Hospitals and Public Health – Case Assignment America's recent economic recession has severely impacted the quality and availability of health care. Reducing funding while increasing the burdens of safety net providers has forced safety net providers to alter their methods or perish. The loss of safety net providers has, in turn, negatively impacted health care for the uninsured, underinsured, Medicaid and Medicare patients, as well as reducing the number of trained medical professionals. Fortunately, health care reform has and will address the most critical health issues facing the nation. California, in particular, has already benefited from partial implementation of health care reform in at least 10 areas. As the existing facts and figures show, health care reform can provide funding and services that are vital to public health.
¶ … Safety net hospitals have traditionally provided medical services vital to public health. Unfortunately, the recent economic recession has dealt a hard blow to safety net hospitals, even to the point of forcing hospital closures. Fortunately, Health Care Reform has already positively impacted U.S. health care and will even revolutionize American health care in some respects.
The Effect of the Closure of Safety Net Hospitals on Public Health
Safety net hospitals, such as Grady Memorial Hospital, serve the public health through providing vital treatment of uninsured, underinsured, Medicaid, and Medicare patients, along with some privately insured patients (Dewan & Sack, 2008). In addition, some safety net hospitals are also teaching hospitals that train medical professionals who contribute considerably to public health. Unfortunately, economic pressures are forcing the closure of some safety net hospitals, resulting in the severe reduction of medical care in certain communities for the "poor and underserved" (Altman, Shactman, & Efrat, 2006). For example, Grady serves a large region of the public in Georgia and its threatened closure will create a significant gap of health care services for uninsured, underinsured, Medicaid and Medicare patients in that region (Dewan & Sack, 2008). Furthermore, the closure of safety net teaching hospitals such as Grady will result in the loss of training for medical professionals (Dewan & Sack, 2008).
The Impact of the Recent Economic Recession on Safety Net Providers
The United States has a long history of safety net providers that vitally serve public health concerns. However, the recent economic recession has severely impacted the ability of safety net providers to continue adequately providing those services. The recession has resulted in significantly increased unemployment and loss of employer-provided health insurance; consequently, safety net providers have experienced an increase in demand for their services from individuals who have no other recourse for their health care concerns (Felland, Cunningham, Cohen, November, & Quinn, 2010, p. 2). In addition, though safety net providers have benefited from subsidies of COBRA and stimulus funding from the Federal government (Felland, Cunningham, Cohen, November, & Quinn, 2010, pp. 3-4), funding has been cut by local and state governments due to their budget crises, reducing the benefits attained through COBRA and the Federal government (Felland, Cunningham, Cohen, November, & Quinn, 2010, p. 5). An extreme example of the crises caused by local funding cuts is Grady Memorial Hospital in Atlanta Georgia, which is a safety net teaching hospital that has seen a drop in the quality of care, owes $71 million to Emory University and Morehouse School of Medicine for their provision of doctors to Grady, and is in danger of losing its accreditation (Dewan & Sack, 2008). Grady must struggle to survive despite the fact that it provides vital services to an entire region and only 8% of its patients receiving inpatient services are covered by private insurance. This also results in increased stress on staff, as this major safety net health care provider works with a model that does not limit the flow/choice of its patients (Amalberti, Auroy, Berwick, & Barach, 2005). Finally, this situation has caused safety net providers to increase their revenues by such measures as charging and/or requesting donations for previously free treatment and reduce their costs by such measures as laying off workers and reducing/eliminating overtime (Felland, Cunningham, Cohen, November, & Quinn, 2010, p. 6). In adopting cost cutting measures, some safety net hospitals have followed some remedies used in the airline industry, such as reducing their capacity; closing their doors; decreasing nurse-staffing ratios, and reducing quality (Altman, Shactman, & Efrat, 2006). It is clear from current research that traditional safety net providers are being forced to alter their methods in the hope of surviving our current economic recession.
Based on http://www.healthreform.gov/, the Effect of Health Care Reform on California
The www.healthreform.gov web site was archived in 2010 and replaced with www.healthcare.gov, which is regularly updated. According to www.healthcare.gov, health care reform will have numerous far-reaching effects for California. When all health care reform measures are implemented, insurance companies will no longer be allowed to drop a California patient's coverage, impose an annual or lifetime limit on coverage or discriminate against patients with pre-existing conditions. In addition, Californians will not lose insurance coverage due to loss of a job or a change of jobs. Third, insurance companies will be forced to cover preventive care, such as cancer screenings, for Californians. Finally, health care reform will invest in state and local efforts within California that assist public health, avert disease and protect the public against health emergencies (U.S. Department of Health and Human Services, 2012).
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