Getting
Healthcare By Thomas Lin When she came to Queens from China in 1998, Yan – who asked that her real name not be used – like many immigrants was terrified she would have to see a doctor. Or even worse, a dentist.
"Healthcare in America is so expensive," she said. Like many working-class immigrants who are unable to qualify for programs like Medicaid or Medicare, because their incomes are a little too high or because they lack documentation, Yan was left with no health insurance at all. Because Queens has such a large immigrant community, Yan said she had little trouble finding out about services by word-of-mouth. In 2002, when she came down with a serious sinus allergy, a friend, who was also uninsured, introduced her to Health Reach, a Queens organization that offers patients free referrals to physicians who provide pro bono medical care. She said she applied for a membership card, described her symptoms to the Health Reach staff and then was scheduled to see a doctor — all for free. Later, when she developed a recurring skin rash, Health Reach found a skin specialist for her. A few days after treatment, the problem was gone. Yan said she’s grateful to the staff at Health Reach, adding that the doctors she’s been referred to also have a wonderful attitude and provide excellent care. Without Health Reach, Yan said she doesn’t know what she could have done other than try to scrape together the money to pay cash at the doctor’s office. She was surprised to find out that the doctors affiliated with Health Reach volunteer their time and services. "That’s wonderful!" she said. At the same time, Yan recognizes that it’s a limited resource, saying she thinks there should be more services like it. Health Reach From the two small rooms in Forest Hills that serve as headquarters for Health Reach, a handful of administrators and volunteers provide a big service to their clients, most of whom are uninsured immigrants. Executive Director Patricia Gallagos estimates that of an active caseload of over 400 patients, 80 percent are immigrants. It all began five years ago, said Dr. Joe Zwek, founder and chairperson of Health Reach. He described it as a time when a group of Queens physicians were doing very well for themselves and felt a need to give back. It was also a time when patients were beginning to lose their insurance benefits due to skyrocketing premiums. Zwek himself was about to retire, so he and Dr. Herbert Lempel went on a mission to care for the uninsured. The basic tenets of this charitable venture, established right from the start, were that medical care would be provided for free, that patients would be treated with dignity, and that physicians would not bear any administrative burden, Zwek said. When a feeler was put out, 45 doctors responded. NY Hospital in Queens agreed to provide supporting services including medical tests, radiology and surgery. Health Reach became a case management system that coordinated and provided free access to medical care for the working poor. Now, the nonprofit, voluntary healthcare network has added the ancillary and emergency services of Elmhurst Hospital and Astoria’s Mt. Sinai Hospital of Queens and is able to refer its clients to one of 120 primary care physicians, many of whom can speak languages such as Spanish, Russian, Hindi, Chinese and Korean. "Small businesses should all offer health insurance," Zwek said. "Healthcare is a right, not a privilege." Though the program receives funding for the administrative component from the New York State Health Department, Gallagos said, "Funding is an issue. We need funding for case management and the outreach piece." Due to recent government budget shortfalls, even "hospitals and health centers are suffering from cutbacks," Zwek added. Gallagos said that while Health Reach wants to help as many people as possible, it’s "not a solution to the healthcare crisis" by itself. Both Gallagos and Zwek expressed hope that their working model would inspire others to follow in their footsteps. "We have succeeded in coordinating free healthcare," Zwek said. "Others could learn from this model. There’s nothing patented about this. We could certainly give them our experience." For information on how to donate to Health Reach or to apply for its services, call (718) 263-1964.
One Doctor’s Choice Dr. Ramsey Fakhuri feels responsible for his patients, even those who cannot afford insurance or the doctor’s fee. Before learning about Health Reach, however, Fakhuri said he felt it would be irresponsible to take uninsured patients because he wouldn’t be able to provide the secondary help — the lab and radiology tests or the surgery by specialists that insurance would ordinarily cover. "From the physician’s point of view," said Fakhuri, who runs a private practice in Sunnyside, "the most important thing for someone who is providing care to someone at no cost, the concern is for follow up and ancillary testing and specialists." Now, through Health Reach, he knows those services will be available to the patients he sees for free. "You need an organization," he said. "You can’t just do it as one person." Despite a struggling practice, Fakhuri said he sees one new patient from Health Reach each week. "I think the working American who has no health insurance is the one that this country should be really paying attention to. The working poor deserve it."
Your Healthcare Rights According to the New York Immigration Coalition (NYIC), backed by information from New York Lawyers for the Public Interest (NYLPI) and the Commission on the Public’s Health System (CPHS), "Uninsured individuals, undocumented immigrants, as well as people who have non-immigrant visas have the same rights to emergency care as all other New Yorkers. "All immigrants have the right to be treated if they have a medical emergency. All hospital emergency rooms in New York State provide medical screening to patients, regardless of their immigration status and regardless of their ability to pay." Likewise, anyone in need of emergency medical attention has the right to an ambulance by calling 911. In cases that are not deemed an emergency, "All uninsured New Yorkers, including people who are undocumented, can receive healthcare from federally funded community health centers, and from the public hospitals, diagnostic and treatment centers, long-term care facilities, and clinics maintained by New York City’s Health and Hospitals Corporation (HHC)." Federally-funded health centers and HHC facilities offer medical care at a reduced rate — also referred to as "sliding scale" or "fee settlement" — based on the patient’s ability to pay. According to the NYIC, "these facilities must ensure that a patient’s inability to pay for care does not create an obstacle to obtaining care, or cause financial ruin for the patient." However, "all patients are asked to contribute a reasonable and fair amount toward their care." NYIC advises patients to consult with a financial advisor or social worker for assistance when signing up for this type of service.
Other resources include state-sponsored programs like Child Health Plus, which provides health insurance to anyone under 19 regardless of immigrant status, and the Prenatal and Children’s Assistance Program (PCAP) for pregnant women. Low-income, undocumented immigrants are eligible for Emergency Medicaid, but legal status is needed to access programs like Medicaid and Family Health Plus. A local organization, Neighborhood Health Providers (NHP) in Jamaica Hospital, provides outreach services for Child Health Plus and Family Health Plus. NHP Director of Marketing Ishmael Carter said the program reaches out to schools and offers mobile units — "moving offices that go from place to place to sign people up." Carter emphasized that people shouldn’t be afraid of coming forward to sign up for these programs. "Immigrants need to understand that information given to health providers is strictly used for providing health care only. It is not shared with other government agencies." For questions about immigrants’ access to health care and insurance, or if you feel your rights have been violated, contact the Legal Aid Society at (212) 577-3575, or NYIC at (212) 627-2227. NHP’s toll-free number is (800) 826-8240.
Miguel Miguel, who also asked that his real name not be used, left Ecuador in 1996 for Queens. Like the vast majority of undocumented immigrants in the U.S., he came to earn a decent living and to support his family. "I came to make money," said the 57-year-old. "We were very poor in Ecuador. I lost all my money there." "Miguel" spoke with the Tribune at Health Reach in Forest Hills, his words translated by Program Director Audrey Perez. Now, he works at a parking lot at night and his wife and two daughters have joined him here. His mother still lives in Ecuador. "Miguel" described becoming sick and pale one day. A coworker advised him to go to the hospital. When he replied that he did not have insurance, another coworker mentioned Health Reach. At the doctor’s office, "Miguel" complained of abdominal pain and was given comprehensive testing, which included testing for prostate cancer. He said he appreciated being treated just like any other patient. Since then, he has seen doctors for other ailments such as migraine headaches and a fungal infection on his foot. Now, he says he feels completely healthy and his whole family has joined the program. Even as an undocumented immigrant, "Miguel" said he has access to better healthcare here than in Ecuador. "In Ecuador, if you don’t have money," he said, "you have to go to a pharmacy and ask for medicine. You can’t even see a doctor in a hospital. It’s easier here even without papers." "Miguel" acknowledged the importance of word-of-mouth, saying he would advise other immigrants about programs like Health Reach. He wouldn’t have known how to find a doctor, he pointed out, if his coworker hadn’t told him. His advice to immigrants seeking health care: "Just ask around. Ask people in community." As "Miguel" spoke, his words and presence reinforced the image of Queens as just that — a community of immigrants.
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