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Willygolightly t1_j1c8cle wrote

Reply to comment by SolitaryMarmot in ‘Major Trustee, Please Prioritize’: How NYU’s E.R. Favors the Rich by goodguyfdny

No, what I’m saying is that Bellevue receives almost all of its funding from the NY State gov, and NYU receives most of its funding from outside sources.

Bellevue is also significantly larger in terms of capacity, and more has a larger ER and in patient facility.

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SolitaryMarmot t1_j1dk1nh wrote

That's not how hospitals work. All hospitals...including the publics run on net patient service revenue. They send the bill for services off to Medicaid, Medicare or private insurance and get reimbursement. All the hospitals that treat mostly Medicaid patients, including the privates, get some type of "extra" funding but usually not a lot. It's usually through the Disproportionate Share program and the Indigent Care Pool. In the years we have a mayor that chooses to support NYC Health and Hospitals (which so far has been deBlasio) - there is also a city subsidy. A lot of that is for outpatient services which runs at massive losses because its servicing the undocumented population of NYC as well.

But no outside funding stabilizes losses which are structural and built into the payer mix. Hospitals that don't have enough private insurance patients run at a loss. And while they aren't supposed to turn away Medicaid patients - they obviously do. NYU and Bellevue are literally right next to each other. NYU has 15% Medicaid and Bellevue has 81% Medicaid. All things being equal.. Why wouldn't Medicaid patients choose the "better" hospital if they actually could?

That isn't because of some freak of statistics. It's because NYU gives privileges to doctors who keep very few Medicaid patient appointments a month and have a long waiting list for new Medicaid patients. And when Medicaid patients come through the ED they tell them the wait is shorter at Bellevue or they don't have the right kind of physician for them on, or they don't have beds in case of an admit...in the case of psych patients they literally wheel them over to the Bellevue ED even though NYU does have psych beds (Bellevue is larger because it has more psych beds but otherwise they are both in the 800-900 bed range.) Bellevue would never say or do these things because it's contrary to their mission.

Your socioeconomic class...including the type of insurance you have, determines the quality of health care you get in NYC and around the country. But NYC happens to be particularly stratified. If you ever need to use Medicaid (or even Medicare to a lesser degree) be prepared to only be allowed to use the shitty hospitals and providers.

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ctindel t1_j1dts0y wrote

> Your socioeconomic class...including the type of insurance you have, determines the quality of health care you get in NYC and around the country.

This happens even in western europe, where everyone has coverage but people with more money can pay for upgraded service or to skip the queue. I don't know any country where a billionaire or whatever their equivalent of a senator is differently in the hospital.

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