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Musings from the Sonoran Desert and elsewhere

Amy McMullen

Amy McMullen
Gold Canyon, Arizona, USA
January 01
Amy McMullen is an activist for human rights, social and economic justice and a blogger and political essayist currently residing in Arizona. Her main interests are anti-racism, immigrant rights, LBGTQ equality, health justice and women's rights. She has worked to remove the worst of the anti-immigrant, Tea Party politicians from office in Arizona and advocates to get progressives elected. Amy's former incarnations include back-to-the-land counter culturist in the 70s, small business entrepreneur, Bed and Breakfast proprietor, charter boat captain, EMT, medical assistant and rehabber of distressed homes.. She currently volunteers for the Phoenix Urban Health Collective as a street medic and is on the board of a new nonprofit devoted to providing free medical care for the uninsured and under-insured in Phoenix. Amy's writings on social justice and other subjects appear in Truthout, Salon, Addicting Info, The Tucson Sentinel, The Pragmatic Progressive and on her blog at Open Salon.

Editor’s Pick
FEBRUARY 10, 2011 11:36AM

A Whole New Kind of Death Panel

Rate: 14 Flag


How undocumented patients will be  

Arizona bill will force hospitals to verify the immigration status of patients

Since Senator Russell Pearce became president of the Arizona Senate this year he’s ushered in a barrage of anti-immigrant legislation, most famously the assault on the 14th Amendment’s guarantee of birthright citizenship.  Now the original sponsor of the infamous SB1070 has introduced a new bill that should attract even more notoriety.  This one has the ominous overtones of being all but guaranteed to cause great harm and even death to some of the people in this state.  

Senate Bill 1405 reads as follows:





What this means is that anyone who is admitted to or receives emergency care at a hospital will have to prove that they are lawfully present in the United States.  This of course presents a whole hornet’s nest of problems-- the least of which is hospitals will most likely not appreciate being saddled with the added responsibility of immigration enforcement.  

Of much greater importance is the likelihood that anyone who happens to be undocumented in this state (an estimated 460,000 people) may avoid hospitals for themselves or their family at all costs-- even if the price is death. 

Of course a reasonable person would ask why someone would risk death to avoid deportation.  The simple answer is that many who go to hospital emergency rooms really have no idea if their condition is life threatening. 

It’s a fact that denial is an inevitable component of our psyche.  If a parent is faced with a child in respiratory distress-- but also the prospect of their family being arrested and thrown into a deportation facility-- chances are very likely that they will try to deny that their child is headed for respiratory arrest and death until it’s too late.  If a child is injured in a fall and showing signs of lethargy, parents may convince themselves that this will get better with time, when in fact time may be quickly running out. 

Few immigrant parents are medical professionals—that is why they need unfettered access to hospital emergency rooms for their children without the prospect of being taken to jail as a result of seeking care.    It is a fact that many of the undocumented tend to avoid hospitals due to ungrounded fears of becoming a target for deportation but now they will face a real and present danger if they enter a hospital and even more will take desperate measures to put off medical care.

Of course it’s not just children who are at risk with this bill.  Mothers who are in labor will need to choose whether to go to the hospital and risk deportation or take the chance that their delivery will be an uncomplicated one to have at home—a very real risk as many of these women do not receive good prenatal care.  Midwives who attend births will be forced to contend with sending their patients off to certain deportation when a breech or other complication threatens the mother and baby or, if their patient refuses to go, being left in an untenable situation.  An adult with an infection will not get treatment and could end up with overwhelming sepsis. Victims of beatings, stabbings, or other violent crimes will refuse to seek treatment.  Cancer patients will be unwilling to have surgery to remove a fast-growing tumor.  The list of bad outcomes possible with this kind of legislation is simply endless. 

And how long before the scope of this law is expanded?  Will emergency medical providers in the field be required to verify immigration status of their patients?  Will urgent care clinics need immigration policies?  Doctor’s offices?  Home health nurses and midwives?  

The rationale offered by the proponents of this bill appears to be that undocumented people really don’t deserve medical care-- or perhaps they do but only if they are willing to accept deportation as the cost.  They’re here “illegally” and now the punishment we are willing to mete out for this breach of our broken immigration system is death or disability.    “Let them die” is often heard from the haters of the undocumented-- these so-called law-abiding folks who have decided that they are judge, jury and executioner of human beings who have at most committed a misdemeanor. Never mind that if any US citizen were to seek medical care in another country such as Canada or Mexico we would not be subjected to this kind of scrutiny. The goal stated by Senator Russell Pearce is to drive the undocumented out of this state.  One can only surmise that he feels that the inevitable death of children is but a small price to pay to reach this objective.

So far this year we’ve seen not only SB 1405 but two bills designed to take away birthright citizenship, a bill that will nullify the use of Consulate ID cards by immigrants and a bill to allow our cash-strapped state to pay for any upcoming legal costs associated with the now enjoined SB 1070.  Also bills that allow guns to be carried into all public buildings-- including universities, a bill assigning Arizona Rangers to patrol the border and one to allow the shooting of “varmints” at night within city limits—and let’s not forget the bill that will authorize the State of Arizona to blithely nullify any federal law it happens to disagree with.   Unfortunately for this state, these examples are just the tip of one very large iceberg of legislative insanity.

These bills constitute nothing but distractions  and distractions are exactly what our so-called leaders are counting on to keep the focus off their inability to deal with the real issues that face Arizona: loss of jobs, a weakening economy, budget deficits, a worsening education system and one of the highest foreclosure rates in the country. 

Arizona, which used to be known for its Grand Canyon and balmy winters, is now more famous across the country for being the number one promoter of nutty gun laws and inhumane ways to drive out Latino immigrants--just short of employing pitchforks and torches.  It’s become ever clearer with each passing day and insane bill before our legislature that Sheriff Clarence Dupnik was absolutely correct when he famously said in the wake of the Tucson shootings that our state has become the Mecca for prejudice and bigotry.   

All of this begs the obvious question: what are we going to do about it?

The effects of these inhumane and unconstitutional laws are far reaching.  There are now numerous states across the nation that are mimicking the bad legislation that has originated in Arizona. It’s only by sending an undeniable message to the epicenter of hate in our country that we may finally see an end to the madness. 

There is currently a grassroots effort underway headed by Citizens for a Better Arizona to recall the mastermind of our hate-based immigration bills, Senator Russell Pearce.    Only 7,756 signatures are needed to bring about the recall and this is a very obtainable goal.  

You can help Arizona change its status from the “dry hate state” back to a place where people and businesses want to come to enjoy the great beauty and opportunities it has to offer. By helping us you can also send a message that these types of laws won't be tolerated, not only in Arizona, but everywhere. 

Please visit to find out how!

 Proposed Arizona sign



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While I don't agree with mixing medical care with politics, I did actually work in walk in primary care for a while last year in Mesa. It was predominantly spanish speaking, no questions of documentation, and people paid in cash. The pros are, quick access to cheap healthcare- unlike Urgent Care- and I have encouraged anyone without insurance to use these places. Naturally, if anything was life threatening, they were referred to the ER.
The reality is, whether or not someone is at risk for deportation, compliance with medical care is extremely poor in these populations and many conditions that could have been managed are well out of control by the time they seek help for it. That is not an immigration issue, perhaps more a social and economic one, and the responsibility of that can't fall on the providers who already take considerably lower wages to help out. It is also true that many of them, elderly and young alike, frequently go back and forth across the border and get medical care in Mexico because it is cheaper. In either case, poor follow up, inconsistent use, and almost no sense of personal responsibility can go hand in hand with leading people to the ER. Naturally, we already have plenty of US citizens that also fall into that category. Not everyone living here without documentation is without financial means, mobility or resources.
I think the whole health system needs to be overhauled, but no one has come up with a realistic solution on either side. Russell Pearce is a supreme a**hole, for many reasons, but he is only one person of many who want things to change. Immigration does need to stay out of the hospitals, but we can't even figure out how to get our own citizens good cheap health care without having to send them to Mexico.
Geez, what a sad state of affairs down there. What'll they do next? Issue varmint rifles?
I can't imagine that any Catholic hospital will follow this law. For that matter, I would imagine that the University hospitals would also not follow it for fear of losing Federal funds.

I lived in Arizona in the 1990s. It's a beautiful state, but quite racist. I remember when they decided to not recognize Martin Luther King Day and lost the Super Bowl for it. So many companies/organizations are profit driven instead of morally driven that today I can't imagine them boycotting Arizona as they did in the 1990s.

The sign is funny but accurate. I always wonder if air conditioning hadn't been invented, would this even be an issue today.
This is so sick - in addition to being morally repugnant and absolutely vile - it defies any logic.

You would think that PURELY out of self-interest the "citizens" of Arizona would not want people running around the state (or rather, cleaning their houses, mopping their kids' schools, and caring for their babies) with full-blown tuberculosis, swine flu, or hepatitis - due to being unable to get any medical care.

The immigrant community is ALREADY terrified to come in for medical care because they are afraid they will be reported to immigration authorities - it's an ongoing struggle to win their trust and allow us to care for their pregnancy, their sick children, their cancer and diabetes.

The last thing we need is to force hospital officials to stand back from the car crash victim and let them bleed out awaiting the Green Card. Or call immigration on the patient in end-stage liver failure. Will we be shackling laboring mothers in the police wagons, dump them in the deserts to give birth on the ground?

Family values. No doubt.
Thank you for posting this. The more people are aware of sadistic initiatives like this, the harder it will be for people who do have legal standing to shrug it off as 'not their problem'. As milkweed said, it is not in our self-interest at all, nor morally justifiable.
I hestitate to comment. But feel it's inappropriate not to.

I have a friend, a former coworker, who relocated to the Phoenix area. He's still up here often, and last year was exhorting us not to write off Arizona - we're a pack o' liberals here, and some were saying they weren't too fond of the new Immigration policies being bandied about down there. He said, "Listen, it's not Everyone! And we're really hurting down there," referring to friends of his who have a gift shopt, dependent on tourism. "Hey, there's a Lot of Arizonans who don't think like that governor!"

Well, I had to admit, that probably was true. I am, after all, from Kansas, and I wouldn't like to be painted with the brush that currently paints Reverend Phelps and his Westboro Gang.

I was even hoping to come down for Spring Training! (I love me some baseball.)

But after Tucson, and viewing the ongoing legislative logorrhea, I said to my girls the other day, "I will never set foot in Arizona again. Sorry, kids, it'll have to be the north rim from now on."

Unfair of me? Perhaps.

Can it be remedied? Unsure.

But it's comforting to read your words; to know that there are those living there that do Not like the atmosphere, and who hope to do something about it.

Good luck.
I'm going to get slammed. I have to show the other side, but not the extreme other side. This country is founded on immigrants. I am not anti-immigrant. I AM anti-illegal immigrant. I AM against anyone abusing our system no matter what their nationality. I AM against my money paying for people who come here illegally to get free healthcare, yet I cannot, yet I DO NOT want anyone to die.

Do I have the answer, NO.

But business as usual is not the answer either. We need to have an effective way to stop illegal immigration and elliminate loopholes.
I AM an NRA member, past military, a scoutmaster, an NRA instructor and range officer and I fought and testified before the Senate in Missouri to get C&C, so I WILL have words for anyone who tries to take my gun rights away.

Do NOT compare me to the sickos who shot the congresswoman or any other psycho shooting out there. Most gun owners are not that kind. And much to the chagrin of my NRA comrades, I am NOT against requiring weapons training, and having background checks. Some people should not be given a weapon.

Plus, unless you are going to have the machines that scan for weapons at every business in the country, the issue of 'allowing' weapons in public buildings is almost comical. Most of us who carry are not going to announce when we walk into a building that we are carrying. Unless something happens that requires us to do something to help someone (which is rare), you will never know who has and who doesn't. But then that's the idea. Neither do criminals. Most are weasels, if they think they might die they will think twice. About the congresswoman...if someone had been carrying that was close to her, perhaps the number shot could have been less. He should have been taken out there. No doubt who did it, why is irrelevant - he killed a child, and it would have saved this country massive amounts of money.

HOWEVER, a weapon can be anything - firearm, knife, sword, throwing stars, a fountain pen, a hypodermic, a ballbat, a cast iron skillet, a car, the list goes on and on. Someone who is going to kill is going to kill - the process may be different but the end result will be the same.

BTW - I'm female.

And I have to address the Catholic hospital comment down below. I'm trying hard not to laugh hysterically. My friend who was 16 got into a fight and injured his hand severely (knife - there you go - weapon can be anything). I took him to the nearest hospital - a CATHOLIC hospital. They would NOT treat him. Not because he was an immigrant - illegal or legal. But becasue he was 16 and his parents were out of state. He almost died, the blood loss was severe.

My brother was doing his internship at the 'other' hospital in town. I ran him there. He said that another hour and he would have been gone.

Tell me where the logic or fairness doctrine is where it is ok to not deny coverage to illegals, but it is ok to deny treatment to an American citizen because his parents are not there to SIGN! I will be forever livid about this situation and this was in the 60's, and this has NOT changed. Issues of treatment for illegals was not even in the picture, but it is now.

Like I said not against treatments, want no one to die, but you can't pick one group and say they have rights yet American citizens whether legal immigrants or born and bred here do not.

Ok, I've vented. Just don't twist what I have said and say I am racist. I have dated every nationality including Mexican, black, almost married a man from Singapore, Iranian, etc. Racism is not in my language. This is not about race, it is about fairness for those that live here legally.

Ok, I'm ready, lol. I know I'm on a site that doesn't agree with my views.
Actually immigrants do not come here to get free healthcare, they get that in their own countries. They come here to work and earn a decent living. They would come here legally if they could but that door is shut to the vast majority of the unskilled laborers that we rely on in this country to pick our crops and do the other menial jobs most of us won't do. The way to fix this issue is to reform our immigration laws.

I won't go into the whole gun thing since I wrote about it in my last post but you should be aware that there was a person in the crowd in Tucson who was carrying a gun but Loughner got off all of his rounds before this person had a chance to react and when he did he couldn't safely return fire without hurting bystanders.

I do not disagree that this country has lousy healthcare but by law a hospital must treat anyone who comes into an emergency room with a life-threatening condition. If your friend was really bleeding out then the Catholic hospital was negligent of their responsibilities. This does not have anything to do with legal status and does not somehow magically mean that undocumented people get treatment when citizens do not. That's simply not how the system works and to say that undocumented people get superior care is simply not true. Most find themselves in overcrowded ERs waiting for hours for the care they dare to seek out.

The point of my article is that people are going to die as a result of making hospitals off-limits to hundreds of thousands of immigrants. We need to separate healthcare from immigration issues. Human beings deserve to have necessary care, period, no matter what their race, sex, creed, religion, sexual orientation or national origin and to scare them off by arresting them when they walk through the door can only be considered inhumane. Not only that but it's dangerous. People who are suffering from infectious diseases need to have immediate treatment or we can have a public health crisis on our hands.
This article just made me ill. How can people be so filled with hate?
Off to visit the website.
Can we clarify that legal immigrants, eg. those that are US citizens or are legally allowed to work here wouldn't be hurt in this? The use of the word 'immigrant' throughout this article is misleading, it makes it sound like legal immigrants would be denied treatment, when really it would be illegal aliens that would be denied treatment.
Also, in no way is this law 'anti-immigration'- its not inhibiting those that want to take legal courses to obtain proper US citizenship in any way.
Fact: I don't agree with this law, and I think the writer brought up some good points when she wasn't trying to spin it so blatantly and stupidly.
To Cindy Dawson -

Thanks for writing. To clarify a couple of misconceptions:

Nobody in this scenario is getting away with free healthcare - legal, illegal, or citizen. The only thing they are guaranteed by law is CARE - in an emergency. Not free care.

Everyone who walks through a hospital door, whether with a gunshot wound or a hangnail gets charged for their care. Even if they are brought in against their will, or unconscious, they are charged for their care.

If they are destitute - legal or illegal - they may apply for charity care. That is the hospital's decision, and is planned for in the hospital budget.

If they have an income, legal or illegal, immigrant or citizen, they will pay for their care.

If they skip out on their bill, they end up in debt and tracked by collections agencies, regardless of immigration status. Unpaid bills end up coming out of all our pockets, in various ways - but this is the same story for everybody. Plenty of citizens are absolutely broke these days, no one has a monopoly.

The idea that illegal immigrants are leaching off of taxpaying citizens is just not true. Numerous economic analyses show that as a group they pay FAR more into the system than they ever receive in public benefits - of any kind.

Most illegal immigrants work under fake Social Security numbers. Tax is taken out of their paychecks automatically. But they never file for tax refunds - and they don't collect Social Security. It's a net gain for the economy, at their considerable loss.

And the folks who are working under the table, for cash, are actually subsidizing the economy, by providing services to employers at far less than they would have to pay a documented worker.

It's a pretty raw deal when you think that illegal immigrants (this includes people who came here as babies and this is the only home they have ever known) could not go to a hospital for routine healthcare, or even in a life-threatening emergency, even for their CHILD - without facing jail and deportation.

The point here is that whatever you think of immigration issues, health care is a human right, a compassionate need, and a public health necessity. It should not get mixed up with police-state politics...
Though the words of this proposed law use the word person, people who have these extreme ideas do not really consider illegal immigrants as human beings. Do not let them say otherwise, they may be kidding themselves but not me. I work in a hospital (not in Arizona) and though there are problems with communication and payment, this is not the answer.
@ceklam, normally I don't respond to people who use words like "stupidly" when describing my writing but since you are wrong about several things in your comments I suppose I'll make an exception.
Fact: all Latino immigrants are negatively affected by the hate-based laws that Russell Pearce has pushed in AZ. They are swept up in the same net because they happen to speak poor English and have brown skin. To pretend otherwise is just that: pretending. That is why I don't always distinguish between undocumented and documented immigrants when I write about this subject Since it's also a fact that racial profiling happens in this state (and studies prove it) then it is also true that it really matters not if you have papers justifying your presence here. You're still going to be a target and unfairly stopped and harassed (and woe be to you if you happen to leave those papers home that day).
And since SB1405 says nothing about "denying treatment" to patients, which would be a violation of federal EMTALA laws, I make no such claims in my piece as well. What SB1405 does is provide a fear factor that discourages undocumented people from seeking healthcare and therefore puts them-- and their communities-- at risk.
And finally, for the "just come here legally" crowd, I can provide a lovely illustrated flow chart that demonstrates perfectly just why poor people dare to enter this country without proper documentation. Our immigration system is broken and it would be far more productive if we spent our time focusing on making necessary changes rather than dehumanizing and persecuting people:
I'm just wondering how does one verify they are in this country legally. I don't go around carrying my birth certificate or SSN card. I do usually have my driver's license, though. Would that be good enough?

And if I'm out jogging or swimming in a pool (with no ID on me) are the medical professionals supposed to determine my immigration status before administering CPR or Mouth-to-Mouth?