Letters to Editor Discuss Wall Street Journal Article Reporting on Charity Hospitals Moving To Suburban Areas

The Wall Street Journal on Oct. 14 reported on the "increasingly common strategy" of not-for-profit hospitals moving out of urban areas, where the majority of patients are uninsured, to more affluent areas -- often in the suburbs -- where a larger portion of patients have private coverage (Kaiser Daily Health Policy Report, 10/14). The Journal on Monday published several letters to the editor addressing the issue. Summaries of the letters appear below.

• Ellen Kugler: If not-for-profit hospitals that have left low-income areas "are villains, they have accomplices: government," Kugler, executive director of the National Association of Urban Hospitals, writes in a Journal letter to the editor. "While the decision of some nonprofits to flee or close is regrettable, there is a degree to which it is understandable, "because although the federal and state governments through Medicare and Medicaid have "legally assumed responsibility for the health care of nearly 100 million Americans, ... they often refuse to meet their obligation to pay fairly for that care," according to Kugler. She continues, "Hospitals can find themselves underpaid for the care they provide to significant proportions of their patients," adding, "Coupled with the huge numbers of uninsured patients they serve, closing usually becomes a matter of 'when' rather than 'if.'" Kugler writes, "When that happens ... it affects more than the poor," concluding, "This scenario is going to be repeated in many communities in the coming years unless the federal and state governments change their ways" (Kugler, Wall Street Journal, 10/20).
  
  
• Anthony Tersigni: The "article points out some of the very real problems that those of us in health care face every day in serving those who are poor and vulnerable," but it "doesn't examine the underlying issues in delivering health care ... all across America" nor does it "examine some of the extraordinary difficulties providers face in achieving our goals to ensure that each individual receives the right care in the right setting within a financially sustainable model," Tersigni, president and CEO of Ascension Health in St. Louis, writes in a Journal letter to the editor. He continues, "Unfortunately, the realities of our current health care system make this challenging, if not impossible," because as "providers strive to best serve their communities, these realities necessitate difficult, sometimes painful decisions about how and where health care services are best delivered in order to achieve improved health outcomes for each individual." He concludes, "Solving the challenges inherent in delivering health care in America today requires the collaboration of all stakeholders, including patients, providers, payors and government at each level" (Tersigni, Wall Street Journal, 10/20).