“Approximately 11.2 million undocumented immigrants have settled in the United States… The Affordable Care Act of 2010 excludes undocumented immigrants (and legal immigrants here for fewer than five years) from its benefits” (Berlinger & Raghavan, 2013, p. 14). It is complex to treat and evaluate patients when financial and social constraints exist. How can resources be properly allocated among undocumented immigrants in the midst of multiple barriers to health care access?
Mrs. VG is a low-income, uninsured, 50 year-old female, with hypertension, controlled Type II diabetes, and recent onset of bilateral lower extremity edema. Until recent onset of edema, Mrs. VG had been able to manage her medical conditions under the care of her primary clinician. Nonetheless, Mrs. VG’s recent edema, prompted further renal evaluation including, laboratories and ultrasonography. Due to the high costs of the exams, Mrs. VG refused services. A week later, she returned to the office with worsening, now generalized edema in spite of taking a high dose angiotensin-converting enzyme inhibitor and a diuretic. Mrs. VG was referred to …show more content…
VG was diagnosed with Stage 4, chronic kidney disease. Mrs. VG was instructed to return to her primary care clinician to be referred to a nephrologist. However, upon returning to the office, Mrs. VG revealed that she could not afford a specialist consult and could not apply for a health insurance or county health care services due to her immigration status.
The ethical dilemma is to establish an approach to correctly advocate health care and treat undocumented patients when their needs exceed their financial resources and charity resources are scarce. It has been 2 months now and although Mrs. VG was able to qualify for an emergency medical which covers most of her medications and basic exams, she is still struggling to get an appointment with a