Luis Alberto Jimenez has no idea about the battle that swirls around him in the lowlands of Florida.

He is completely unaware that he has come to represent the collision of two deeply flawed American systems, that is the immigration and the health care systems.

About eight years ago, Mr. Jimenez, a 35 year old illegal immigrant working as a gardener in Stuart, Fla., suffered life threatening injuries in a car crash involving a drunken Floridian. A community hospital somehow saved his life and kept it as a ward for several years at a cost of $1.5 million, after failing to find a rehabilitation centre that was willing to except an uninsured patient.

Later, Mr. Jimenez was deported to the country he came from. This was done not by the federal government but by the hospital, Martin Memorial. After being pulled in his wheel chair up a steep slope to his remote home, Mr. Jimenez has not received any medical care or medication, said his 72-year old mother. It has been learnt that over the past one year his condition has deteriorated.

Mr. Jimenez’s case represents a little-known but a widespread practice. Many American hospitals are themselves sending back home the seriously injured or ill immigrants because of unavailability of nursing homes willing to accept patients without insurance. This situation arises mainly due to the fact that Medicaid does not long-term care for illegal immigrants, or the newly arrived legal immigrants.

The American immigration authorities have nothing to do with these private repatriations that are done by ambulance, air ambulance and commercial plane. Most of these hospitals claim that they do not do repatriation until the patient’s condition is stable and that they make arrangements to deliver them into a physician’s care when they are left in their homeland.

Medical repatriation are taking place with varying frequency and varying consent, from one state to another and one hospital to another. Also, none of the government agencies are keeping a track of these cases and so it becomes difficult to qualify them. The statistics provided by few hospitals shed some light on the phenomenon: almost 96 immigrants are repatriated every year by St. Joseph’s Hospital in Phoenix; 6-8 patients are sent back home from Broward General Medical Center in Fort Lauderdale; almost 10 were returned back home in early 2007 by Honduras from Chicago and same for others as well.