A new report released Tuesday by the group Social Contract at a press conference at the National Press Club in Washington, DC asserted that “hospitals throughout the country have been inundated by uninsured immigrants” and that “the financial strain has affected the quality of medical services, forced hospitals to close clinics and emergency rooms, and put infrastructure expansion plans on hold.”

The report, "The Twin Crises: Immigration and Infrastructure," prepared by Edwin S. Rubenstein, a former senior economist at W.R. Grace & Co. where he directed studies of government waste and inefficiency for the Grace Commission, and a former director of research at the Hudson Institute, stated in the report that “illegal immigration is a major factor behind” the crisis in so many hospitals’ emergency departments (ED).

These claims do not come as surprise to hospital administrators and emergency medical care professionals. Similar studies in recent years have concluded that escalating uninsured and uncompensated care for ED and trauma unit services are a major factor behind the closings not just emergency rooms and trauma units across the country, but also entire hospitals.

Congress’ investigative arm, the Government Accountability Office (GAO), arrived at the same conclusion in a study of ED and trauma center closings more than a decade ago. See the acclaimed May 2004 HSToday report, The Trauma in America’s Trauma Care.

The impact of uninsured and uncompensated emergency care as a principal contributing factor behind ED/trauma unit closings – and even the shuttering of some hospitals – also was detailed in part two of an HSToday.us report last year on the crisis in emergency medical care.

For more than five years, HSToday has been reporting on the crisis in America’s emergency medical care system and how it impacts preparedness for a mass casualty terrorist attack or catastrophic natural disaster.

The new report by Social Contract further highlights the problem and addresses one of the root causes for the financial crisis responsible for so many ED and trauma center closures. In May 2004, the National Foundation for Trauma Care (NFTC) report , US Trauma Center Crisis: Lost in the Scramble for Terror Resources, pointed out the escalating problem of uninsured and uncompensated care. For more on the crisis in trauma/ED care, see the September 2006 NFTC report, US Trauma Center Preparedness for a Terrorist Attack in the Community.

“On the demand side, illegal aliens utilize hospital EDs at more than twice the rate of the overall US population: 29 percent versus 11 percent,” and “on the supply side, uncompensated illegal alien care is the cause of many ED closures,” the report stated.

“Not surprisingly,” the Social Contract report states, “California EDs are among the hardest hit.” The study sites reports that 60 percent of [LA County’s] uninsured patients are not U.S. citizens, that more than half are here illegally and that bout two million undocumented aliens in Los Angeles County alone are crowding emergency rooms because they can’t afford to see a doctor.”

“In the last decade, 60 California emergency rooms closed,” the report noted. “One federal law in particular has made things worse,” the report stated. “The Emergency Medical Treatment and Labor Act (EMTALA), enacted in 1986, requires that every emergency department in the country treat uninsured patients for free. Naturally, this includes immigrants and illegal aliens.”

Continuing, the report pointed out that “EMTALA defines medical ‘emergency’ as any complaint brought to the ED, from hangovers to hangnails, from gunshot wounds to AIDS. The hottest ED diagnosis, according to medical lawyer Madeleine Cosman, is ‘permanent disability’ – a vaguely defined condition that covers mental, social, and personality disorders.

“Drug addiction and alcoholism are among the fastest growing of such ‘disabilities,” Social Contract’s study concluded, adding, “a disability diagnosis automatically qualifies illegal aliens for Supplemental Security Income, a federally funded cash transfer payment.”

“Fines of up to $50,000 are imposed on hospitals refusing to treat ED patients—even when the attending physician examines and declares the patient’s illness or injury to be a non-emergency,” the report pointed out. “Lawyers and special interest groups are granted more authority than doctors in these matters.

Social Contract stated that “EMTALA was supposed to make EDs more accessible to the uninsured.” But citing the September 28, 2006 New England Journal of Medicine report, Crisis in the Emergency Department, “not only did this unfunded mandate contribute to the closure of numerous emergency departments and trauma centers, it also created a perverse incentive for hospitals to tolerate emergency department crowding and divert ambulances while continuing to accept elective admissions. Rather than improving access to emergency care, EMTALA diminished it.”

While advocates for illegal aliens and pro-amnesty supporters maintain that statistics and other evidence that shows that providing emergency medical care to uninsured illegals and related unreimbursed costs are flawed or biased, studies HSToday.us has reviewed and authorites HSToday.us has interviewed assert just as strongly that that argument is unfounded. Indeed, studies by GAO and the Department of Health and Human Services tend to support the conclusion of the new Social Contract study.