitable mission, forcing layoffs, increases in fees and the elimination of services.

“Years and years of providing this free care has led Grady to the breaking point,” said Matt Gove, one of the hospital’s senior vice presidents. “If we don’t make the gut-wrenching decisions now, there won’t be a Grady later. Then, everyone loses.”