Karin Dryhurst

Urban Hospitals: Winners or Losers?

It appears it's possible to spin the effect of health care reform on local hospitals either way. From the Dallas-Fort Worth Star Telegram:

Public hospitals are bracing for potential cuts that could cost them billions in federal safety-net dollars.

And the Broward-Palm Beach New Times ponders whether the expansion of coverage to 32 million uninsured will make public hospitals obsolete.

Presumably, the cuts to direct federal money for these hospitals should be balanced by a decrease in uninsured patients. But both outlets ignore those left out of the health care package: undocumented immigrants.

Undocumented immigrants are ineligible to receive coverage under the federal plan, but public hospitals take in emergencies regardless of immigration status. And at one Houston public hospital district, officials predict undocumented immigrants will become the largest patient pool as the newly insured move to other hospitals.

That answers the question of whether these hospitals will become obsolete.

The health care bill excluded immigrants to avoid political heat from anti-immigrant conservatives. But in reality it will stress urban public hospitals--especially in areas like Houston with large immigrant populations.

For example, the public Jackson Health System in Miami continues to operate under a threat of financial collapse largely due to unpaid bills for the uninsured. As the system's governing board outlines a "Sustainable Jackson" plan, it will have to grapple with the large number of immigrants who will remain uninsured.

Congress should turn its attention to immigration reform to ensure that urban public hospitals don't continue to struggle under a broken system.

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Posted at 2:35 PM, Mar 24, 2010 in Cities
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