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Grady Hospital, the public hospital here in Atlanta GA that provides care for the indigent sick, has been having financial troubles in recent years with multimillion deficits. Now based on the recommendations of an outside consulting firm they have proposed saving money by denying dialysis treatments to Non-citizens. For those who are not familiar with it, dialysis is a procedure performed two or three times a week in patients with kidney failure which uses a machine to remove toxins from the body that are normally removed by the kidneys. Taking away dialysis is a death sentence. The brilliant plan of Grady includes giving people plane tickets to Connecticut or back to their home countries, or letting them go to the Emergency Room if and when they start dying.
This is so obviously an unethical procedure that it makes you wonder how anyone who calls him/herself a member of the medical profession can go along with this. It obviously is a violation of the Hippocratic oath which states that doctors should not do harm. Come to think about it, our entire medical system, which has people making a profit from people’s sickness, along with everything that goes along with that, like riscission (insurance companies dropping people after they develop a chronic illness), churning tests and procedures that do not benefit patients health, and now making non-citizens walk the plank in the name of saving money, is a violation of the Hippocratic oath. I think a system that incentivizes medical personnel to undercut health is immoral.
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how would you have Grady balance its budget, Doctor Bremner?
@Eden: You didn’t ask me, but my answer would be, “Not over my dead body!”
I am no financial genius, having recently run my own practice into the ground at least in part because of too many reduced-fee patients, but I would say they could start by eliminating cronyism and inefficiencies (e.g., in the billing “system”). Other counties whose citizens use Grady (accident victims, for example, are choppered in from all over North Georgia) should be expected to contribute operating funds. They could stop offering elective procedures.
And if they have to, let them close the dialysis clinic. But it is not ok to choose who to treat and who to let die.
As usual, a Grady critic takes half truth and uses it to great effect. The word from the inside is – as announced at the July board meeting – Grady will no longer provide outpatient dialysis at all but is referring folks out to the 110-plus outpatient dialysis centers across Atlanta. If current patients need assistance getting somewhere else, I’m told they will help. So, rather than throwing patients in the street, they appear to be providing the kind of charitable assistance you would hope to see.
I agree with you that we have a crisis in healthcare and the profit motive is corrupting. But I can’t throw stones at Grady when it sounds like they’re actually doing the best they can. You might want to check your “leave or die” sources.
Doug:
How bout you donating your money to the Grady dialysis unit to help pay for their care. Or better yet, mandate that Grady dialysis unit continue to lose money, so they can close their doors to everyone, and leave more dialysis patients with nowhere to go.
Orlando Florida Town Hall Meeting 8/17/2009~ Single Payer Now!! http://www.youtube.com/watch?v=_8OyNG0FjyU
These cases are distressing, but I don’t feel that all medical providers ought to be required to give free medical care to the point of bankruptcy. Shouldn’t ALL Americans help to shoulder the cost for those who are unable to pay? Maybe we ought to talk to Obama about this. Or maybe he already is trying to do something about it.
Here in Las Vegas, UMC (the county/indigent hospital) is spending about $20 million/year on dialysis for illegal aliens. Said illegals must go through the emergency room to access dialysis, which of course increases the cost (the patients are in far worse shape by the time they reach the emergency room than if they had access to a dialysis center.) UMC can identify who is illegal – anyone who doesn’t have insurance or Medicare. The illegals are largely from Mexico, so UMC is trying to work with the Mexican consulate here in order to resolve the problem. UMC could turn all the illegals’ names over to ICE, but to paraphrase the UMC spokesman, “We’re doctors. We’re interested in saving lives, not acting as the immigration police.” And apparently ICE doesn’t want the illegals with ESRD, because the deportation process can take months, and ICE would be stuck with the bill for dialysis and other medical care. What a mess!
Definition of a liberal: “One who wishes to use someone else’s money to pay for touchy feely stuff that the liberal is unwilling to pay for.”
Prove me wrong – take a 25% paycut while working 25% more hours with the money your University saves going to Grady to fund illegal immigrant care. Oh yes, next year when there are even more illegals you’ll need to take another 25% pay cut and work 25% more hours. Repeat indefinitely until you drop dead or become conservative.
To Not Exactly -
You wrote:
“Grady will no longer provide outpatient dialysis at all but is referring folks out to the 110-plus outpatient dialysis centers across Atlanta.” Will the illegals get free (or affordable – affordable by the illegals’ standard) dialysis at these op dialysis centers as they did when they went to Grady? If yes, your point that “rather than throwing patients in the street, they [Grady] appear to be providing the kind of charitable assistance you would hope to see.” is well taken. If the answer is no, I’ve got a funny feeling the illegals will not be able to afford dialysis, in which case, it does become a “leave or die” matter of throwing patients in the street.
I don’t know if the answer is yes or no. If you know, please inform me on the board.
And by the way, I’m no fan of providing illegals with free healthcare or other benefits.
To Nerissa Belcher:
When you start hurling invective like flaming bags of dog shit, all hope for rational and reasonable discourse dies.
Nevertheless…
There’s nothing “touchy feely” about ESRD, dialysis, or death due to lack of treatment.
And the definition of the epithet “liberal” (that you so kindly provided) doesn’t apply to Dr. Doug. Why not?
Because Dr. Bremner, as an Emory professor and researcher probably earns a fairly hefty salary with the accompanying hefty taxes, so he strikes me as one who wishes to use HIS OWN (TAX) MONEY to pay for illegals’ healthcare that he is OBVIOUSLY WILLING TO PAY FOR.
As someone who earned his MD yes I do make a larger salary than most I suppose, and yes I am willing to pay taxes to prevent people from needlessly dying. But more importantly, as an MD I took an oath to do no harm. Turning dialysis patients out into the street is giving them a death sentence and MDs who participate in that in any form are doing just that. The state of Georgia has hired an outside consulting company in a perverse bid to make Grady “profitable” along the lines of private companies, hence the recommendation to leave or die. The “charitable referral” reference above is a lie.
Health care isn’t a business. The language of “profit” should not apply.
If a person cannot pay for his or her care, they should still be receiving a decent standard of care, and we, as society, should collectively pay for it. In my neck of the woods, we call that *civilisation*.
Mr. Bremner,
I work at Grady and know the actual details of how each outpatient dialysis case is being handled. You are more than welcome to state your opinion but please label it so. There is no state of Georgia involvement here. The decision to cease outpatient dialysis services was not made by an outside consultant. No patients have been told to “leave or die,” whatever in the world that means. All patients are being handled with care and compassion.
You obviously feel strongly about this. Perhaps your energy could be harnessed for good…maybe you could start a non-profit fund to pay for dialysis treatments for those who can’t qualify for Medicare?
In any case, your reckless accusations do nothing to further the conversation or help us at Grady keep the doors open for the 800,000 or so non-outpatient-dialysis patients that rely on Grady every year.
Well we can quibble about who made the *decision*, whether it is the outside consultant (which I will name here for the first time as Price Waterhouse Cooper). And terminating dialysis does not show care and compassion. It is a death sentence for those who rely on it. And no I am not going to start a non profit fund. I am going to say that a civilized society should not send its sick off to die who cannot pay, while letting the worried well throw money away at healthcare gimmicks that offer no benefit to them. And that healthcare personnel who participate in this unethical activity should ask themselves why they got into this field in the first place.
It is now August 31 and as of Spetember 17 the patients of the Grady Dialysis Clinic will NOT be receiving life-sustaining care. Despite what the Grady Board has said, they have NOT made any provisions for these patients with private Dialysis centers in Atlanta or anywhere else. The Grady Advocates for Responsible Care are physicians, nurses, patient advocates and commnuity members who know the patients first-hand and know that this situation is a death sentence. We are asking the Board and Administration to DELAY the closing of the clinic until we can find transitional treatment for these patients. We have spent three weeks asking the private sector to help us and so far no one has heard our plea. As medical professionals, we have taken oaths to save lives. We ask the Healthstat commnuity to help us do just that.
I commend the Grady Advocates for Responsible Care.
It’s very simple people. Without dialysis, your body builds up toxins and you die. In 1968, when I was only 13, my father almost died were it not for benovlent intervention and Baltimore City Hospitals. I ask any and all of you:
“Which one has the guts and balls to send these people off to die? Which one of you hard asses has the guts to tell there children and grandchildren?
Yeah, I thought so. And, what kind of country, what kind of people are we, to act like that?
Perhaps some are undocumented…but these people pick the fruits and vegetables you eat, they change the beds at the motels, they do the grunt construction work and they serve you at a fast food joint. Yes, they contribute and share.
This horrific scenario of health care professionals turning patients away to die without their necessary dialysis treatment is beyond comprehension. These patients are human beings, just like you and me. I cannot imagine the fear and suffering they and their loved ones must be feeling at this time. My daughter is currently fighting for her life against Stage IV metastatic breast cancer. Her life depends upon her treatments. How would I feel if she weren’t “lucky” enough to have health insurance and were forced to discontinue treatment? Again, I cannot imagine. It’s simply not acceptable. I urge everyone to throw their support behind the heroic efforts of the Grady Advocates for Responsible Care! It’s easy. Just contact Dorothy Leone-Glasser at dlg@wisdomofwellnessproject.com for a copy of a letter of support you can sign and fax back to her. Your compassion and action will make a difference!
I am one of Grady Advocates for Responsible Care and we need the support from everyone in our community. Grady Administrators plan of action is a death sentence to each one of these undocumented patients. We cannot let this happen. Emergency dialysis is the only option for more than 50 people who cannot go back to their home countries or do not have the means and resources to relocate in other “humanitarian” states. Grady Administrators say they are working hard to individualize each patient’s plan. However for most patients, this means implausible relocation to other states or countries. Therefore, the real option they are offering these patients is just “emergency dialysis”. How does Grady’s mission of “providing medical care to the underserved in a compassionate, respectful and dignified manner” fit into this? If Grady’s financial crisis is an obstacle to sustaining Grady’s mission then it is the responsibility of Grady Administrators and of all our community to work together to find solutions. Being documented or undocumented is not the point; these are human beings in a life-death emergency. We can discuss later whether or not they “deserve” to have insurance, if undocumented people should be deported or legalized, if the American businesses that brought them to the US must be punished or pay for their medical bills, etc, etc. Now, the emergency is in front of us, it is slapping us. We need to act and involve the community at all levels: legislators, administrators, health care providers, patients, dialysis providers, private physicians, educators, and people who care about others. That is what an organized society with moral principles would do; we can do it. Please, support our cause: contact Dorothy Leone-Glasser at dlg@wisdomofwellnessproject.com for a copy of a letter of support you can sign and fax back to her.
As someone who’s suffered with severe Rheumatoid Arthritis (RA) for over 30 years, I can tell you first hand the importance of having health insurance and access to adequate treatment and how fortunate I am to have both. This is why I advocate for others less fortunate through Grady Advocates for Responsible Care by urging my Senators, Congressman and Gov. Sonny Perdue to step up to the plate and sign the support letter (see previous 2 postings) asking Grady to delay closing their dialysis clinic. It is cruel and inhumain to not place these patients in other facilities. I have watched my fellow advocates over the past several weeks work tirelessly on this issue and I only hope that our efforts are not in vain. The clock is ticking, lives are at stake, won’t you please help!!
It never ceases to amaze me how many people can turn a blind eye to others’ misfortune. If I recall, our forefathers built this country in an effort to provide a better life to its citizens (all of whom were “illegals” at one point or another unless you are of Native American descent). And to Nerissa Belcher, and all of those who think like her, I am not a liberal, but you are an embarrassment to conservatives who would still like to believe that we don’t need bigger government to run this country. Unfortunately, when the private sector is as cold, callous, and greedy as it has been for so long, there is no choice left but to default to government intervention. Let me ask you, if you were born in a country where you had no rights, were persecuted regularly, and your children had no hope for a better future, would you hope that another country which stands for freedom might give you a chance? And once you risked your life for that freedom, you found that you were left to die simply because you have an illness that warrants medical intervention. To have no empathy whatsoever for this type of scenario is as inhumane as this discussion. If it is true that a private consultant has recommended this as Grady’s only financial resolution, than Dear God we have NO HOPE of handing the fate of this country into the private sector any longer. Of all things, it is the private sector that has left us all nearly bankrupt – not just Grady. Give me a break, we are supposed to be a country of innovation AND freedom. How about we put our heads together and come up with a resolution that provides both?!
I am a former Advanced Nurse Practitioner. Saving lives was my life.
However, I recently saw a story on 60 minutes whereby the State of Nevada had decided to deny payment for chemo treatment for highly treatable patients, because of lack of funds.
At the same time, one hospital in Las Vegas is supplying dialysis therapy to 80 illegal Mexican immigrants. I am sorry, but how can we tell U. S. citizens that there lives are expendable but treat Mexican citizens who are criminals because they are here illegally
The Federal Government should arrest the dialysis patients and make an emergency deportation hearing available and contact the Mexican government and liason with them to see that the patients get back to Mexico for treatment. A year’s worth of coverage in Mexican Social Security or health coverage is about $350 a year. Supply the patient with a safe transfer and pay their first year’s payment and have them seek coverage in their own country. That is more than they are doing for U. S. citizens with cancer.
It is wrong, unethical and against our oath to uphold life to deny treatment of chemo to any patient. It is equally wrong to scare patients by cutting off their life line of dialysis and not offering an viable options to continuity of care. The “wrong” of the denied chemo does not make denying dialysis “right”! As practitioners we offer help to full acccess of care for everyone without threats and with sound options.
matt grove
I know one of the patients personally, and i know that what grady hospital said was a lie. they promised to give them care and transport them to other facilities, but in reality they were just going to leave them. If not, why do you think the patients(and others helping them) are doing so much to overturn this situation. The date to close the dyalisis was sept 19, that date has passed, and they havent found(or tried) a place for all these patients.
Oh my gosh, is this for real? Did Grady really tell their dialysis patients to “go back to their country!” How freaking prejudiced is that! Did I read the date correctly on the newspaper – is this really 2009? This is almost like a Dave Chappelle spoof or something…Go back to your country – for what – to die? Give me a break!!!
Way to go Grady Advocates. Stay on Gov. Perdue, etc. Where’s Jane, Ted, Usher, Mr. ColliPark, Real Housewives ATL?… Maybe a Wachovia account on behalf of the dialysis clinic.
I believe there are only 51 patients whose healthcare at Grady Dialysis is at risk. I think the good people of ATL ought to be able solve this problem.
Grady Advocates – be sure to play the race card – you know this is a racial issue. You will win.
Maybe we could send “those people” immigrants off on the same “Trail of Tears” that we used for the Cherokee Indians!!!
For followup on this unfolding story see side bar for
‘Do I have the right to live?’
‘I need the dialysis I think I will die’
‘Grady patients face certain death sentence’
‘These are real people’
Surreal, you are right! what about all the millions spent in unnecessary things like show-off on that fake and annoying program… We are also worried about dogs and animals, but sending patients to “dead penalty” just because they are illegal and sick. Gosh… they are human beings
It’s hard to think that even know people are cruel and racist. Haven’t we hurt to many different races and people enough? When is enough, enough? My husband is one of those patients. People always say ” well why don’t you get his papers” or why isn’t he legal. When the simply fact is that to be legalized as of 2011 ( when terrorist attacked twin towers ( God bless their falling soles) a new law was placed that affect people in that process). Know when you are finalizing and meeting with officials you have to go back to the country of origin. When before 2011 you could do everything here. We have went through all the steps but the problem is that when he does go to Mexico for the meeting their isn’t insurance or dailysis like here. So I could be sending him to die. It’s not as easy as everyone thinks or says. It’s easy for someone to say ” well their illegals and using tax payees only” Well guess what I am a tax payer and so is all my family but we still pay for people who don’t want to work and are baby havers that do it yearly to keep benifits so that don’t have to work. Is that right to? No. My husband came here to work, to pay taxes, and to live the American dream like everyone else. He got sick here not in his country. He has paid Tass for more than 5 years and wont ever see a penny of it to help him like “Americans” will. No one in this group is asking for a free ride. They are asking for a just and fair treatment. Anyone else that has been turned away from a hospital could have sued and won for abandonment. Y’all don’t know what we have been through so you should not be so opinionated until you have walked in our shoes. Not knowing what going to happen and being bound my a small word like “illegal”. God Bless everyone fighting in our fight and God Bless everyone that doesn’t want to see the justice and truth, because the true judger is God on judgement day.
Sorry for all the typos I am on my cell phone and can’t see very well.
No offense, but why should we have to pay for someone’s healthcare that can’t even respect the laws enough of our country to enter it legally? They SHOULD go back to their home country and be their country’s responsibility. There are american citizens or legal immigrants who fall on hard times and need free or low cost medical care, but they can’t receive it due to the financial drawback of caring for all the illegals. Would you take food out of your child’s mouth and feed it to a stranger? Absolutely not! So why should America function any differently? Citizens and LEGAL immigrants are her children, and should be the ones taken care of. Period.
As for the people who were citizens and cut off, I do feel this is wrong. Maybe Grady should do like Planned Parenthood and ask for donations from each patient or set some sort of minimal treatment fee based to at least put a dent in the costs. Just saying.
He lives in Oklahoma, we have to take it easy on him.