Coronado was rushed to the nearest hospital-Chicago Charity Hospital Medical Center in the south side of Chicago. The doctor injected the medicine into his vein and cleared the blood clot that had entered his brain in time.
Coronado got timely treatment and turned the corner, but the hospital that saved him was on the verge of bankruptcy.
A precarious situation
In the past 20 years, rural hospitals in the United States have been in a state of accelerated closure, and now, because of the COVID-19 epidemic, national safety net hospitals in cities are also facing the same fate.
There are three public hospitals in Chicago, but most low-income patients are served by safety net hospitals such as Chicago Charity Hospital Medical Center.
Such hospitals are close to patients' homes, have a good reputation and provide employment opportunities for a small number of community residents, so they have always been owned by local residents.
Chicago Charity Hospital Medical Center was established 168 years ago, which is the first city hospital in Chicago. Although it survived the Chicago fire of 187 1, the hospital had to be defeated in the face of the epidemic. Due to lack of funds, the hospital with 465,438+02 beds can no longer serve the poor. In July 2020, the hospital informed the national regulatory authorities that it planned to close all inpatient services as soon as February 2026, 5438+0.
David Ansel, senior vice president in charge of community health at Rush University Medical Center, Chicago's West Side Teaching Hospital, said, "Once the medical center of Chicago Charity Hospital closes down, there will be no hospital within about 7 miles, which is equivalent to forming a medical desert in the south side of Chicago."
An evaluation report previously released by Chicago Charity Hospital Medical Center showed that 55% of the poor and 62% of African-American residents lived within their service scope. If the hospital is closed, it may take local residents 15 minutes or more to drive to the nearest Chicago charity hospital, and many local residents don't have cars.
Until July 2020, Maya Rolf was a resident of Chicago Charity Hospital Medical Center. She said that many of the clients of the hospital are high-risk women, and closing the obstetrics and gynecology department of the hospital will cause substantial harm to them.
Ansel said: "In the past year or so, Chicago has closed three hospitals, all of which are located in black communities. In my opinion, closing the medical center of Chicago Charity Hospital is tantamount to a crime, and someone will die. "
As early as 20 19, two safety net hospitals in the United States also went bankrupt. They are Haniman University Hospital in Philadelphia and Providence Hospital in Washington. In addition, the only public hospital in Washington, the United Clinic Center in the poorest area of Washington, also plans to close its inpatient service in 2023.
According to foreign media reports, although the closure rate of safety net hospitals in the United States is not as frequent as that of rural hospitals, some hospitals that are still operating may cut some professional services in the future, such as delivery services and trauma care. This will cause patients to go to hospitals far away from home even in an emergency.
Reasons for being on the verge of bankruptcy
In fact, it is inevitable that the national safety net hospital will be in trouble.
First, patients can't afford medical expenses. Most patients treated in these hospitals have no insurance and cannot pay for medical expenses. Although some patients enjoy Medicaid, it is still difficult to pay.
Second, other private hospitals are more competitive. Compared with other private hospitals, the situation of urban safety net hospitals is more difficult. Because other private hospitals are often more advanced, many patients with insurance and the ability to pay medical expenses prefer these hospitals to safety net hospitals.
Third, the COVID-19 epidemic has seriously affected the core patients in the hospital. In big cities such as Chicago, the poor and colored people are the core patients in such hospitals, and at the same time, they are also the people most affected by the COVID-19 epidemic. Therefore, during the COVID-19 epidemic, the responsibility of safety net hospitals became more important, and the financial crisis became more and more serious.
Trying to save yourself was unsuccessful.
Nancy Kane, an adjunct professor at Harvard University's Chen Zengxi School of Public Health, has been studying the situation of national safety net hospitals in American cities since 20 10. She said, "Even if some hospitals fail, most hospitals will choose to try to enter a larger system and try to stick to it for a few more years until the authorities shut them down."
In the 20th century, most American city governments operated a public hospital to serve the local poor. Later, after the emergence of government medical insurance and medical subsidies in the United States, coupled with rising medical expenses, the economic budgets of local governments were overwhelmed, forcing many municipal governments to give up operating public hospitals. Today, of the 5230 general hospitals in the United States, only 498 are public hospitals.
In recent years, some medical institutions in the United States have sold safety net hospitals to some enterprises, which are unable to maintain the operation of hospitals.
In 20 18, Tenet Medical, a profitable hospital chain in the United States, sold Haniman University Hospital to Joel Friedman, a private equity investor in California, for $65,438+700 million. A year later, Friedman declared that he could no longer bear the loss of the hospital and filed for bankruptcy. At the same time, he stripped off the real estate under the name of the hospital, including physical buildings, and transferred it to another company to facilitate its resale to real estate developers.
West Lake Hospital, located in melrose Park, Illinois in the western suburbs of Chicago, also belongs to the National Safety Net Hospital. 20 18 Tenet Medical was sold to a private investment company. Only two weeks after the sale, the company announced the closure of the hospital. Melrose Park sued the original institution of the hospital, accusing them of misleading local officials by claiming that they would continue to operate before the sale. Finally, the original organization of the hospital paid $6.5438 +0.5 million to melrose Park.
Although these hospitals are in a very difficult situation, some hospitals are still trying to save themselves.
District of Columbia wanted to stop the loss in time, so it outsourced the management of the joint clinic to a number of private consulting companies. However, instead of turning the hospital into a profit, this move made things worse. One of the companies was accused of abusing taxpayers' funds, and a series of serious patient safety incidents occurred, including violations in maternity wards. 20 17, the district of Columbia was forced to close the ward.
Global health service company is one of the top 500 enterprises in the United States, with 400 hospitals and financial income of 1 1 billion dollars. Earlier this year, the District of Columbia reached an agreement with the company to operate a new hospital. Compared with the original joint clinic, the number of beds in the new hospital will be reduced by one third. In addition, Global Health Services cooperates with George Washington University to operate George Washington University Hospital. Although this partnership has been controversial-in 2065438+09, George Washington University accused the company of misappropriating 1 billion dollars that should have been left in the medical system. In June 2020, the judge rejected most of the complaints of George Washington University.
Rolf said, "People tend to put their money where they want." Important hospitals in some communities in a city are about to close, but the city is still spending a lot of money to beautify the city center. This means that in the eyes of cities, patients in these communities are not as important as patients in other communities.
Original source: KHN
Original title: The Last Lifesaving Straw of Coronavirus Pneumonia-City Hospital