Posted on 06/10/2007 11:26:49 AM PDT by libertarianPA
DETROIT - Her legs crippled by diabetes, Mary Lewis is grateful it's a short distance between her doctor's office at Riverview Hospital and the adjacent apartment tower where she lives.
It will become a painful struggle next year when the hospital closes and physicians' offices are forced to move. The hospital last week said it was losing too much money and already stopped accepting inpatients, though the emergency room will remain open for now.
Because roughly 90 percent of its 11,000 annual inpatients are covered under the Medicare or Medicaid public assistance programs, Riverview has struggled economically, said Bob Hoban, a senior vice president for St. John Health, Riverview's parent company.
Experts say Riverview's decision to close fits a distressing, decades-long pattern of hospital closures in older cities across the nation. The trend has left large swaths of predominantly poor, black neighborhoods in cities such as St. Louis, Philadelphia and Cleveland underserved.
Many say the loss of medical facilities for low-income patients is increasingly leaving overcrowded emergency rooms to double as primary-care centers.
"This hasn't been happening in the suburbs and it isn't happening in Phoenix, Arizona, where they can't build hospitals fast enough," said Bruce Siegel, a research professor at the George Washington University Medical Center in Washington, D.C. "This is occurring in older, urban inner-city areas."
New York City, Philadelphia and parts of New Jersey have seen waves of hospital closings in inner-city neighborhoods, said Siegel, who directed a 2004 report examining the phenomenon for the Robert Wood Johnson Foundation.
But few cities have been hit as hard as Detroit.
The number of hospitals in the city has dwindled to seven or eight from 42 in 1960, said Alan Sager, director of the Health Reform Program at Boston University's School of Public Health. Hospitals that are larger, have major medical school-affiliated teaching programs and more money in the bank tend to survive.
Siegel's report warned that Detroit's safety net was already in a "fragile" state and could collapse entirely with further hospital closures. It said Detroit had lost more than 1,200 hospital beds with the closure of four hospitals since 1998.
"Some of it is population shifts and declines," Siegel said. "There's (also) more and more people without health insurance and Medicaid payments that don't keep up with the cost of providing care."
Riverview, a community hospital with 285 beds, specializes in general medical and surgical services, such as treatment of congestive heart failure, diabetes and obstetrics.
The hospital finished its last fiscal year with a nearly $9.5 million deficit and expects to end this fiscal year $23 million in the red.
Medicare payments to hospitals averaged 92 cents for every dollar spent providing care in 2005, the most recent figures available, according to the American Hospital Association. Medicaid's reimbursement rate was lower, at 87 cents per dollar.
Officials at other area hospitals have complained that Riverview's closing will burden them.
"We're 90 percent full on average and there are many days where we're 100 percent full," said Nancy Schlichting, president and chief executive of Henry Ford Health System, which has a trauma center hospital in Detroit.
Karmanos Cancer Institute plans to spend $20 million to renovate the 20-year-old Riverview and reopen it as a clinical center next year.
But Lewis is concerned her doctor's office will be forced to move too far from her home. "I'll have to find another doctor," the senior citizen said.
While waiting for a bus after a physical therapy appointment, Mary Sanders said Riverview is the closest hospital for residents of the east side, including many disabled senior citizens.
The 54-year resident of the neighborhood said she doesn't know where she'll go once the clinic closes.
"Point blank, we need this hospital," she said.
What I wonder is does HIPAA give these walk-in clinics, such as Wal-Mart, access to your medical information.
I have been to a walk-in clinic twice because it was a week-end and the second time was pretty interesting. After being asked what medication I was on and after providing that information I was asked to sign my name on the report that stated what I had said. When the Dr. came in and after he prescribed a medication I again had to sign.
I presume this is all about liability but from what. This particular clinic is a back-up for my regular physician.
I really resent having my Blood Pressure taken and having to provide a list of medications to my dentist. I have to do this every time I get my teeth cleaned. Then I have to attest to it by signing.
What is this signing all about? Why am I expected to provide it every time when HIPAA was suppose to be the answer to medical information regarding patients?
My regular Dr. does not request this stuff so I cannot decide if it is a requirement or something that these medical or so called medical people devised for themselves. Anyone know?
“The number of hospitals in the city has dwindled to seven or eight from 42 in 1960, said Alan Sager, director of the Health Reform Program at Boston University’s School of Public Health. Hospitals that are larger, have major medical school-affiliated teaching programs and more money in the bank tend to survive.”
Take away the emotion in this statement and you’re left with the business model, a parallel to Wal-Mart, CostCo, etc; this didn’t happen because this generation suddenly became poorer, sicker or blacker, it happened because the hospitals became larger, predatory, more impersonal and isolated.
Only the giants will be left, the fast-fading first-feeders frittering away millions on advertising and fund-raising until the last bolt in the last door is slammed shut.
It is just heart breaking oh how magnificent Detroit and its suburbs were in its day!
After the 1968 riots the city and free trade deals to underminding the auto industry it is like a skeleton of what it once was.
Wow, with any luck you’ll miss the bucket full of bricks this time around.
"Show me just what Mohammed brought that was new, and there you will find things only evil and inhuman, such as his command to spread by the sword the faith he preached." - Manuel II Palelologus
Maybe it was inspired by the Joker when he inquired about Batman, “Where does he get those marvelous toys?!?”
Hospitals are losing money because of the patients who don’t pay and the paying patients who are tired of paying for those who don’t pay.
Liberals want privately-run hospitals to fail so that they can step up and say “we’ll save you, here is a national healthcare system”.
What do you expect in a place so cold that the only way to stay alive nine months out of the year is to work yourself silly or burn the family Bible in the hearth and suddenly all the jobs are done by machines or simply disappear altogether.
And Wisconsin Dems want to raise taxes on hospitals....
hold on to your aspirin in Michigan and Wisconsin too. Or move to Cuba, ehehehehe!
The hospital might actually be pretty good... but if the Democrats have trashed the entire city - driving away the hard-working folks and encouraging the welfare-scum, well then it's no wonder the place will go bankrupt!
Detroit is just one of the first in a string of cities facing a similar fate.
Repeat after me... "Union YES!"
Eh, eh. I spent 10 days at the hospital at Nellis AFB, NV recently. During that time, I must have been seen by 10 different doctors. Each one had me answer questions from the same form, sometimes 3 or more times a day.
I complain not. Medical care was excellent. Uncle Sam appreciates my contribution to my country.
yitbos
That is the operative word UNION they ran Detoit DRY!
I was born in Detroit and raised East Detroit now called East Pointe and very few families live their now.
Gosh it was was full of hard working moral folks once!
Did you have to attest to what you said by signing?
I think you are very close to correct in your observations. We discuss this daily at our institution. Hospitals do not work well in a for profit model. MD’s yes but hospitals no. They are the patients port of last resort. The not for profit model works if the money made (all institutions have to make a profit to survive) is reinvested in the hospital and not in buying up MD practices etc. and bonus’s to administrators. Dumping my for profits makes it very hard for the academic centers. They skim the cream and dump the buttermilk.
Hey they're just bankrupting the hospitals that Americans dont want to bankrupt!
What's really neat is that the socialistic democrat strongholds seem to be the areas most affected.
Atlas shrugged..
free trade has squat to do with the demise of Detroit....
If you think it's "free trade", go to a bank borrow some money and open up a "business" downtown Detroit in something that will take advantage of "free trade". Let's see how many weeks it takes for you to pack up and leave.
High taxes, no rule of law, class warfare, criminal protection, race protection rackets, union thuggery, and on and on....
If Detroit fell off the face of the earth we'd be better off and could start your beloved auto makers company in the non union south or west.
Rust-belt states (Penn in particular) are known to be anti-doctor. Doctors educated in these states are in a hurry to leave. People want to have their doctors, and eat them, too—else why would they elect crooks like Rendell?
You drop off the face of the earth beast!
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