Try Not to Have a Medical Emergency
Urban and suburban areas have lost a quarter of their hospital emergency departments over the last 20 years, according to the study [gated, but with abstract] in The Journal of the American Medical Association…
Emergency departments were most likely to have closed if they served large numbers of the poor, were at commercially operated hospitals, were in hospitals with skimpy profit margins or operated in highly competitive markets, the researchers found.
Full article on the swiftly increasing rate of hospital emergency room closings.
Some advertised Emergency Rooms aren’t ERs at all, but merely transfer stations, such as this unit of the Tarrant County (Arlington TX) charity hospital.
Depending on where the hospital is located, Emergency Departments (ED) are often big money losers when they are forced to treat disproportionately large numbers of indigent patients. In areas where poverty is higher than average, EDs often treat patients in the ED who seek charity care for non-urgent conditions. It should come as no surprise that being in an area where competition is fierce; or the local residents poor, makes the hospital able to support money-losing ERs.
To help alleviate the shortage in emergency medical care, some doctors and nurses opened up an “urgent care” clinic at a medical office building near me. They do x-rays, stitches, set broken bones, treat snakebites and other urgent medical needs that are normally handled after a lengthy wait at the overwhelmed emergency department in our rural county hospital. Severe trauma or life-threatening problems are still transported by ambulance to the hospital, or even by helicopter to one of the city hospitals. Who is the main opposition to the “urgent care” clinic? The hospital.
Try not to have a medical emergency? I’ll do my best.
From the NY Times article: “This suggests market forces play a larger role in the distribution and availability of care” in the United States, Dr. Hsia said, especially emergency care. “We can’t expect the market to allocate critical resources like these in an equitable way.”
Dr. Hsia has an interesting notion of “markets”, “critical resources”, and “equity.”
The conflict of objectives in U.S. hospitals is unmanageable. Imagine if the government tried to solve the homeless problem by declaring that for-profit hotels were immoral and ordered hotels to be non-profit (e.g. Columbia Presbyterian Hotel, St. Mary’s Hotel, Mount Sinai Hotel) and offer free rooms to those who cannot afford to pay for accomodation. Fee-paying guests would cross-subsidize those impoverished guests.
I’ve never heard anyone suggest this as a solution to the homeless problem. But we’ve accepted it as a solution to the health-care problem for over a century!