Be sure to read the entire article, as well as the comment that
follows by a US citizen who describes how citizens are being charged
$6,000/hour - $8,000/hour CASH for operations as a way for US
hospitals to recoup the money they lose to hordes of non-paying
illegal aliens who receive treatment FREE via the Emergency Medical
Treatment and Active Labor Act of 1985 (EMTALA).
Illegal Aliens & EMTALA

by Dr. Madeleine Cosman, PhD, ESQ

The influx of Illegal Aliens has devastating, hidden medical
consequences. We judge reality primarily by what we see. But what we
do not see can be more dangerous, more expensive, and more deadly than
what is seen.[1] Illegal Aliens' stealthy assaults on medicine now
must rouse Americans to alarmed alert.[2] Even President Bush
describes Illegal Aliens only as they are seen: strong physical
laborers who work hard in nasty jobs with low wages, who cultivate
their families, and who pursue the American dream. What is unseen is
their free medical care that has degraded and closed some of America's
finest emergency medical facilities and caused hospital bankruptcies:
84 California hospital are closing their doors forever.[3] An
important cause of these hospital closures is the Emergency Medical
Treatment and Active Labor Act of 1985 (EMTALA).

What is seen is the political statistic that 43 million lives are at
risk in America because those people have no health insurance.[4] What
is unseen is that medical insurance does not equal medical care.
Uninsured people get medical care in hospital Emergency Rooms under
the coercive EMTALA that obligates hospitals to treat the uninsured
but does not pay for that care. Also unseen is the percentage of
uninsured who are Illegal Aliens. No one knows how many Illegal Aliens
reside in America. If 10 million, they constitute nearly 25% of the
uninsured. If more, more.


EMTALA requires each Emergency Room to treat anyone who enters with an
"emergency" associated with cough, headache, hangnail, cardiac arrest,
herniated lumbar disc, drug addiction, alcohol overdose, gunshot
injury, automobile trauma, HIV-positive infection, mental problem, or
personality disorder. Definition of emergency is flexible and vague
enough to include almost any condition as requiring mandatory care.
Any patient coming to a hospital emergency room requesting emergency
care must be screened and treated until stabilized for discharge or
stabilized for transfer whether or not insured, whether or not
"documented," and whether or not able to pay.

A woman in labor must remain to deliver her child. Babies born to
Illegal Alien women are called Anchor Babies for once they are born,
like anchors dropped to keep boats safely in harbor, they pull their
Illegal Alien parents and siblings into lucrative residency. The
babies instantly qualify as citizens for welfare benefits. They have
caused volcanic eruptions in Medicaid costs and skyrocketing stipends
under Supplemental Security Income and Disability Income.[5],[6]

What is seen is the strong-backed Illegal Alien who will come to the
Emergency Room and cough, sweat, and bleed but is assumed basically
healthy even though he and his Illegal Alien wife and kids never were
examined for contagious diseases. By our glance and by our shrug we
grant Illegal Aliens health passes. What is unseen is that many
Illegal Aliens harbor within their bodies fatal diseases that long ago
American medicine fought and vanquished. Now Illegal Aliens carry drug
resistant strains of tuberculosis, malaria, leprosy, plague, polio,
Dengue Fever, and Chagas Disease.[7],[8]

A hospital with an Emergency Room must have specialists ready to treat
on call at all times for all departments that provide medical services
and specialties within the hospital's capabilities. EMTALA is an
unfunded federal mandate. Government imposes viciously stiff fines and
penalties up to $50,000 for each incident upon any physician and any
hospital refusing to treat any patient that a vigorous prosecutor
deems an emergency patient even though the hospital or physician
screened and declared the patient's illness or injury
non-emergency.[9],[10] But government does not pay either the hospital
or the physicians for treatments. In addition to the fiscal attack on
medical facilities and personnel, EMTALA is a handy truncheon to
pummel politically unpopular physicians by falsely accusing them of
violating EMTALA.

High-tech hospital emergency units degenerated into local free medical
offices. In California, for instance, between 1993 and 2003, 60
hospitals closed because of over 50% of unpaid services, and another
24 California hospitals closed in 2004. Even ambulances from Mexico
come to Emergency Rooms with indigents because the drivers know that
EMTALA requires accepting patients who come within 250 yards of a
hospital. That geographic limit has figured in many lawsuits.[11],[12]

Los Angeles County Trauma Care Network, built in 1983, was one of
America's finest Emergency Medical Response organizations. Consisting
of 22 hospitals, super-high-tech equipment, superior emergency
physicians, surgeons, specialists, nurses, and technicians, it offered
365-day, round-the-clock emergency care for people suffering
life-threatening car crashes, industrial accidents, urban crime,
natural disasters of earthquake and wildfire, and national disasters
of terrorism. Now most trauma hospitals have left the Network and so
have many emergency physicians and surgeons.[13] EMTALA contributed to
the Trauma Care Network's loss of focus and loss of money.[14]


Illegal Aliens perpetrate much violent crime whose physical results
arrive in ERs. [15],[16] "Dump and Run" patients dropped on the
hospital sidewalk or at the emergency room entrance before the car
speeds away usually are connected to drugs and gangs. Patients
requiring tracheotomies and thoracotomies for stab or gunshot wounds
are dumped at hospitals whether or not exclusively dedicated to trauma
care and EMTALA governs their treatment.[17],[18]

While nationally most people coming to emergency units are not poor
and have medical insurance,[19] cities such as Los Angeles with large
Illegal Alien populations, high crime, and powerful immigrant gangs
are losing their hospitals to the ravages of unreimbursed care under
EMTALA. In Los Angeles, 95% of outstanding homicide warrants are for
Illegal Aliens, likewise for 66% of fugitive felony warrants. The
notorious 18th Street Gang has 20,000 members the California
Department of Justice deems 60% Illegal Aliens, but 80% according to
the Los Angeles Police Department. The Lil' Cycos Gang notorious for
murder, racketeering, and drugs in Los Angeles's MacArthur Park was
thought 60% illegals in 2002, though higher now. Francisco Martinez of
the Mexican Mafia ran the gang from prison while incarcerated for
felonious reentry after deportation.[20]

Illegal Aliens move freely in crime sanctuary cities. [21],[22] In Los
Angeles, San Diego, Stockton, New York, Chicago, Miami, Austin, and
Houston, no hospital, physician, city employee, or police officer can
report immigration violators to the Department of Homeland Security's
Bureau of Immigration and Customs Enforcement (the old INS). Los
Angeles Police Department Special Order 40 (begun in 1979 by then
Chief Daryl Gates) prohibits cops from "initiating police action where
the objective is to discover the alien status of a person."

Daily as many as 10,000 Illegal Aliens cross the 1,940-mile-long
border with Mexico. [23],[24] About 33% are caught. Many try again,
immediately. Authorities estimate about 3,500 Illegal Aliens daily
become permanent U.S. residents, at least 3 million
annually.[25],[26],[27] EMTALA rewards them with extensive, expensive
free medical services if they claim emergency requirement for care.

Government welcomes Illegal Aliens by refusal to police our borders,
by reluctance to prosecute people who violate basic American law, and
by fervor to please those who snidely abuse our generosity and
cynically ply our compassion against ourselves.


1, Frederic Bastiat's Selected Essays on Political Economy: What is
Seen and What is Unseen. Irvington-on-Hudson, New York: Foundation for
Economic Education, 1995.
2, Madeleine Pelner Cosman's Who Owns Your Body?: Doctors and Patients
Behind Bars. Westport, CT: Praeger, 2005.
3, Chong, J-R. Hawthorne Hospital to Shut Doors. R.F. Kennedy Medical
Center Cites Financial Problems for ClosureSixth ER in La County This
Year. Los Angeles Times, September 24, 2004.
4, John Goodman, Gerald Musgrave, Devon Herrick's Lives at Risk:
Single Payer National Health Insurance Around the World. Lanham and
New York: National Center for Policy Analysis, Rowman and Littlefield,
5, Wright, CM. SSI: The Black Hole of the Welfare State. Cato Policy
Analysis 224, April, 1995.
6, Peter J. Ferrara's Social Security: The Inherent Contradiction.
Washington: Cato Institute, 1980.
7, Lee B. Reichman's Time Bomb: The Global Epidemic of Multi-Drug
Resistant Tuberculosis. New York: McGraw Hill Professional, 2001.
8, Laurie Garrett's The Coming Plague. New York: Penguin, 1995.
9, Cosman MP. Medicare and the Criminalization of American Medicine:
1965-1993. 6:1 National Trial Lawyer (1994).
10, Turner GM. HIPAA and the Criminalization of American Medicine.
22:1 Cato Journal, Spring/Summer 2002.
11, 237 F 3d 1074.
12, Arrington v. Wong, 237 F3rd 1066 (9th Cir. January 22, 2001)
13, Roark AC. Surgeon Tires of Effort to Plug Gap in Trauma
Care-Hospitals: A doctor on call in emergency rooms. Los Angeles
Times, December 23, 1990.
14, Weber T., Ornstein C, Landsberg M. King/Drew Trauma Unit Faces
Closure. Drew Proposal Assailed. Los Angeles Times, September 14,
15, Michelle Malkin's Invasion. Washington: Regnery, 2004.
16, Jon E. Dougherty's Illegals: The Imminent Threat Posed by our
Unsecured U.S.-Mexico Border. Nashville: WND Books, 2004.
17, Roark AC. Surgeon Tires of Effort to Plug Gap in Trauma
Care-Hospitals: A doctor on call in emergency rooms. Los Angeles
Times, December 23, 1990.
18, Heather Mac Donald's The Illegal-Alien Crime Wave. New York:
Manhattan Institute, 2004.
19, Weber, EJ. Does Lack of a Usual Source of Care or Health Insurance
Increase the Likelihood of an Emergency Department Visit? Results of a
National Population-Based Study. Annals of Emergency Medicine,
October, 2004.
20, Heather Mac Donald's The Illegal-Alien Crime Wave. New York:
Manhattan Institute, 2004.
21, Heather Mac Donald's The Illegal-Alien Crime Wave. New York:
Manhattan Institute, 2004.
22, Michelle Malkin's Invasion, Washington: Regnery, 2004.
23, Michelle Malkin's Invasion. Washington: Regnery, 2004.
24, Colorado Alliance for Immigration Reform (CAIR)
25, DeWeese T. The Mexican Fifth Column. 2003
26, Guzzardi D. Illegal Aliens: The Health Cost Dimension. January 25,
27, DeWeese T. The Outrages of the Mexican Invasion. American Policy
Center. February 27, 2003.

Dr. Cosman is a medical lawyer located in California. Her forthcoming
book in 2005 is Who Owns Your Body?: Doctors and Patients Behind Bars.
She lectures worldwide on medical law and medical policy, has
testified before Congress on medical law issues, and has spoken in
Washington for Cato Institute and Galen Institute. She wrote the ABCs
of the Clinton Medical World for Congress in 1993. A Director of
California Rifle and Pistol Association, she writes "Guns and
Medicine" for Firing Line. One of her 15 published books was nominated
for the Pulitzer Prize, National Book Award, and was a Book of the
Month Club Dividend Selection.

Madeleine promotes free-market, patient-centered medicine, and Health
Savings Accounts.

Her J.D. is from New York's Cardozo School of Law, Ph.D. from Columbia
University, M.A. from Hunter College, and B.A. from Barnard College.
She is a member of the New York State Bar, New Jersey Bar, American
Bar Association's Health Law Section, and American Inns of Court.
Madeleine is Professor Emerita of City College of City University of
New York and a Life Fellow of the New York Academy of Medicine.

Comment From Davd B.

Jeff -

I'm attempting to get hernia surgery. I finally found an independent
center in El Paso, TX with a reasonable cost, primarily because
they're new and they know the physician. Why couldn't I get it in Las
Cruces, NM, or in nearby Deming, NM? Because the surgery centers are
connected with hospitals, and their prices are between $6000 to $8000
for ONE HOUR!!!

After getting one honest person on the phone, explaining that I'm
paying for this myself and I want to know why it's so expensive, this
is what I was told--"the illegals are coming to the hospitals in
droves and can't be turned away and the hospitals are attempting to
recoup their expense". She continued "I'm very sorry, I know it's not

No, it's not. It's hard enough not having insurance, but to pay this
kind of outrageous fee for people that are not even supposed to be
here really pisses me off.

I have been married three times, and my first two wives are hispanic.
They have always been angry about the illegals, but when I see them
now they're really angry. So am I....

David Brandt

"So, likewise, a passionate attachment of one nation for another produces a variety of evils. Sympathy for the favorite nation, facilitating the illusion of an imaginary common interest in cases where no real common interest exists, and infusing into one the enmities of the other, betrays the former into a participation in the quarrels and wars of the latter without adequate inducement or justification. It leads also to concessions to the favorite nation of privileges denied to others, which is apt doubly to injure the nation making the concessions by unnecessarily parting with what ought to have been retained, and by exciting jealousy, ill will, and a disposition to retaliate in the parties from whom equal privileges are withheld; and it gives to ambitious, corrupted, or deluded citizens (who devote themselves to the favorite nation) the interests of their own country without odium, sometimes even with popularity, gilding with the appearances of a virtuous sense of obligation, a
commendable deference for public opinion, or a laudable zeal for public good the base or foolish compliances of ambition, corruption, or infatuation . . .

"Against the insidious wiles of foreign influence (I conjure you to believe me, fellow-citizens) the jealousy of a free people ought to be constantly awake, since history and experience prove that foreign influence is one of the most baneful foes of republican government . . . Excessive partiality for one foreign nation and excessive dislike of another cause those whom they actuate to see danger only on one side, and serve to veil and even second the arts of influence on the other. Real patriots who may resist the intrigues of the favorite are liable to become suspected and odious, while its tools and dupes usurp the applause and confidence of the people to surrender their interests.

" . . . nothing is more essential than that permanent, inveterate antipathies against particular nations and passionate attachments for others should be excluded, and that in place of them just and amicable feelings toward all should be cultivated. The nation which indulges toward another an habitual hatred or an habitual fondness is in some degree a slave. It is a slave to its animosity or to its affection, either of which is sufficient to lead it astray from its duty and its interest."

-- President George Washington
Farewell Address
September 26, 1796