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Old 03-05-2017, 12:02 PM
 
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Originally Posted by Airborneguy View Post
NYC public hospitals do not span the 5 Boros as the article claims.
Airborneguy feels this is unfair. Airborneguy would prefer if there were no public hospitals. Airborneguy wants poor people to die in the streets.
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Old 03-05-2017, 12:14 PM
 
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I think a lot of this comes down to geography. Most of the major academic medical centers are located in higher income areas. They may also be a reverse issue. Because there were major academic medical centers, those neighborhoods developed as higher income areas.
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Old 03-05-2017, 12:40 PM
 
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Originally Posted by BBMW View Post
I think a lot of this comes down to geography. Most of the major academic medical centers are located in higher income areas. They may also be a reverse issue. Because there were major academic medical centers, those neighborhoods developed as higher income areas.
The academic medical centers have a lot of poor patients though. The student doctors and dentists practice learning medicine on the poorer clients, who get more affordable medical care through this arrangement. Of course the people who have more money and go to these hospitals can just get the experts.
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Old 03-05-2017, 12:42 PM
 
Location: Bronx
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I remember thier was an article about testing lower income pregnant women for drug use. While drug use is just as prevalent in upper income areas of society compared to low income. I do believe their is health segregation in this city and it correlates with the growing income inequality that we mainly see in extremely liberal cities such as San Francisco, dc and Boston.
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Old 03-05-2017, 12:46 PM
 
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Originally Posted by Kefir King View Post
If you want to see the truth of that assertion, just walk up Second Avenue past the entrance to Metropolitan Hospital between 97th and 98th to judge the clientele.

Well come on now. If you had the choice would you take Metropolitan or Mount Sinai just a few blocks east?
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Old 03-05-2017, 01:07 PM
 
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Quote:
Originally Posted by Bronxguyanese View Post
I remember thier was an article about testing lower income pregnant women for drug use. While drug use is just as prevalent in upper income areas of society compared to low income. I do believe their is health segregation in this city and it correlates with the growing income inequality that we mainly see in extremely liberal cities such as San Francisco, dc and Boston.

If there is anything causing and or feeding into healthcare "segregation" in New York or elsewhere it likely has much to do with access to quality PCP and good insurance.


Hospitals, doctors, and others aren't thrilled with Medicaid as reimbursement rates are very low. Medicare is a bit better so you can often find doctors willing to accept, not as many as one would think, but still. In either case once you need a specialist the good to excellent doctors by and large do not take Medicaid nor even in some cases Medicare.


The two main ways patients are admitted to hospital are via PCP or ER. Hospitals are choosy who they give admitting privileges to, and not every practice has access to NYP, North Shore-LIJ (now Northwell), Mount Sinai, NYU-Langone, or Montefiore. So unless it is an emergency chances are you will be admitted to where your doctor has rights.


If you don't have a PCP (and many New York City residents do not for various reasons), your choices for medical care are mostly limited to urgent or ambulatory care clinics, and or simply going to emergency room. In fact many persons who do have insurance and or PCPs still use ERs. This has mostly to do with convenient access. That is many doctors do not have extensive office hours, and few work nights, late evenings or weekends. So if you need healthcare during "off hours".....


As for ER admissions, HHC and charity hospitals (when NYC had them), long complained that the big private (and often wealthy) hospitals did all they could to discourage the "poor" from getting to their emergency rooms. Everything from making the places hard to find, to out right patient dumping. The latter was made illegal, but still. This is because by federal law once you arrive at a hospital's ER they must treat you.

Every hospital or doctor in NYC (as elsewhere) is chasing after the same sort of patient; financially well off to wealthy and or with good to excellent health insurance. It does not help that patients are more informed today and or are capable of making decisions as to where they seek healthcare.


Despite all the new wealth in Greenwich/West Village, Chelsea, Tribeca, Soho, etc... Saint Vincent's floundered. Much of the new well off residents down there would not go to the place if their lives depended upon it. They saw Saint V's as a dirty "charity" or "welfare" hospital and avoided in droves. Choosing instead the more wealthy NYP, NYU-Langone, and Mount Sinai healthcare networks.


Across the river in Brooklyn the same thing is playing out. Despite all the new wealth downtown, and whites/more wealthy moving into places like Clinton Hill, Bedford Stuyvesant, Williamsburg, Red Hook, Bushwick, etc.... people will *NOT* go to local Brooklyn hospitals on average. Instead they choose to go into Manhattan or out to Long Island. This was part of the reason why Long Island College Hospital closed (it was Saint Vincent's all over again), and why places like Wycoff, Interfaith, Brookdale, and Kingsbrook are in such a financial mess.


Each night you see ambulances crossing the East River bringing patients from Brooklyn to hospitals in Manhattan. Know several females who despite living in Brooklyn went back into Manhattan to deliver their babies.


The hipsters, transplants and others moving out to Bushwick or BedStuy have lots to say about Wycoff Hospital, much of it not very good. You read the comments on Yelp or elsewhere and you see why healthcare is "segregated" in NYC. That is if given a choice certain people will simply vote with their feet.

Last edited by BugsyPal; 03-05-2017 at 02:28 PM..
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Old 03-05-2017, 01:18 PM
 
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Originally Posted by BBMW View Post
I think a lot of this comes down to geography. Most of the major academic medical centers are located in higher income areas. They may also be a reverse issue. Because there were major academic medical centers, those neighborhoods developed as higher income areas.
When Columbia, Mount Sinai, and New York hospitals were built those areas of Manhattan (UES, Morningside Heights), were vastly different areas.


If you look closely often the original hospitals were located elsewhere, then places moved when they needed to expand, and went where land could be found (often cheaply).


There is a reason why so many hospitals are on the East Side by the FDR (New York Hospital, NYU, Bellevue, Beth Israel. Land over there was cheap and easily had with expansion being done either by landfill and or over the FDR.


Bellevue Hospital is built in parts over landfill and wetlands and at one time was only a block or so from east side docks. As common to such areas the place was over run with rats. So much so that it was called "Rat Hospital" for a good part of the last century. Even today parts of that campus or buildings still have problems with rats. RATS AT BELLEVUE HOSPITAL. - THE CASE OF THE NEW-BORN CHILD GNAWED BY VERMIN--INVESTIGATION BY THE COMMISSIONERS OF PUBLIC CHARITIES--HOW THE HOSPITAL IS OVERRUN. - NYTimes.com


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Old 03-05-2017, 01:37 PM
 
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New York Presbyterian/Columbia is in Washington Heights, which is still poor and mostly minority. Columbia's Morningside Heights Campus is built on what used to be the Brookdale Insane asylum. They moved to the area because it was cheap (it was full of poor people). Columbia used to be downtown, then midtown, then they decided to move to Upper Manhattan because it's full of poor people and easier to expand.

Mt. Sinai is in East Harlem. So that's two major academic medical centers in poor neighborhoods.

New York Presbyterian is near York Avenue, and as Bugsy said, that wasn't always a nice area and certainly not when that hospital was built.

Yeshiva's Albert Einstein medical school is affiliated with Montefiore in the Bronx.
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Old 03-05-2017, 03:01 PM
 
Location: New Jersey!!!!
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Originally Posted by BoogeyDownDweller View Post
Airborneguy feels this is unfair. Airborneguy would prefer if there were no public hospitals. Airborneguy wants poor people to die in the streets.
I take no issue with public hospitals. I do take issue with the fact that I pay for the services I use while skells do not. Outside of immediate emergency care, nothing should be free.
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Old 03-05-2017, 03:23 PM
 
31,705 posts, read 26,631,805 times
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Originally Posted by Airborneguy View Post
I take no issue with public hospitals. I do take issue with the fact that I pay for the services I use while skells do not. Outside of immediate emergency care, nothing should be free.


To be fair outside of clinics or whatever, no one is "giving" away hospital care "free".


NYS requires all hospitals to make a good faith effort to collect on all care provided, including to the indigent. Only after such efforts are places allowed to seek funds from NYS to cover their loss. Much of those reimbursed funds come from a tax NYS levies (surprise, surprise) on health insurance. A N.Y. health law so stupid, it


One of the reasons Saint Vincent's system and later hospital went bankrupt (besides bad management, low reimbursement rates and other problems), is that the nuns refused to turn their backs on core mission; to provide care to anyone regardless of ability to pay. It was a well known secret you could get care costing tens of thousands from that place, cry poor mouth and end up paying little or nil.


By law hospitals in NYS are required to offer "assistance" to indigent and or the uninsured. How extensive that assistance is or easily gotten is another matter.


https://www.wehealny.org/services/financialassistance/
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