Things May Get Worse For "Worst" Hospitals, Study Warns

Dear Editor:

Yesterday you reported in “Things May Get Worse for the ‘Worst’ Hospitals, Study Warns” that researchers have identified 178 low-quality, high-cost hospitals. Taking into consideration that the Affordable Care Act dictated that money be taken away from these institutions and given to those that provide quality care in a cost-effective way, it begs the question: What type of people will be most impacted by this transition? As this study notes, the “worst” hospitals treat twice as many elderly, black patients as did the “best” hospitals. So it appears we have our answer: the under-privileged will be hurt the most, per usual.

As a student interested in the ethics of resource distribution, I believe extra attention needs to be given to what we call “social determinates of health.” While I too am concerned with national health expenditures nearing 18% of the GDP, I believe we must take a second to consider who will be impacted during the changing payment process. One way to decrease the pressure put on the under-privileged is to make policies in which increasing education, creating jobs, and combating racism is the end goal. If this were the primary focus of health care reform (guidelines of care and cost effectiveness secondary), we would likely see drastic improvements in health outcomes as well as other aspects of social life.

Sincerely,

Lindsay Forbes