Destroying Public Hospitals

Public Hospitals like Highland and San Francisco General are essential health centers, and they are on the chopping block. These safety net hospitals serve the poor, those without health insurance, and are also some of the best and most widely used trauma centers. And now, over the next five years, the federal government plans to cut their funding in half.

The Affordable Care Act was supposedly designed to give Americans access to health insurance. Really this means locking thousands of new patients into plans with the existing insurance companies, guaranteeing their profits. A little-discussed portion of the Affordable Care Act also slashes funding for public hospitals. By 2018, funding for public hospitals will decrease from $11.2 billion to $5.6 billion. The excuse for the funding cut is that these hospitals, serving the bulk of uninsured patients, will start to generate new revenue from their patients as more and more people have insurance. But this is very unlikely. This ignores the reality that many people have not received insurance through the Affordable Care Act. There are 3.2 million California residents who still rely on public hospitals and clinics. In addition, the new Affordable Care Act plans come with high premiums, shifting the burden of payment onto patients who may not have the means in the first place. Either they will avoid receiving health care altogether, or public hospitals will absorb the cost.

Already public hospitals are being strangled. In 2013 alone, public hospitals spent $80 billion on care for patients who had no means to pay. The federal government reimbursed these hospitals for only 65 percent of this treatment. That means that public hospitals were forced to provide worse care, cut corners, and drive hospital workers harder to make up for the lack of funds. It is no wonder that at hospitals like Highland in Oakland, workers and staff find insufficient and expired supplies. Doctors and nurses are forced to improvise, providing care with limited materials. Ultimately, many public hospitals are simply shut down. In the last decade, more than 26,000 community hospitals nationwide closed their doors. The effect of these closures is an overall decrease in the health of entire communities. The fact that public hospitals are also essential trauma centers means that everyone’s health care suffers when these cuts are made.

The Affordable Care Act was written by representatives of the big drug companies, health insurance agencies, and large private, hospital chains. No wonder they aim to eliminate public hospitals. They want to ensure that health care in this country puts the dollars in their pockets and under their control. This means private hospitals, private insurance, and the worst possible care at the highest price.