January 20, 2011; Source: New America Media | A long slow exodus of public hospitals from urban communities has recently escalated leaving low-income and minority communities at risk. This article from New America Media states that approximately half of the uninsured across the nation are people of color.
Brian D. Smedley, vice president and director of the Health Policy Institute at the Joint Center for Political and Economic Studies in Washington, D.C. says that subsidies from the state and federal government to hospitals have been reduced and this has created financial problems for those hospitals. Although the health care reform law will eventually expand insurance coverage to more people and help hospitals recoup costs for uncompensated care, more cuts to federal payments for hospitals with high patient loads of uninsured will partly pay for the expansion, creating a situation in which low-income communities will lose important infrastructure.
Currently, hospitals have closed or are planned for closure in Cincinnati, Philadelphia, St. Louis, New York, Washington and many parts of New Jersey. Neither Detroit nor Philadelphia has a public hospital. The State University of New York Downstate Medical Center conducted a study on hospital care in the 100 largest U.S. cities and their suburbs that showed that from 1996-2002, public hospitals closed at a far greater rate than for-profit or private nonprofit hospitals. The report also found that hospitals under serve high-poverty suburbs as compared to low poverty areas.
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There is, as you might imagine, a good deal of push back from local residents and public officials when a hospital begins to publicly weigh the option to shut its doors. A local trauma center associated with the Cleveland Clinic had to slow its process down when the mayors of both Cleveland and East Cleveland filed suit. In Cincinnati, the local NAACP got involved when Mercy Health Partners moved to close two hospitals and move a third to a more well-heeled neighborhood.
Vernellia Randall, an expert on racial disparities in health care, said the erosion has been occurring since the 1930s. “Back then, there were more than 200 hospitals located in minority neighborhoods. You’d be lucky to find 20 now,” she said.
Randall thinks that privatizing these institutions as nonprofits is not necessarily a good deal, “Under the law, nonprofit does not mean charity. They’re not giving away free health care. At public hospitals, they could not turn you away.”—Ruth McCambridge