Author Rudy Villareal discusses his book, “Arizona Hispanic Flyboys 1941-1945,” the story of Hispanic young men from Arizona who served as pilots, navigators, bombardiers, flight engineers, gunners, and radio operators during World War II. Gilbert Orrantia, an Army Air Corps pilot who is profiled in the book, joins the discussion.
>> José Cárdenas:
Good evening. I'm Jose Cardenas. Welcome to "Horizonte." Are undocumented immigrants coming to the United States for healthcare. Hear what two local physicians think. Tonight we'll talk to the author of a book featuring Hispanic young men who fought for their country. The issue of undocumented immigrants and their effect on the Arizona healthcare system. Providing medical treatment for injuries and illnesses costs huge amounts of money. Healthcare providers have an obligation to offer that care but they also worry about how it will be financed. In addition, they have concerns about the impact of immigration policy on their profession. Joining us is Dr. Zudhi Jasser, member of the Arizona medical association Board of Directors. Dr. Jasser put together a publication called "the impact of a failed immigration policy on Arizona medicine" in the March and April issue of the Arizona medical association publication. Also is Dr. Paul stander, medical director of Banner Good Samaritan. He also contributed to the publication. Gentlemen, thank you for joining us on "Horizonte." Dr. Jasser, give us an overview of this particular issue of the magazine.
>>Dr. M. Zuhdi Jasser:
When we decided to look at this issue, I can't tell you how many physicians every day in Arizona across the state see that the immigration problem is looked at on the front line in our hospitals, in our emergency rooms, in our ICUs and in our medical offices because we have an ethical obligation to take care of patients when they come to our door and when we take care of those patients, many of them who end up being undocumented immigrants end up having the pressures of lack of provision of care, inability to seek or access the system that we have to deal with. So we thought, we need to put together an issue that can be used in reference to all of the issues that address and that need to be looked at. We took -- I asked an ethicist, David beta, chairman of the ethics committee at children's hospital, look at the ethical dilemmas we face at the bedside.
>> José Cárdenas:
Is that Phoenix Children's Hospital?
>>Dr. M. Zuhdi Jasser:
Phoenix Children's Hospital. I asked congressman Hayworth to look at on the federal map, President Bush had put together a guest worker program and an amnesty provision. We asked two of the state congressmen to look at their opinions, and the reason I asked congressman Hayworth and congressman flake because they fall on two different sides of that issue. Congressman Hayworth had looked at the fact that this is just a second version of amnesty that had been looked at in the '80s and failed and congressman flake actually felt it was an appropriate thing to do to move policy along. I also asked Paul stander to look at it from a large hospital perspective, Banner health, and the cost that it does to them, and also Greg PEVAROTTO, the CEO of UMC in Tucson gave a thoughtful piece about the creative things outside of government solutions that they've done to try to decrease the cost to Tucson.
>> José Cárdenas:
Dr. Stander before we get to what banner is doing in this area, give us an overview of the problem, numbers in terms of patients we're talking about and the dollar costs.
>>Dr. Paul Stander:
Sure. The exact numbers are very difficult to know exactly, but Banner is the largest healthcare system in Arizona, and in particular Banner Good Sam with its trauma programs and being located inner city Phoenix we just saw increasing numbers of these patients, at least several a day, it doesn't sound like a lot but gets up into 10 or more a week, occupying our beds in our hospital, and at Banner Good Sam last year it cost us about $5 million alone, one hospital, and throughout our system, about $10 million. But the demand is virtually limitless. Patients -- we had numerous instances where patients specifically came across the border seeking care, which, of course, we can't blame them, but the demand is virtually limitless. So it became necessary for us at Banner to try and regulate it to a certain degree.
>> José Cárdenas:
Do you have an estimate as to what the cost is statewide, not just ban center.
>>Dr. Paul Stander:
Again, it's very difficult. Banner again is the largest healthcare system, about 10 million. There's estimates from down at University Medical Center it was costing them a million dollars a month. So the overall estimates probably $50 million or more per year.
>> José Cárdenas:
Dr. Jasser, you mentioned the two congressmen, both of whom acknowledged that this is a problem, both of whom think their approach is the answer to dealing with it. Congressman Hayworth suggesting that tighter enforcement, stopping people from coming across, is the answer, and congressman flake saying that's never going to happen, so you need to have some kind of legal legalization. What do you think is the answer vis-a-vis the guest worker program?
>>Dr. M. Zuhdi Jasser:
I'm not sure that the guest worker program is the right solution. You know, I agree that -- for example, congressman flake in his discussion talked about the fact that in the war on terror it's good for us to start to be able to document who is in the country and that will help our security but the issue is there's no provision for healthcare within that -- within the legislation. So what you're doing is you're taking $43 million uninsured in this country and adding another 7 to 12 million people to that list. So I'm not sure that the cost is going to be there, number one. Number two, guest worker amnesty was tried in the '80s and failed, and there's no discussion as to whether that's going to be successful again, and it may be a further in sentive for more undocumented immigrants to come to the U.S. I think the solution, beyond -- and congressman Hayworth really laid out very well a lot of the issues that are not answered in the guest worker program, and he actually disagreed with the plan. But as far as I'm concerned, I think that the solution really resides, and we were talking about this earlier, for us to deal directly with the Mexican government as far as Arizona is concerned and be able to transfer patients that we have back to their nation as foreign nationals so they can be cared for and that cost can be taken by the country that they pay taxes in or they belong to.
>> José Cárdenas:
Dr. Stander is that the answer? As I understand it, Banner has, all hospitals have, has some system where they can transfer patients back, but there have been problems, aren't there.
>>Dr. Paul Stander:
There are tremendous problems. The first obstacle is that the Mexican government has to identify a receiving hospital that's willing to accept them, and then the patients and family have to be willing, and then its up to our hospital, the American hospital, to actually pay for the transport. So really --
>> José Cárdenas:
In addition to the care in the interim.
>>Dr. Paul Stander:
We've had instances where we've had to pay for the equipment like ventilators so the Mexican hospital would take them. So I mean the other solution is if the Mexican economy and the Mexican healthcare system could handle the problems more than themselves so there was less of an in sensitive for those patients to come here. But that, I think s pretty far down the road. In the meantime, my own sense is that if we as a society, whether in Arizona or nationally, believe that the presence of undocumented aliens who are fulfilling perhaps -- taking jobs that Americans are unwilling or unable to fill, if we believe that's a benefit to us, and I think there is probably some, then we as a society need to step up and make those people eligible for our other indigent healthcare programs. That is a huge burden, additional cost to taxpayers, but until and unless that decision is made, we don't believe that it's fair to just put this problem onto private and/or other hospital systems to pick up the tab, essentially.
>> José Cárdenas:
What is Banner doing right now?
>>Dr. Paul Stander:
Basically what we decided to do is we had to put some rational approach to this, and we agree to provide the care for people who present with emergent problems. Now, the definition of an emergent problem that we use is the one that both the state and federal governments have put forth, which is admittedly very narrow, and that is, an acute onset, a sudden onset, of a new problem, that threatens to cause imminent loss of life or limb. That is a narrow definition and we provide that care. If somebody presents to us, however, with a problem that clinically would normally be taken care of but doesn't fit that definition, we essentially ask them to pay or provide some reimbursement for that service, and if they can't, then we essentially don't -- we work with them, we provide alternatives, we may provide medication or something instead of the grandiose care that they might need, and frankly I think it has been successful from the standpoint it's given our physicians and our -- and the rest of our system a little bit of organized approach to this.
>> José Cárdenas:
It's been in effect for about a year?
>>Dr. Paul Stander:
About a year.
>> José Cárdenas:
Any measurable results?
>>Dr. Paul Stander:
It's die measure but I think that our physicians and staff, at least the morale is a little bit better. Some of the waiting time, some of the throughput, the availability of beds is better. We frankly have fewer people sometimes presenting than we used to have because frankly the word when it was more liberal policy the word went through the community is, if you need free care, go to Good Sam. And that was not really --
>>Dr. M. Zuhdi Jasser:
And I think this is a perfect example of why medicine is at the front line. I look at this and I listen to Paul talking about this and say, boy, I'm in my office 90% of the day, and when patients get discharged from their emergency problem that they have, acute renal failure, then they come to my office or every other doctor in Arizona for that continuity and they're unable to pay. They don't have the resources. And we have no way of collecting, and as a physicians, I have that burden or that -- the reason I'm a doctor is I want to take care of patients and I have to. It's part of my covenant. So we take care of them. And it's at the expense of all the other taxpayers and all my other patients, and as a society we have to look at that. It may be easy to talk about adding them onto the uninsured or to AHCCCS or to Medicaid but the issue is those -- the population we already are accountable to is underserved. The population we already need to give prescription coverage to is already underserved. So for us to add even more to that list of patients that we want to take care of is -- it's those ethical dilemmas of distribunetive justice versus taking care of our individual patients.
>> José Cárdenas:
One reason why people would come to get medical treatment here in Arizona is it may be better than what's available in Mexico. One of the articles you published was about programs that university medical center is doing in Mexico. Tell us about this.
>>Dr. M. Zuhdi Jasser:
Greg, CEO of UMC, did a wonderful job of laying out some of things they've done. They started with education programs where they had their pediatrics residents work both in -- they had pediatrics physicians and neonatologists come up from Mexico and work in Tucson and have an educational environment and continuing education, and then our residents from Tucson went down to Mexico and also worked there, and they develop a cooperation. Then they developed a project where they opened the neonatal ICU in Mexico, paid for by UMC and their foundation. So basically the Arizona taxpayers. But still they demonstrated after a year of operation that they decreased infant mortality in northern Mexico by 17% and they hardly had any further infants that were taken care of that were undocumented in Tucson. So you see that with that small investment, it's a large investment, but it was still smaller than the investment they would have done with the continued crisis management that they were doing when they came to the doorstep at Tucson. So that project, they now have been working on opening some other hospitals, tells you that if the government is not going to act, our private corporations are going to take their own resources, put them in Mexico, to take care of some of the populations that are coming across the border.
>> José Cárdenas:
Dr. Stander, talking about government action, I do want to talk about some state and federal legislation in terms of compensation. There was a piece of state legislation that was killed this week, I think. Can you tell us about that?
>>Dr. Paul Stander:
Right. My understanding is that there was a proposal put forth that in an effort to enforce immigration policy to a greater degree they were asking that healthcare facilities report to the immigration service any undocumented patients that they encounter in the healthcare setting, and virtually all healthcare institutions were vehemently opposed to that.
>> José Cárdenas:
Why is that?
>>Dr. Stander:
It puts an unfair burden -- as Dr. Jasser said, when patients come us to, they're coming for care, and that's our primary focus. It's not up to us to be policemen, it's not up to us -- number one, the burden of trying to prove or disprove whether they are legal or not is very -- is overwhelming and would just put added -- we need to hire more people, we -- we don't have the capability of actually doing it, and it would deter people from reporting, from actually presenting. It may make the problem worse in terms of some of the healthcare issues. But basically the fundamental thing is that healthcare people, you know, have an obligation to take care of the patients who need the care on an emergent basis when they present. We can't be expected to be policemen and investigators and so forth.
>> José Cárdenas:
Now, one of the other articles that was in this publication was a piece from Senator Kyl talking about federal legislation that does provide some money.
>>Dr. Stander:
We do appreciate Senator Kyl's efforts. Basically he is trying to get federal funding to compensation the states that have that had the greatest burden placed on them, so whether it be Arizona, Texas, California, Florida, and we do appreciate that to reimburse us for some of the care we're not getting reimbursed. It to me is a stopgap measure. It's not an ultimate solution unless, again, the federal government just decides that federal tax dollars will be used for this and we'll just go on and provide the care to everybody who shows up and then -- we'll pay for it. I don't think that the federal government wants to do that. It's still going to provide limited dollars but it's at least an interim stopgap mesh do you remember help provide some relief to the hospitals and physicians who have been providing a lot of free care.
>> José Cárdenas:
I'm afraid we're out of time but thank you so much for discussing this important top wick us today.
>>> José Cárdenas:
Many fought for their country in World War II but you may not know anything about the Hispanic young men from Arizona who did. Now there is a book to tell you all about them.
>> Reporter:
There were many who served our country in World War II. What you may not have heard about are the Hispanics who fought in the war from 1941 to 1945. Nearly 500,000 Hispanics fought in World War II. They served in the U.S. Army and Navy air corps. A book documents Hispanic men who served as pilots and air crew from Arizona. The book is called "Arizona's Hispanic flyboys 1941-1945." Although they were a small minority group, they went to war with other nationalities and together the entire group became a majority in the armed forces. While combing through newspaper archives, author Rudy Villareal found many Arizona Hispanics served as pilots, bombardiers, navigators, gunners, flight engineers and radio operators. For years, Villareal traced the steps of these men and their families by copying pictures, sending out questionnaires and learning more about World War II in the process. He also had to compile pictures and information from war archives from veterans and their families. Many of these Arizona Hispanics served bravely on the ground and sea during World War II. Villareal wants his book to serve as a tribute and acknowledge the Hispanics from Arizona who answered their call to duty.
>> José Cárdenas:
Here with us is author of the book Rudy Villareal, also with us is Gilbert Iran which you. Gilbert was a pilot in the army air corps. Rudy, tell bus your background.
>>Rudy Villareal:
I'm originally from Morenci, a small copper mining town near the New Mexico border, and I -- my interest in aviation was really began as an early -- as -- as I was growing up, and I had the opportunity to meet a few veterans, but most of them were usually army, Navy or marine corps.
>> José Cárdenas:
Your background is not as an author?
>>Rudy Villareal:
No, it isn't. I'm in aviation, but I'm retired from 30 years in the aerospace industry.
>> Jose Cardenas:
How did you come to write this book?
>>Rudy Villareal:
Well, I'm kind of a historical buff of sorts, and I was at the Phoenix library one time about 15 years ago, and I happened to be looking at some microfilm of the "Arizona Republic," and I noticed that a lot of the names -- this was -- the "republic" issues were the fall of 1945 so a lot of the veterans were returning from the war and I noticed appear lot of these names were the Hispanic names, a lot of the men were pilots and air crew, and some of them had -- many of them, as a matter of fact, had been decorated with distinguished flying crosses, air medals, et cetera, and so I -- it just kind of floored me because I had never heard of any that had been in these positions.
>> José Cárdenas:
Then you started working on the book?
>>Rudy Villareal:
Well, I started just gathering names, and then after a period of time, after going through all the issues of the "republic" and looking at other newspapers from other towns and cities in Arizona I compiled a pretty long list and at that time I decided to go ahead and see if I could put into it a manuscript.
>> José Cárdenas:
How much time did you devote --
>>Rudy Villareal:
I started in about 1986 on the project, and I didn't publish it until about a year-and-a-half ago.
>> José Cárdenas:
So this has been a real labor of love in.
>>Rudy Villareal:
It was a labor of love and I was able to finish it once I retired from the aerospace industry and had the time to do it.
>> José Cárdenas:
Then you profiled people such as Lieutenant Orrantia, right?
>>Rudy Villareal:
Exactly.
>> José Cárdenas:
Gilbert, let's talk a little bit about you. I know we've got some pictures that we wanted to show to illustrate some of the experiences you had. This is you back in 194 --
>>Gilbert Orrantia:
That's in 1942.
>> José Cárdenas:
You were a lieutenant?
>>Gilbert Orrantia:
Yes, I had just graduated from advanced flying school in Texas. It was in Houston, he willington field at the time. It was an army Air Force Base.
>> José Cárdenas:
You were flying bombers?
>>Gilbert Orrantia:
It was a B25, the Billy Mitchell, and it's famous for the plane that was used to perform that raid on Tokyo with Jimmy do little, general do little.
>> José Cárdenas:
This is your crew?
>>Gilbert Orrantia:
This is my crew. This was taken in Africa in 1943, about the summer of 1943. That's my whole crew there.
>> José Cárdenas:
Any of them from Arizona?
>>Gilbert Orrantia:
No, there's one there from Texas, and you can see him, he's the third one to the right standing up. His name is Ramirez. He was part of my crew. You know, it's interesting that we talk about -- a lot of times we talk about segregation and discrimination and so forth, and this is interesting, because Ramirez came as a replacement. I had my crew. And he was a radio gunner. And I had my crew, but one day the operations officer says to me, hey, Gill, I have a nice young man out here, he's well qualified and everything, and, he says, I know you have your own radio gunner and all that, but we'd like to have you -- we'd like to know if you would take him. I said, okay. I had an idea what was going on. It was because the other pilots didn't want him because he was Hispanic. So I said, well, tell me his surname. He says his name is Ramirez. I said, send him to me. So he came, and he became my radio gunner. Also I had a crew chief who was of Mexican decent. His name was Torres. He was from San Antonio. He also, the other pilots would not take, because, as you know, the crew chief is the person who keeps your airplane in the air. He's the guy, he's the head mechanic. The most important. Of course, they didn't like that. So I took him. I had him.
>> José Cárdenas:
Did you yourself experience any overt acts of discrimination?
>>Gilbert Orrantia:
I wouldn't say overt, but there were -- there were some individuals who would say things, of course, that were quite discriminatory, but I was always there to defend myself, and I managed to quiet them down and make them realize that we, too, had the brains and ability to do the things that we were doing, and I was a flight leader. I had six planes that I flew, that flew under me.
>> José Cárdenas:
You were involved in campaigns north Africa, Sicily and Italy?
>>Gilbert Orrantia:
In Italy, they called it the Naples campaign, which started way down south just a little north of TARANTO. There was a little airfield called GROTAGLIA where we started our bombing missions. As we flew we went from Africa to Italy and we were the first group to be stationed there actually in Italy. Later on other groups came --
>> José Cárdenas:
You came back to the United States in what, 1943?
>> Gilbert Orrantia:
I came back in November of 1943 after having completed 50 combat missions.
>> José Cárdenas:
Did you experience any other acts of discrimination?
>>Gilbert Orrantia:
Yes, there were some. When I was in the training command, I was assigned to a training command, after having come back, we were sent to a -- what they called a replacement center, but what it was was the center in a hotel -- the hotel Del mar in Del mar in Santa Monica, and what they were doing is observing us to see if we were still sane, because a bunch of the pilots had returned and were not -- you know, they had psychological problems. So we were kept there for -- it was about eight weeks, and they poked us and they examined us and they did all these things. Then I was sent to Greenville, South Carolina, where I was in the training command and we were instructors in combat tactics, because nobody knew anything about combat. We went there, we knew nothing. We just went and learned it firsthand. So when we came back, we tried to come back and teach them some of the things would that help them stay alive, and so there I did encounter a few things that I spoke up against. I spoke up and made them realize that, hey, we too are human beings, we too, are intelligent, and we too do have the ability to do the things that are needed in this country.
>> José Cárdenas:
Rudy, how many Hispanic flyboys did you profile in you are book?
>>Rudy Villareal:
There's about 70 that are in the text. I have 200 names in the appendix.
>> José Cárdenas:
Of the ones you researched, were their experiences similar to Gilbert's?
>>Rudy Villareal:
Yes, I always did -- in some cases, I would talk with them and they would indicate that they had experienced some form of discrimination.
>> José Cárdenas:
Were there any other distinguishing characteristics that really struck you when you were doing your research? You're from one of the mining towns in Arizona and so is Gilbert. Was there any unifying element such as that that struck you as interesting?
>>Rudy Villareal:
Well, they are -- they're all pretty motivated, I realize that, and, you know, they were able to come back from the war and deal with the problems that they had experienced and put it behind them and go on to bigger things.
>> José Cárdenas:
We've got just a few second left. Any final thoughts on the book? Anything that stands out that really struck you as you were doing the research you're writing?
>>Rudy Villareal:
Like you said, it was a labor of love, and -- but I can't think of anything in particular, you know.
>> José Cárdenas:
All pretty outstanding characters?
>>Rudy Villareal:
Yeah, exactly.
>> José Cárdenas:
We thank you both for joining us on "Horizonte." It's an you are to have you here, Lieutenant Orrantia and Rudy thanks for making this contribution to Hispanic history. If you want a copy of the book you can go to the changing hands bookstore in Tempe. Commemorative Air Force museum in Mesa or Museo Chicano in downtown Phoenix. Thanks for watching and join us next with a on "Horizonte." I'm Jose Cardenas. Have a good night. See you next week.
Dr. Paul Stander: Medical Director, Banner Good Samaritan;
