Mired as we are in politics, the consequently enormous sums spent on campaigning and the lead up to the end of the residency application season, my mind turned to one issue that I feel is all too rarely addressed by mainstream leadership. While much has been made of the need for people to be able to afford care, much less thought seems to have been given to the question of who will take care of those patients.
Since the collapse of Hahnemann first opened my eyes to the issue, the fate of safety net hospitals has been of concern to me. Among the biggest issues and one directly involved in Hahnemann’s demise has been increasing privatization hospitals as dwindling reimbursements leaves non-profits vulnerable to acquisition or closure. For profit management is often in no way more cost-effective than their non-profit counterparts and can be argued to be more expensive to run. To compensate however, the resources expended per patient are lessened while funds diverted to shareholders and administrators are increased. The growth of for-profit ownerships of hospitals has in many ways engendered a vicious cycle in which for-profit entities raid formerly community-built institutions, absorb their assets then by controlling patient mix( i.e prioritizing those with robust insurance coverage) further harm vulnerable populations. Compounding the institutional issues is the potential loss of medical professionals who have already proven a willingness to utilize their skills in terms of the most vulnerable members of society. While I will not rehash my entire earlier thoughts about the tragedy of losing Hahnemann a reminder that the loss of one hospital cost hundreds of highly-skilled practitioners and nothing stops repeat performances in years to come.
The role of the election in prompting this post was the revelation that the collective elections of this year are estimated to cost about $6.5 billion. This would account for about 4 years of the safety net hospital shortfall of the state of California. While it would be too idealistic to say that all campaign funds should be directed to bolstering medical institutions it does raise the idea that we select leaders to improve our lives and directly doing so is difficult to argue as an ineffective method of proving one’s capability to do so. Even if done cynically, directly investing in institutions which serve to keep communities both physically and fiscally healthy could serve as advertisements far outliving any media blitz a prospect particularly valuable for Senators and Representatives who desire to reliably retain their seats term after term.
