AV Hospital courts China 'birth tourists'


Section One of the Fourteenth Amendment to the United States Constitution reads: "All persons born or naturalized in the United States, and subject to the jurisdiction thereof, are citizens of the United States and of the State wherein they reside."

It's a fairly straight-forward clause. If you were born in the U.S., you get instant citizenship. You are an American from your very first breath. It doesn't matter if your parents are from Mexico, Pakistan or China - you're in the club.

The amendment was adopted on July 9, 1868. It's a safe bet its supporters at the time had no inkling of "birth tourism."

What is birth tourism?

Imagine a pregnant woman arriving in California on tourist or business visas from China, or any other foreign land. They come to Antelope Valley Hospital to have their baby. And they pay a lot of money for the privilege of creating brand-new U.S. citizens, thanks to the constitutional protections of the Fourteenth Amendment.

They say it's a brave, new world. We say the insanity is starting to pile up.

Former state senator George Runner, now a member of the statewide Board of Equalization, agrees with that sentiment. The highest statewide elected Republican officeholder called the practice of courting foreign travelers who would give birth to infants who gain automatic U.S. citizenship "both immoral and unethical."

"This idea disrespects not only our nation's heritage, but also those in our community who came together to develop a public hospital for the Antelope Valley nearly 50 years ago," Runner wrote in an open letter to hospital officials.

"Citizenship is a sovereign right of our nation. It is not a mere commodity to be opportunistically sold," Runner wrote.

Dr. Abdallah Farrukh, chairman of the hospital district's board of directors, was asked about birth tourism at a meeting of the elected board of the Antelope Valley Healthcare District last week.

Farrukh defended the closed-door negotiations taking place between the hospital and Chinese representatives, citing "trade secrets" and "competition" to tap in to this potentially lucrative revenue stream.

"We're looking at programs to improve our cash flow," Farrukh told representatives from the nursing department during the public comment portion of the meeting.

It's no secret the hospital has significant cash-flow worries. Moody's Investor Service has given both AV Hospital and its associated healthcare district a negative rating. According to the audits, the facility has too many patients who are "non-pays" and not enough reimbursement from government programs such as Medicare and Medi-Cal.

"Forty percent of our hospital's program are uninsured (patients) getting free service," Farrukh told Valley Press staff writer Alisha Semchuck.

Needing at least $21 million in annual revenue to maintain operations, Farrukh and the board are putting everything on the table. This includes courting an agreement for Chinese women to come have their babies at 15th Street West and Avenue J.

Berna Mayer, another member of the hospital district board, is backing the proposal. "We are delighted that Lancaster has been considered for its expertise in women's and infants' care. It is exciting to offer its expertise to the citizens of China. What a public relations opportunity," she said.

Not so fast, countered Los Angeles County Supervisor Don Knabe. He called for more rigorous zoning restrictions on "maternity hotels" popping up all over the southland, particularly in the San Gabriel Valley.

"Across the United States, the recent trend in 'birthing tourism' has led to money-making schemes that put the health and safety of mother and babies in jeopardy," Knabe said.

Supervisor Michael D. Antonovich, who represents the Antelope Valley and has significant relationships involving China, is also not in support of this arrangement.

L.A. County officials have confirmed 24 of these maternity hotels are operating illegally in unincorporated areas of the San Gabriel Valley, mostly in the community of Rowland Heights.

Occupants have refused to allow county inspectors to enter the premises, which is where women who have traveled from outside the United States stay before and after they have given birth to their children in the hospital.

Medi-Cal, California's state-run health insurance system for poor people, covers 46% of births in the state.

Recipients of Medi-Cal lived at five of the 24 maternity hospitals, according to an Aug. 1 county report. Although there was "no clear evidence" that government benefits were obtained illegally, that's still taxpayer money helping fund this enterprise.

Supporters will argue this is an "outside-the-box" solution to help ease the hospital's financial strain. We say the practice raises some serious and potentially troubling issues and think the whole idea needs to be abandoned.

If it's true, and it is true, that we have illicit (as opposed to lawful and therapeutic) massage parlors, along with dog and cockfighting operations, do we want another blatant violation of zoning operations that most of these so-called birth resorts represent?

Is birth tourism a flagrant flaunting of our current citizenship process? Do Chinese mothers - or Mexican or Pakistani or Irish for that matter - warrant this kind of treatment and reward ahead of all others who dream of becoming American citizens? Even if they're willing to pay for it? In other words, those well-off enough to pay get a "buy it now" card for a family member born into citizenship?

Complications abound. Medical records in Mandarin, a need for interpreters, losses that could mount from births that go awry owing to prenatal care in another nation. And, finally, a probable eruption of these under-the-table housing arrangements in neighborhoods where the neighbors will most likely raise strident complaint about the zone violations that have accompanied this phenomenon elsewhere.

We also in a survey of media reports have been unable to find a hospital whose leadership has publicly embraced such an initiative. Why is that?

Dr. Farrukh has a view that he understands. It is that people who can pay at Antelope Valley Hospital provide the revenue to underwrite support for those who cannot pay. And the elected hospital board chairman badly wants to keep the needle headed toward the black instead of the red. Fair enough, up to a point.

"It's a welcome business," Farrukh said. "It's phenomenal. They pay up front, and they pay double what Medicare pays."

We, like others, believe the Antelope Valley, and its hospital, needs to find a more appropriate blueprint to balance the books.


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