(Circulation. 2000;101:e9029.)
© 2000 American Heart Association, Inc.
Safety Net in Jeopardy
An extract of the first 250 words of the full text is provided, because this article has no abstract. |
On March 30, 2000, as the sun was beginning to set, a group of medical, college, and high school students gathered in front of Ben Taub General Hospital in Houston, Texas, for a candlelight vigil to remind the county’s citizens of the needs of the area’s medically indigent. The vigil was particularly appropriate in that place at that time because of the $30 million gap between the needs of the hospital district that runs the city’s public healthcare facilities and the amount that will be provided by tax funds. It was also a reminder that even in times of prosperity in the United States, 45 million people have neither public nor private health insurance; this number is equal to the combined populations of Canada and Australia.
Across the nation, the public hospitals where these indigent patients seek care are in jeopardy. The increasing numbers of people who look to them for health care has made their burden greater. At the same time, both federal and private insurers have reduced the amounts they will pay these hospitals, making cost shifting to cover the indigent impossible. Federal Medicare and Medicaid programs to reimburse hospitals who provide a "disproportionate share" of care to indigent patients have been steadily reducing the amount of money they are willing to give. Local and state governments have also been unwilling to provide funds adequate to provide care to the nation’s citizens who lack the funds or insurance to pay for their health care.
A 1999 survey of