The Interfaith Medical Center, a major health provider in the Crown Heights and the Bedford-Stuyvesant neighborhoods is experiencing an increase in uninsured patients using the emergency room as their main source of healthcare. Administrators at the hospital attribute the trend to the sluggish economy and say a pool of federal funds intended to pay for the uninsured is running out.
“You see it in cycles” said Diane Porter, Vice President of Interfaith’s Board of Trustees, “with whatever’s going on in the larger society and with recessions and high unemployment.”
Unemployment for Kings County, which encompasses Brooklyn, is 9.6 percent. According to the NY Department of Labor this percentage is higher than the national average of 9.1 percent, and the rate for the city as a whole, which is 8.7 percent.
Interfaith treated over 60,000 emergency room patients in 2010. A pool of money received from the federal government this year, called the charity pool, is nearly exhausted after just nine months, Porter said. By the end of December she predicts that the expenses the hospital will be forced to incur, to treat the increased numbers of uninsured, will have well exceeded the money left in the charity pool, forcing the hospital to cover the uncompensated costs. With no guarantee for more funding, Porter is concerned about the increase in the number of uninsured emergency patients they have to treat. “It’s growing and it’s not going away,” she said, “that’s the point.”
“It’s a burden” Porter said, “because we’re consuming goods, labor, equipment, [and] supplies, for which we are not going to be reimbursed.” Uninsured patients only add to the Medical Center’s negative cash flow, she said. “For every dollar we spend, we are reimbursed 45 to 50 cents,” she said, so servicing people who can pay little or nothing puts a further strain on Interfaith’s finances.
Federal law requires hospitals to treat patients who arrive seeking help, even if they are uninsured or unable to pay. “If a person presents themselves at the emergency room for care, by law you are required to treat them” Porter said.
Because they know they will receive treatment without paying, some people use the emergency room for routine medical care instead of going to a primary care physician, who are not required to treat patients who cannot pay.
Angela Roper (49) was a recent patient at Interfaith’s emergency room. She grew up in Crown Heights and now lives in Bedford-Stuyvesant. She said had been unemployed and uninsured for three and a half years, until finding a job this January. Before she was laid off she had been working at her previous job for eighteen and a half years.
She received unemployment compensation, but did not qualify for Medicaid. “I felt vulnerable,” she said.
In June 2009, she started experiencing painful swelling in her hands. She felt that she had no choice but to go to the ER because “one option is better than no options”. Having no existing heath conditions, she went to Interfaith’s emergency room three consecutive times in one week as the pain escalated. Doctors at the ER were finally able to diagnose her condition as rheumatoid arthritis.
“Maybe once I gave them 5 or 10 dollars but after that I didn’t give them anything… I had nothing [more] to give,” she said.
She has gone to Interfaith’s emergency room several times in addition to this incident. She knew that there were clinics available to patients who were uninsured but she often felt her arthritis pain and other health worries could not wait for a doctor’s appointment.
One Sunday, she was in so much pain that she could not wait to see a Rheumatologist on Tuesday. Her arthritis flared up so badly that she could barely walk into the emergency room, she said. Just a few days later, she was finally approved for Medicaid.
New York City has a variety of other health facilities, such as clinics or community health centers, that serve people who cannot afford private insurance or are not eligible for public health insurance.
The increase in uninsured patients is a rising problem in the City. According to the Department of Health and Mental Hygiene, 32.5 percent of Central Brooklyn residents are unemployed and uninsured, and 13 percent of the uninsured population uses the emergency room for health care.
The New York City Health and Hospitals Corporation, which is dedicated to providing health services to people without insurance, has seen an increase in uninsured patients and a decrease in funding. Last year the corporation reported a 14 percent rise in the number of uninsured patients over the past four years at the same time the system was experiencing budget cuts.
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