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Transcript Page 4
NARRATOR: BUT ISOLATION CAN TAKE MANY FROMS. LANGUAGE AND CULTURE CAN BE JUST AS CRUEL AS MILES OF SEPARATION.
Mark Babitz, M.D.
As people have come to American they have brought these wonderful things to add to the wealth and greatness of our society. But as people come and do that, and come to work here and contribute, they also bring beliefs about health care, and of course they bring languages that may often be different.
Nell Hodo, M.D.
Well since we're in Rose Park on the West side, our typical patient is probably an immigrant, most likely Spanish-speaking, although we do have a large Vietnamese-speaking population and we have a growing African population.
NARRATOR: CULTURAL BARRIERS ARE EVERY DAY DILEMMAS AT THE RATCLIFFE CLINIC.
Jay Moreland, M.D.
Cultural barriers are more along the lines of sort of explaining how certain illnesses work or certain parts of life work and being able to understand where the patient is coming from can help you engage their own cultural power.
Mai Sundare (interpreting)
Healthcare here is really new for a lot of people because, uh, back home if you not get sick you don't go to see doctor. Here is more prevention.
NARRATOR: MAI [MY] SUNDARE [sun-DAR-uh] WORKS AS A VIETNAMESE AND LAOTION TRANSLATOR. MUCH OF HER JOB IS BUILDING A BRIDGE BETWEEN PATIENT AND DOCTOR—BETWEEN EASTERN HERBAL MEDICINE AND WESTERN SCIENCE.
Mai Sundare
Because sometimes they take your medicine and then with that medicine or you give them the medicine and they don't take it, they just take the herbs. We had to really say that it's OK to tell us what you do.
(Esther and Nell speaking Spanish)
NARRATOR: ALTHOUGH MANY DIFFERENT CULTURES AND LANGUAGES EXIST IN ROSE PARK, THE AREA IS PREDOMINANTLY HISPANIC.
Dr. Nell Hodo
Most of our staff, though not all, are Latino and many of them are second or third generation here, so our phone staff and all of our medical assistants speak equally well English and Spanish.
Esther Quezada (Spanish)
When I first came here, they didn’t speak that much Spanish and now all the doctors speak and everything but before no, it was very difficult.
NARRATOR: ESTHER QUEZADA [kay-TZA-dah] BEGAN VISITING THE CLINIC EIGHT YEARS AGO WHEN SHE WAS PREGNANT WITH HER FIRST CHILD. ORIGINALLY FROM ZACATECAS, MEXICO, SHE AND HER HUSBAND CAME TO UTAH LOOKING FOR WORK.
Esther Quezada (Spanish)
Well where we are from, it’s just a small ranch and there is nothing else there. It is really hard because who is going to buy your corn, nobody is going to. That is why everyone has come here, for the same reason, because where we are from there is no work.
NARRATOR: ALTHOUGH WORK WAS EASIER TO FIND IN UTAH, ESTHER DISCOVERED THAT GETTING HEALTH CARE IN THE UNITED STATES HAD ITS OWN CHALLENGES. AND CLINICS HERE DIFFER FROM CLINICS OR “SEGUROS” IN MEXICO.
Esther Quezada (Spanish)
There where we live in Mexico it was, we didn’t have to pay because of, it was called, the Seguro, and they don’t charge anything. They operate and everything and don’t charge anything. For that reason it is really hard here, because you have to pay a lot of money. I know it is better here, but it is expensive. Yes, but it is better here.
NARRATOR: STRUGGLES WITH MONEY, CULTURE, AND LANGUAGE OFTEN PREVENT IMMIGRANTS FROM RECEIVING HEALTH CARE. AND MANY PATIENTS HAVE AN ADDITIONAL BARRIER. THEY ARE UNDOCUMENTED - IN THIS COUNTRY ILLEGALLY.
Juanita Reyes
I'm the person that patients get referred to when they don't have any documentation. When they don't have any insurance they're usually sent to me so I can be able to somehow get a specialist for them or medication. It's just you know good to know you can help people that otherwise wouldn't receive the help.
NARRATOR: FOR JUANITA REYES, WORKING WITH UNDOCUMENTED PATIENTS IS PERSONAL.
Juanita Reyes
It just brings up my parents. (Interviewer- “was it tough for them?) They immigrated to this country like twenty some odd...almost thirty years ago. When my parents got here they were actually working on crops and vegetables and fruits and, you know just bending over and picking them up from the floor, picking them from the trees. I know there are people that understand. They understand the concept, but not the actual fear that people go through just because they're undocumented and it's just a big, big burden on so many people in so many different ways.
Nell Hodo, M.D.
And then of course people who are not citizens don't qualify for Medicaid or Medicare and actually a lot of the pharmaceutical programs that are in place from the drug companies to help people get medications for little or no cost, you have to be a citizen in order to qualify for them--not all of them, but lots of them. So we find a lot of our adults are in a position where it's very, very hard to get them the care they need short of just sending them to the emergency room.
NARRATOR: FEDERAL LAW PROHIBITS EMERGENCY ROOMS FROM TURNING AWAY PATIENTS BECAUSE OF THEIR INABILITY TO PAY. AND HOSPITALS STRUGGLE WITH BEING THE ENFORCERS OF IMMIGRATION POLICIES. AGAIN THE QUESTION - DOES EVERYONE HAVE A RIGHT TO HEALTH CARE?
Joe Krella
The illegal immigrant population is becoming a very significant problem for hospitals across the country and particularly here in Utah as well. Again, federal law stipulates that if you present at an Emergency Department, the hospital has to treat you, they have to triage you, and they have to provide you with care. That applies to illegal immigrants as well. And certainly hospitals in this state aren't going to turn anyone away. But that also leads to overcrowding and it also leads to delays to individuals who truly have an urgent need in getting access to that care.
Marc Babitz, M.D.
So someone from another country comes here and they are working at a hotel, in the kitchen or restaurant or changing the linen, and they happen to have Tuberculosis. Now tell me, would you rather have that person get medical care to treat their TB or would you like to have them coughing down the halls of that hotel spreading Tuberculosis among the citizens who happen to have been born here. Denying care to undocumented people puts the rest of the society at risk for illness that could be spread.
NARRATOR: ONE OF THE MOST CLEAR AND COMPELLING MEDICAL NEEDS AMONG IMMIGRANTS IS THE CARE OF PREGNANT MOTHERS.
Nell Hodo, M.D.
I mean these women who often come here and deliver don't have coverage for any of their prenatal care.
NARRATOR: IT IS A PROFOUND IRONY OF OUR HEALTHCARE SYSTEM THAT IT WILL PAY TENS OF THOUSANDS OF DOLLARS FOR A NEWBORN INTENSIVE CARE UNIT, BUT WILL NOT PAY A HANDFUL OF DOLLARS FOR PRENATAL SCREENING.
Nell Hodo, M.D.
Their delivery will be covered by emergency Medicaid but their actual prenatal care and ultrasound and everything else will not. And so, sometimes, they turn up shortly before they are due and they've had no care at all. And you have absolutely no idea what sort of problems there might have been.
(Dr. Jay Moreland: So right now I'm measuring the size of the baby).
NARRATOR: THIS CLINIC KNOWS THAT A DIFFERENCE CAN BE MADE BY INEXPENSIVE PRENATAL CARE.
Jay Moreland, M.D.
Our rate of premature and low birth weight is less than the Utah average and we're a high risk clinic so I think our rate is like 7% and Utah average is something like 9% so we do a pretty darn good job of preventing that, and those are expensive babies. In the NICU’s a million dollars for a baby, is not unheard of at all, so put a little bit of money up front to prevent that. I don't know. It seems like it's a good investment to me.
Look at other industrialized countries. Look how much they spend and what they get for what they spend. The other countries are far better at keeping people from falling into the pit. Our country is the best at pulling people out of that deep, dark pit. We have a really, really high infant mortality rate. You're not going to decrease that infant mortality rate by putting more money into NICU’s... into Neonatal Intensive Care Units. It doesn't work that way. You can throw all of the money into that pit that you want, but it's not going to keep people from falling into it.
NARRATOR: AS A NURSE AT THE UNIVERSITY OF UTAH HOSPITAL’S NEONATAL INTENSIVE CARE UNIT, CAROL HENDERSON IS FAMILIAR WITH THE PIT.
Carol Henderson, R.N.
It takes a lot of support especially for the low-birth weight patients. It takes a lot of technology. It takes a lot of equipment. It takes a lot of personnel with highly specialized training. It's very expensive therapy. Some of the finances we're talking about are pretty daunting. It's not uncommon for a baby to have spent over a million dollars during his hospital stay, and even for families with insurance, that can still leave quite a hardship and a burden.
