Florida officials have stopped medical flights from Haiti after learning federal officials intend to move as many as 50 more patients a day from the devastated island to the U.S. for an indefinite period.
In a letter Wednesday to Kathleen Sebelius, head of the U.S. Department of Health and Human Services, Gov. Charlie Crist said Florida's health care system is reaching saturation, with nearly 500 Haitians already being treated in the state's hospitals.
"Florida does not have the capacity to support such an operation," Crist wrote of plans to continue the emergency airlifts. "We will not be able to sustain these efforts alone."
The governor's plea comes after two flights delivered 37 seriously injured earthquake victims to Tampa area hospitals this week.
Previous flights brought 440 Haitians to South Florida and Orlando hospitals for treatment. More than 90 percent of those patients had multiple trauma and 25 percent were under the age of 18.
The emergency airlifts were in response to the need for specialized medical care unavailable in Haiti. But the financial burden being assumed by Florida hospitals and social service agencies is expected to mount quickly into the millions. No one is clear on where they're supposed to send the bill.
"We haven't had any word on how reimbursement will work out or if it will happen," said John Dunn, a spokesman for Tampa General Hospital, which is treating 14 Haitian evacuees, the largest number of any local facility. "It's fair to say these patients are very seriously injured and some will require long-term care. We're just keeping track of the cost."
On Thursday, Crist said costs incurred in caring for the Haitians were going to be shared with the federal government.
Whether that money funnels down to the hospitals is another question.
"We'll double check," Crist said.
Jay Wolfson, a professor at the University of South Florida's College of Public Health, is skeptical that local hospitals will ever see reimbursement for care for the Haitians, noncitizens who are not eligible for Medicaid.
"Once the treatment has been provided, it will be very hard to find the lever to release monies we don't have anyway," Wolfson said. "So the hospitals will just write it off."
Nonprofit hospitals like Tampa General, St. Joseph's in Tampa, which has eight Haitian patients, and Bayfront Medical in St. Petersburg which has six evacuees, routinely write off millions of dollars in uncompensated care. Providing such treatment is required as part of their tax-exempt status.
But insured patients and government programs like Medicare and Medicaid end up paying higher hospital charges to offset the expense of nonpaying patients. And hospital care may be just the first step of a costly recovery for many Haitians.
A 3-month-old girl who arrived in Tampa Wednesday night had severe burns on her upper body and face. One patient was taken to Shands Hospital in Gainesville with serious spinal injuries. Wolfson said some Haitians may need long-term care, which can cost as much as $140,000 a year.
"There's only so much humanitarian stuff you can do before it has an adverse effect on your bread-and-butter services to the community," Wolfson asked.
No one involved in the evacuations doubts the need for help.
Capt. Bill Wade of Tampa Fire Rescue was present when the Haitians arrived in Tampa.
"The human misery and suffering inside that aircraft was palpable," he said. "These people have been injured for two weeks, with just enough care to keep them alive, yet they smiled at you. They knew somebody was trying to help."
Times staff writer Rick Danielson contributed to this report. Kris Hundley can be reached at firstname.lastname@example.org or (727)892-2996.