US ‘Safety-Net’ Hospitals in Crisis


Despite being one of the world’s richest countries, the US does a shockingly bad job of providing health-care for the poor. The nation’s public hospitals are central to this, but there are 300 fewer public hospitals today than at the start of the 1990s.

Now comes the crisis at Atlanta’s Grady Memorial Hospital, one of the nation’s largest safety-net hospitals. Grady’s is located close to the neighbourhood where Martin Luther King Jr. was born. The full story can be read in the New York Times here.

The Times comments: “Like other public hospitals, Grady is operating on a business model that is no longer sustainable. A third of the hospital’s patients, including those treated as outpatients, are uninsured, among them a rapidly growing group of immigrants. Another third are covered by Medicaid, which reimburses at rates well below Grady’s actual costs”.

Public hospitals in Miami, Memphis and Chicago are also in a critical state. Public hospitals use privately insured patients to cross-subsidize those who can’t pay much (or anything at all). But this is becoming less viable as the fully insured go elsewhere (to America’s well-provided private hospitals). Public hospitals account for 2% of all US hospitals, but provide 25% of uncompensated care. Unless public hospitals get more help, America’s already dire health outcomes for the children of poor families will get even worse.

Makes us Brits thankful for the much-maligned NHS.


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