Thursday, April 24, 2008

Will new hospital keep suburbanites from having to share waiting room with inner-city folks?

I'm making a broad leap this morning but follow me here ...

With today's scheduled noon announcement of a new hospital in Northern Summit County comes the valid argument that moving medical facilities closer to where people live is a necessity as we age.

O.K. I get it. I agree with it. I'm cool. Lots of folks in Cuyahoga Falls, Stow, Hudson, etc .. need health care and having a hospital close by is a great asset. Plus there's jobs involved there too.

Still, by creating a health care system that allows the suburbanites to avoid having to share chairs in the waiting room with poorer, inner-city folks at Summa and AGMC... are we supporting the further division of the lower and middle classes? Will we set up a system that encourages the better doctors to work at the suburban hospital because more of their patients are likely to have insurance? If the area is getting a new medical resource, are we more likely to put it in the suburban hospital?

Maybe I'm totally off base at 8:38 a.m. .... i haven't had my cereal yet and I still need to go exercise.

Still .. anyone else see a downside to a new hospital?

Just asking the question to stimulate discussion here.


Anonymous said...

I'm with you, Eric. I think a lot of decisions are made in the country to seperate the poor from the rich and the black from the white, etc. It's a shame.

vanillacokehead said...

Eric, in a way, this gentrification of health care has been going on for a while now.

You see it with more new doctors choosing to go into higher paying specialties (like plastic surgery and sports medicine that tend to cater to more affluent people) rather than into general practice and emergency medicine. You see fewer doctors in private practice seeing patients who are on Medicaid. You see it with "boutique" medicine where people who can afford it pay extra for the privilege of having quick access to doctors who block out more time to spend with these patients.

The sad thing is that there are so many folks who are under- or un-insured who use urban emergency rooms (such as AGMC or City) as their de facto primary care health providers. These patients can't afford the necessary preventive care that decent insurance plans provide and this often results in relatively minor maladies developing into major illnesses.

The US health care system is messed up in a major way: it's inefficient; its funding mechanisms are flawed; the legal atmosphere for health care providers is less than friendly; and lots of people who need care fall through the cracks.

I don't see a lot of the principals involved in the US health care system looking to change any time soon the way things are. Too many people have a "gravy train" from the health care industry: insurance companies and trial lawyers are two of the most firmly entrenched parties I see as a hindrance to any meaningful reforms in the way health care is financed and delivered...

Swanny said...

When I lived in Akron, I always used the ER at Falls General. Sorry, but if you wanted to be seen in one of the Akron hospital ERs in a reasonable amount of time, you almost needed to stab or shoot yourself.

Seriously, the ERs at the Akron hospitals are horrible, largely because so many people just show up at the ER for things that they should be making an office visit with their doctor to resolve. People with simple colds and the flu shouldn't be clogging up the ER. The ER is for life-threatening situations, trauma, and treatments that can't wait.

The problem is, the ER can't refuse to treat these people. They can triage them, assess the criticality of their medical condition and make them wait for hours, but they can't refuse to treat them. To this end, there are countless stories of people who have simply left the ER, gone around the corner, called 911 and have been brought through the trauma unit just to avoid sitting in the ER waiting room.

The other problem is that people use ERs because they know that they won't have to pay. While a doctor can refuse to treat you at their office if you can't pay for the treatment, hospitals have a legal obligation to provide treatment, regardless of the person's ability to pay. While this is a very altruistic notion, it gets abused constantly.

As a result, many hospitals are closing their ERs. They simply don't want to deal with the hassle.

Swanny said...

BTW, Summa recently bought Wadsworth-Rittman hospital and has been dumping a ton of money into renovations and an expansion.

At the end of the day, I just see this as moving the service providers closer to the populations that need them. The City of Akron is losing population, and the suburbs are growing. New facilities and strategic acquisitions of other smaller health systems in places like Stow and Wadsworth just make sense.