The July 27 Sunday edition of the Post-Gazette had a lead article entitled “In Pittsburgh Region, the Safety Net Falls Apart.” It details the closure of 11 area hospitals, but then makes the quantum leap that free health care is harder to find in the city due to the closing of the hospitals. What? Really?
Hospitals close for many reasons. With a shrinking population, we’ve developed tremendous redundancy. Some local hospitals were losing money from unfilled beds and/or from inefficiency. As federal and insurance dollars have become increasingly restricted, all hospitals have had to become more fiscally sound and effective; those that could not adapt were compelled to close. Quality of service and readmission rates now affect reimbursement rates for hospitals and physicians; those that deliver substandard care are penalized. They have to be able to afford to stay open.
Hospitals are not the problem — they are meant for inpatient care. They were never meant to be used for outpatient care, free or otherwise. And yet emergency rooms are swamped with people who use hospitals as a primary care center. No one can be refused emergency care from an emergency room, however an ER is a very expensive and very ineffective primary health care provider.
People who need free care need to be seen in a clinic or facility that will care for the poor, and should only be in the emergency room when they are ill enough that they may need to be hospitalized, not for a minor illness. Those are the facilities that should have been addressed in the article, not hospitals.
Timothy M. Campbell, M.D.