Are hospitals passing off their low-profit patients?

From the Chicago Tribune:

Indigent and under-insured patients are turning to Cook County’s Stroger Hospital after not getting fully treated at non-profit hospitals, swamping the cash-strapped public facility while fueling the county’s sky-high sales tax, a Tribune investigation found.

Some of these patients arrive at Stroger’s emergency room bearing discharge slips, prescriptions, even Yahoo and Google maps from non-profit hospitals, according to documents obtained by the Tribune.

“Go to Cook County Hospitals immediately,” says a discharge slip for a man with a broken jaw.

“Go to Cook County ER to be evaluated for admission,” reads a discharge slip for a man with a tumor.

Here’s the Wall Street Journal Health Blog‘s take on the issue:

Just because a hospital is a non-profit, that doesn’t mean it has to provide charity care to everyone who seeks it. Beyond the requirement, shared by all hospitals, to treat patients who are having medical emergencies, non-profits can send away some of those who can’t pay. That often leaves publicly financed “safety-net” hospitals holding the bag.

Non-profit hospitals do provide more charity care than for-profit hospitals — in the Chicago area, about 2% of their total revenue, versus 1% at for-profit hospitals, according to an analysis cited by the Trib.

But, as the WSJ reported last year, as some nonprofits have moved to begun to operate more like for-profit businesses, some lawmakers have questioned whether they’re doing enough to deserve their tax-exempt status. A recent IRS study found that a small minority of nonprofit hospitals provide the bulk of uncompensated care for the poor.

The Chicago nonprofits in the Trib story say they do offer charity care to poor patients. And an official at the Illinois Hospital Association said efforts to move non-emergency patients out of emergency rooms are designed to provide more efficient care, not to dump patients.

‘We Run Red Lights For a Living’


Not many young drivers make the jump from riding a motorcycle around town to weaving a 15-ton red behemoth through traffic with lights flashing and sirens blaring, but when Boston Fire Captain and driver trainer Scott Wahlen joined the service 13 years ago, he didn’t even have his own driver’s license. Now he teaches young recruits how to drive the big fire engines safely.

He warns against the public parking on corners which are marked as free spaces to accommodate a fire-engine’s maneuvers, especially in a city with narrow streets like Boston: “Don’t park on a corner for fire trucks. Taking a right-hand turn with a car on that corner, he gets hung up on that car a lot; it’s imperative not to park there as we can take that car out. The big concern is: When do you take the car out? With a fire showing, a lot of times you have to make that decision. If it’s an emergency, the ladder truck will take that car out.

“I took out a state trooper car one time when there was fire showing. I had to push his car and I just remember saying, ‘Oh my God,’ but there was fire showing, and my lieutenant was cool.”