A friend of mine works for a major New York City hospital, very close to someone in a very senior role. In this position, this person (whose gender I’m keeping deliberately vague) has a clear view of some issues in the healthcare debate most of us don’t. I hadn’t seen this person in a while and asked how work was going — after all, every news report suggests that healthcare and education are booming, even in the recession, unable to find and hire all the help they need. If anyone’s job is safe and secure, this person’s must be.
Not true, they said. This year is OK, they told me, but next year might not be. As the recession drags on, this major, well-known and respected hospital is losing patients who are losing their jobs — and with them — their health insurance. The dominoes are falling in so many directions it’s hard to keep track.
As more Americans lose their jobs this hospital is losing patients, i.e. income. Without sufficient income, the hospital will likely have to cut services or staff. So this friend of mine might lose their job, too.
When patients don’t have insurance, they can go to an emergency room for care and get whatever the hospital decides it can afford to supply them. So, in two ways, the recession is draining income from hospitals: the formerly insured who can’t afford optimal care and the uninsured or indigent who take whatever they can get, a growing tab that hospitals legally must pick up. They’re getting hammered financially from two directions.
What strikes me about the healthcare “debate” is how little we still understand the minutiae, and how eager some stakeholders are that we do not. Those of us outside the system — and there are so many players, many with competing interests inside the system — can’t even ask all the tough, smart, informed questions because most of us, however intelligent or educated, don’t even know what to ask. There is a real sense of urgency to get to answers, now, as President Obama has said there will be a new healthcare plan by the end of this year, only 5.5 months away.
And how much do you even understand, or trust, the answers we’re being given?