Hospital and public health essay

The topic of the paper is the condition of modern public health in the USA and current health reform, and particularly the safety net hospitals and safety net providers.
First of all it is necessary to say that a safety-net hospital is one that provides a medical care to low-income, uninsured, and vulnerable populations. Safety-net hospitals are generally distinguished from other health care providers by their commitment to provide care for people with limited or no access to health care because of their financial or insurance status or health condition. These hospitals provide the most important health services to great number of people, so they are not only vital sources of care for the indigent and uninsured, but also important providers of specialty services to the whole community
Since safety-net providers rely practically on government support and donations, have numerous funding sources to finance the care they provide: local or state government subsidies, Medicaid and Medicare DSH payments, cost shifting, and other programs. But changes in Medicaid policy over the last years and concretely the economic recession have had a great impact on safety-net providers. First of all it is connected with the overall process of loss of employer-based health insurance that has left many people uninsured or Medicaid-bound, and also with deficit in state and local government budgets to finance the public health. All these have caused the closure of safety-net hospitals, that has several problems:
1. The first is that services provided by safety-net hospitals are high-cost and unprofitable. Due to the economic recession of the nowadays if safety-net hospitals in some areas were to close, other community hospitals might be reluctant or financially unable to broaden the scope of their care.
2. The safety-net hospitals are the sole provider of a particular service, and so other hospitals may not be able to fill the gap and be overcrowded.
That is why access to public health and specialty services can be affected by closing a safety-net hospital. The conclusion may be taken from a 1996 study published in the Journal of the American Medical Association (JAMA) that “the closing of a public hospital had a significant effect on access to health care and was associated with a decline in health status.” (www.healthreform.gov)
Taking into consideration all the said above, we may say the current health reform, and particularly American Recovery and Reinvestment Act (ARRA) enacted in February 2009 are very important for public health. According to the ARRA, the government will ensure special funds for state Medicaid programs, increase funding to support hospitals serving low-income population, uninsured and Medicaid patients. (www.healthreform.gov)
Also it is important to mention the government support and additional grants to federally qualified health centers (FQHCs) that are community health centers, public housing centers, outpatient health programs funded by the Indian Health Service, and programs serving migrants and the homeless. (www.healthreform.gov)

Conclusion
Concluding all the said above the safety-net hospitals are very important for public health because they provide certain public health and specialty services, give services that attract potentially difficult-to-treat patient populations, including psychiatric care and alcoholism treatment. Also, safety-net hospitals are the major providers of public health and specialty services in their communities, that is why hospitals provide benefits for the uninsured, and the larger community as well.
So maintaining community access to safety-net services is of great importance while providing care to economically disadvantaged patients. That is why government must provide policies and programs targeted to support the safety hospitals, and very important step towards this goal was made in the current health reform, that is highlighted in the ARRA.

Works cited
Amer Kaissi. “Effects Of The Economic Recession On “Safety-Net” Hospitals And Clinics”. Healthcare Hacks, 2010/02/18. Web.