By RAFAEL GERENA-MORALES rgerena@tampatrib.com Published: Jan 8, 2003

TAMPA - Florida hospitals last year spent $40.5 million providing care to uninsured patients who are not U.S. citizens, a burden that has wounded the industry's financial health, according to a report released Tuesday.

The cost has become especially difficult to bear because hospitals are struggling with falling Medicare and Medicaid reimbursement rates and rising medical malpractice premiums, reports the Florida Hospital Association, which conducted the study.

``Hospitals have to absorb most of these costs because there is very limited [government] funding to pay for'' the care of patients who are not U.S. citizens, said Kim Streit, the association's vice president of health care research and information.

``We need some form of federal funding to help pay for these costs,'' she said. ``The people of Florida are paying for this through higher medical costs and insurance premiums.''

The study did not track the costs in previous years to care for uninsured patients who are not U.S. citizens.

Federal law requires hospitals to care for all patients who visit an emergency room, regardless of their ability to pay or citizenship.

Hospitals are also largely responsible for providing follow- up care in which an uninsured resident may remain bedridden for months, if not a year or more in a small percentage of cases, Streit said.

-- Anonymous, January 08, 2003

Answers

The report suggested that:

* The federal government clarify how hospitals provide follow-up care to patients who are not U.S. citizens.

* Foreign nations be required to accept the medical transfers of their citizens.

* Tourist visas be issued only if travelers document their health status and financial ability to pay for care.

In the Tampa Bay area, hospitals are spending millions of dollars to pay for the care of uninsured residents, including U.S. citizens.

In Hillsborough County, Tampa General Hospital annually provides roughly $65 million in charity care for all patients. St. Joseph's provided $9.4 million in charity care in 2001. In Pinellas County, Bayfront Medical Center annually provides $13.5 million in charity care, including services for U.S. citizens. Officials at these Bay area hospitals said they did not immediately know how much of their overall charity care was provided to patients who are not citizens.

Still, an expense of $40.5 million for uninsured patients who are not U.S. citizens might not be extraordinary when spread statewide across hundreds of hospitals that collectively generate billions of dollars in annual revenue. But it might be symptomatic of a larger issue: how to pay for all uninsured patients.

Jay Wolfson, a professor of public health and medicine at the University of South Florida, said hospitals need help paying for uninsured patients, and must continue caring for them.

``As a community, we have a moral obligation to be compassionate and care for people even if they are not citizens,'' he said.

-- Anonymous, January 08, 2003