California example of pending safety net collapse
California Association of Public Hospitals and Health Systems
On the Brink: How the Crisis in California’s Public Hospitals Threatens Access to Care for Millions
California’s public hospitals and health systems today confront a severe crisis. Driving this crisis is a steadily growing demand by uninsured and vulnerable patients for health care services matched against a shrinking pool of funds available to pay for that care. If the imbalance between rising costs and declining revenues is allowed to continue, draconian cuts will have to be made. Emergency rooms and trauma centers will close. Thousands of health care workers will be laid off. Entire public hospitals will close. At stake is access to health care for millions of Californians.
Based on analysis by CAPH, over the next five years California’s public hospitals and health systems will face a cumulative budget shortfall of at least $3 billion. This drastic divergence between revenues and expenses cannot be sustained without extensive reductions in services and loss of access to care for millions of Californians.
Why the Crisis in Public Hospitals Matters to EVERYONE
Although they make up only six percent of hospitals statewide, California’s public hospitals and health systems:
- Provide 55 percent of the cost of hospital care to the uninsured * Serve a patient population that is 76 percent people of color, including more than 50 percent Latino * Represent 62 percent of the state’s level I trauma centers * Train almost half of all medical residents in the state * Provide 54 percent of all hospital-based outpatient visits to the uninsured * Employ more than 70,000 health care workers
Without public hospitals, the state’s emergency and trauma care network would collapse, thousands of jobs would be lost and millions of Californians would be forced to go without needed health care.
Unstable Patchwork of Funding
Public hospitals and health systems are uniquely reliant on a tenuous patchwork of funding made up primarily of Medicaid revenues and state and local funds. This unstable patchwork is the result of the lack of a comprehensive public policy to ensure universal access to health care for everyone, particularly those least able to afford care.
For the full report: http://www.caph.org/publications/WhitePaperFINAL.pdf (Although the report is on California’s safety net system, the principles apply throughout the nation.)
Comment: Although there may be political support for improved funding of trauma centers, there is only a feeble squeak of a political voice for those least able to afford care. We are already spending enough to fully fund the public health care safety net. But we lack a rational system for allocating our resources.
We desperately need a single, publicly-administered program of social insurance that includes everyone.