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.
You're not serious.
HIPAA, like all the other Leninist health initiatives since 1965, is designed to destroy what we have.
As Lenin his own self said,"The worse, the better", meaning that if you destroy whatever works first, the people will turn to you in frustration.
Nobody who does not know Lenin can understand the course of US health policy over the last forty years.
The pinnacle of "right thinking" intellectuals is the Northeast and other liberal enclaves. I'm just a little nothing living in flyover country.
I've said it before and I'll say it again. I'd rather be a garbage man in Texas than a $1,000,000 a year salaried suit up north.
we'd be making the same net pay and my kids would have to grow up with the government nipple mentality that a majority of folks have who live in democrat fiefdoms.
bingo...look at the first thing that Chavez destroyed.
Emergency rooms (at least one's I've seen in Seattle and Los Angeles) have big signs all over the place informing people (in English and Spanish) that they cannot be turned away if they don't have insurance. Why would anyone buy insurance if this is the case?
Who do you think is making $1,000,000 all I know you have insulted me so you can blow off steam, even if you don’t like Detroit it was once a solid City if was the 5th largest city in its day!
BTW Michigan is consider midwest not northeast!
Unless you are self employed you get the insurance your
employer provides.
Even if you have to buy it, it affords more convenient
care than you get shlepping into LA Co General, Parkland
or some other big inner city ER.
But anyway, the point is that we as a humane society aren’t
going to leave folks, fellow humans made in the likeness
of God, to die on the sidewalks for lack of care.
If we begin to do that, this won’t be my country anymore.
Hospitals exist for reasons beyond the profit motive.
The same thing is happening to emergency rooms around San Diego. The illegal aliens use them for "free" medical care. They continue to close. San Diego is hardly a poor, urban center. The problem is the same. Hordes of non-paying "customers".
The problem is the fact that people who can't afford insurance (or don't see it as a priority for them) use the emergency rooms as their primary care givers and go there for everything from the flu to toothaches. How many illegal immigrant births are performed on a daily basis? Is the solution simply make the rest of us fork over all out earnings to support this?
But they need to pay their employees and suppliers with cash.
No cash, no hospital, whatever the "reasons" they exist.
I get treated the same way at most restaurants. They aren't going to serve me if they don't think I'm going to pay the bill. Same thing at the auto dealer. Money talks, BS walks.
I know. I was trying to make a point. I resisted HIPAA because I resent the distribution of my medical information. Be that as it may, now after the fact, I am asked to jump through even more hoops. I am sick of hoops and signing my name under the guise of waiving, in some fashion, some right. We are waiving our rights right away—for nothing.
Further, the invasion of medical information under the guise of HIPAA with regard to a Dentist I find really disgusting. Fix my teeth already—my health (including my Blood Pressure) is none of their business and I WILL sign a waiver for that.
“Emergency rooms (at least one’s I’ve seen in Seattle and Los Angeles) have big signs all over the place informing people (in English and Spanish) that they cannot be turned away if they don’t have insurance.”
Does anyone know the intent of that law? Is it to provide EMERGENCY CARE only- i.e, stabilize a heart attack patient, or does the law require that someone with a splinter cannot be turned away?
Seems to me this could be handled in triage....anyone not having EMERGENCY symptoms could be turned away.
It's about not getting sued. It's about informed consent. Your service provider is making sure decisions are made based on the best information YOU provided. Your provider is ensuring that you understand the services/medications and attest that you understand. Those documents will magically appear in court should you try to sue with the claim that you didn't understand what was going on.
I planned to go to medical school during the summer following 8th grade. When I graduated with a degree in Molecular Biology at age 19, I was no longer interested in medicine. The legal profession made it very unattractive. My sister stayed the course as an RN. She has been in the OB department at Mercy Hospital since 1979. She spends 90% of her time filling out paperwork to protect the hospital from lawsuits. Not much nursing.
That's a popular bumper sticker on the decrepit vehicles around Pocatello. The other one is "Right to Work Laws Suck". The unions can't compete with better quality. They depend on government thuggery to force people to join their ranks. The unemployed union members are clueless.
Instead they wait in line with everyone else. The only ones sent to the head of the line are those with breathing problems. Emergency rooms still get tied up dealing with these cases, doctors still have to spend their time on them.
WRONG! It was managerial INCOMPETANCE that sunk the Big Three. Maybe if they didn’t build rust buckets with poor fuel efficiency in the 1960s and 70s, to say nothing of the cheap interiors of the current vehicles, Americans would buy more of their cars.
True, although Detroit does not exactly have a large illegal population. Even the illegals are too scared to move to that city.
high taxes=check
union stronghold=check
democratic enclave=check
class warfare mecca=check
I've come to agree with you, that I shouldn't expose myself to the great state of Michigan or the veritable Nirvana of Detroit. I'll never live North of the Red River, West of the Pecos River, East of the Sabine or south of the Nueces River....
I'm sure that the folks that live outside of those boundaries are glad to be rid of me as I am to be rid of them.
I honestly couldn't care less if Detroit was the 5th largest city, so what...... I remember an interview with a typical northeastern snob that was shocked that I mentioned that I was born in San Antonio... he thought it's a nice little city. I mentioned that it was bigger than Boston and he proceeded to tell me I was wrong and that there was no way that could be.
I had a nice little chuckle when he pulled the 1980 census data up and looked it up to show me how stupid Texans are about little old San Antonio.
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