Illegal immigrants often are accused of benefiting from health-care services for which they dont pay. But health officials say in reality they are ineligible for services through most government-funded programs.
One program that does serve immigrants without documents is San Juan Basin Health Departments Promoviendo La Salud.
The program strives to improve health and reduce health inequalities among Latino adults in La Plata and Archuleta counties, according to its website.
Karen Forest, coordinator for the program, said clients receive education, screenings and help managing chronic diseases all services that can prevent lengthy and costly hospital stays.
Its kind of like pay now or pay more later, she said.
Forest said the outreach workers, called promotoras, dont ask clients about their status.
To me thats not our concern, she said.
But the program is only a stopgap where more comprehensive reform is needed, said Forest.
Were in this juncture of a failed health-care system and a failed immigration system, she said.
When prevention falls short, illegal immigrants often end up at the hospital for care, but efforts to quantify the costs associated with treating them have been mostly unsuccessful at all levels.
A 39-page report from the U.S. General Accounting Office came to this conclusion: The impact of undocumented aliens on hospitals uncompensated care costs remains uncertain.
Uncertain, but not insignificant.
A husband-and-wife pair of illegal immigrants who came to Durango three years ago from Arizona recounted how she ended up in the hospital there with a life-threatening ruptured ovarian cyst.
The man said hospital officials initially refused to treat her because the couple didnt have health insurance.
They wanted $28,000 up front or payments of $4,000 to $5,000 a month, he said. I told them I was willing to pay if the installments were reasonable and I still am.
With no official identities, illegal immigrants are difficult to impossible for bill collectors to find or prosecute.
Calvary International Pastor Raymond Mestas, who conducts a bilingual service in Durango at 10 a.m. every Sunday, sees the issue from both sides.
He regularly ministers to migrant families and hears how inadequate the health-care system is for the poor in Mexico.
If you want health care, you are going to have to pay for it first, then theyll treat you, he said.
He knows that some immigrant families receive medical services here that they are unable to pay for, and he struggles with this, having himself had to cover a $12,000 hospital bill out of pocket for a surgery he required while uninsured.
The only solution to this is reform, said Mestas, whose family has lived in the region for generations, even as far back as the Spanish settlement of New Mexico in the 1600s.
He believes hard-working, civic-minded undocumented immigrants should be brought above ground.
I believe they should allow them to get citizenship here, he said.