Medical care in this country is rapidly heading for a K.O.
Baltimore’s Bon Secours Hospital considers closing as it is getting crushed under the costs of providing uncompensated care. The hospital lost $22 million last year.
Northeastern Hospital in Philadelphia is also preparing to close. Its emergency department usually sees 50,000 patients per year. The hospital lost $6 million last year and expects to lose $15 million this year. Charity care has increased by 33% in the past 12 months and more than three quarters of the patients at the hospital are Medicare or Medicaid – “insurance” plans which “do not pay the full cost of care.” State lawmakers and community activists are trying to force the hospital to stay open. State Sen. Michael J. Stack stated that “closing this ER is going to have a devastating effect.” The article made no mention of how the good senator planned to fund his grand initiative .
A Chicago Tribune “Watchdog” article criticizes “for profit” hospitals that pass the buck on uninsured patients, showing how for profit hospitals provide patients with an “EMTALA screen” in the emergency department, stabilize any emergencies, and then send indigent patients to public hospitals for further care – sometimes with directions on how to get to the public hospitals. The article quotes one University of Pennsylvania emergency physician as stating that the practice amounts to “legalized patient dumping.” No word on how much of a pay cut the emergency physician has taken to curtail such problems in his own state. Also no word on when the Chicago Tribune is going to stop “advertiser dumping” – a process that requires all advertisers to pay in advance for advertisements in its newspaper.
A Naples Daily News (Virginia) article shows how communities are creating more and more “freestanding” emergency departments that cater to patients with the ability to pay. The article notes that out of 12,000 patient visits per year, the freestanding emergency department “is seeing very few people with no insurance”. Incidentally, wait times are 10 minutes in the freestanding emergency department and 5 hours in the traditional emergency departments.
The manner in which healthcare providers fight for financial survival is causing rapid market adjustments. Hospitals that cannot afford to comply with the federal EMTALA laws are either curtailing emergency services or closing. Patients with public insurance or no insurance that depend on EMTALA laws to survive are being herded into larger public institutions where waits become untenable. Private physicians increasingly refuse to care for patients with public insurance due to low reimbursement and administrative hassles.
Government-created market forces are pushing us toward a two-tiered socialized system at a dizzying pace. Those fortunate enough to have insurance will receive faster and likely more competent care, but care that will come at an increasing financial cost. Those patients without insurance will receive “free” care that is time-rationed and haphazard. Emergency medical care for all Americans will be less accessible because of continuing hospital and emergency department closures.
We asked for it.