Democracy Gone Astray

Democracy, being a human construct, needs to be thought of as directionality rather than an object. As such, to understand it requires not so much a description of existing structures and/or other related phenomena but a declaration of intentionality.
This blog aims at creating labeled lists of published infringements of such intentionality, of points in time where democracy strays from its intended directionality. In addition to outright infringements, this blog also collects important contemporary information and/or discussions that impact our socio-political landscape.

All the posts here were published in the electronic media – main-stream as well as fringe, and maintain links to the original texts.

[NOTE: Due to changes I haven't caught on time in the blogging software, all of the 'Original Article' links were nullified between September 11, 2012 and December 11, 2012. My apologies.]

Tuesday, August 20, 2013

NYC's Disappearing Neighborhood Hospitals

For many New Yorkers, the trip to treat a broken appendage or receive vaccination shots is growing longer. Since 2000, nineteen hospitals across the city have closed due to financial pressures—a number that could have even been higher had a judge not recently ordered Long Island College Hospital (LICH) in Brooklyn to resume services.

Nurses gathered outside LICH in early July to deliver a nearly 7,000-signature petition to SUNY Downstate Chancellor Nancy Zimpher’s New York City office demanding she stop the process of closing the hospital. Journalist Sarah Jaffe reported that after a SUNY representative refused to comment on the ongoing situation, the crowd turned to civil disobedience and blocked the doors to the building and refused to move until police took them away in cuffs.

Though those protesters were successful in fighting for the return of emergency services, the twentieth closure may occur soon if plans to shut down Interfaith Medical Center in Brooklyn go through.

Community members held an all-night vigil Sunday to protest the planned closure.

Reverend Herbert Daughtry, 82, said, “The absence of this hospital means that people will have to go distances for medical attention.”

Thus far, Governor Andrew Cuomo has not expressed sympathy for hospital staffs and residents losing easily accessible medical care, and has said he is unwilling to bail out failing hospitals.

ABC News:

    “If you look closely and follow the proper guidelines, money is available for safety-net hospitals,” District Leader for the 56th Assembly district Robert Cornegy said.

    “Safety net hospitals” is how advocates describe facilities in low-income areas that provide much needed services. They say the government has a moral obligation to care for the sick and the poor.

    “What the government is saying to us, though, is that there are beds available within the borough, so it’s okay to close a hospital,” Cornegy said. “Because make it with beds in Coney Island and beds in other places, but it doesn’t account for the emergency response time necessary to save a life.”

For many residents, the walk from their apartment to the nearest hospital has increased from a few blocks to, in some cases, a few miles. Advocates say that change is a matter of life and death, especially for the city’s poor residents.

Bedford-Stuyvesant resident Stephen Autry told an ABC affiliate that the nearest hospital to his home is in Woodhull on Flushing Avenue, and that is several miles away.

Kaiser Health News notes that most of the hospital closings have occurred in relatively poor communities, while a handful were in affluent areas but served as “safety-net” facilities, because local residents who were wealthy and insured favored other facilities farther away.

    “If a hospital is serving a low-income community, it probably has a fair number of patients who are not paying—who are uninsured,” said Jim Tallon, president of the United Hospital Fund of New York. “So, left on its own, a hospital serving a low-income community is going to be financially in distress.”

New York applied to the federal government a year ago for a Medicaid waiver that officials hoped would net the state $10 billion through better care management, some of which going towards bolstering and modernizing Brooklyn’s healthcare system. But almost a year later, Albany has received no money from Washington. In May, Governor Cuomo went so far as to send a plea to Health and Human Services Secretary Kathleen Sebelius.

“Due to a rapid deterioration in the financial status of essential components of the health care services system in Brooklyn, if nothing is done within the next 12 months, the outcome will be disastrous,” Cuomo’s letter said. “Without the waiver, at least four hospitals—having among them nearly one thousand inpatient beds and supporting hundreds of thousands of emergency room and ambulatory care visits—will be in danger of closing.”

Alan Sager, a professor of health policy at Boston University, calls the phenomenon of the dwindling neighbourhood hospitals “medical deserts.”

Sager notes that the decline in hospital beds comes at a time when the baby boomer generation has begun to age, and will most likely need hospital care.

“We may look back in 10 years and say, ‘How could we not have seen this coming?’” Sager told the Star Tribune. “Keeping open a hospital today is going to cost a lot less than rebuilding at $3 million a bed.”

Mayoral candidate Bill de Blasio has addressed the problem of dying community hospitals and was one of the arrestees last month at the LICH protest. His office sued to block the shutdown, arguing that it lacked proper review and would rob the community of needed services.

A New York Times editorial this week said that while Mayor Bloomberg has waged war against sugary soda drinks and trans fats, he has “checked out” when it comes to the issue of community hospitals closing.

“Struggling community hospitals, including the two on the brink of extinction—Long Island College Hospital and Interfaith Medical Center in Bedford-Stuyvesant, which is in bankruptcy court—have been badly managed and are ill equipped to survive in a changing marketplace. Many are disappearing under mountains of debt and need to be either rescued or reinvented,” said the Times.

De Blasio is proposing to rescue the hospitals through a new entity, a Brooklyn Health Authority, run jointly by the city and state, with the power to modernize hospital systems borough-wide, coordinate the spending of healthcare dollars and set higher standards of care.

A report released by de Blasio warns of “devastating consequences” if Interfaith Medical Center closes next month. Interfaith is Brooklyn’s largest private provider of psychiatric care, with 67,000 patients receiving out-patient care and 1,750 in-patient hospitalizations each year.

According to de Blasio’s report, “Tearing the Safety Net,” losing those services would push remaining hospitals across Brooklyn to 107 percent capacity, and leave tens of thousands of Brooklyn psychiatric patients without care.

The Brooklyn Daily Eagle reports that Interfaith has already sent layoff notices to its 1,544 employees. The hospital declared bankruptcy in December and announced August 1 that it was beginning the process of shutting down.

At the vigil over the weekend, de Blasio stated, “If LICH and Interfaith go down, a quarter of a million people will have to go much farther for their emergency care, when every minute makes a difference.”

Original Article
Source: thenation.com
Author: Allison Kilkenny

No comments:

Post a Comment