There’s been a lot of buzz this week about a news segment
on the NBC program Rock Center
about “permanent patients” – that is, patients who in essence become tenants at acute care hospitals because there’s nowhere for them to go once they’re discharged. These patients can stay for months and sometimes years, even if they no longer need an acute level of healthcare services. And because many of these patients lack health insurance, they can rack up overwhelming costs that the hospitals must absorb.
The news team shared stories from hospitals in New York, Illinois, Florida and Arizona, but I've seen it here in New Jersey as well. Very often these patients are uninsured; sometimes they are undocumented immigrants. They arrive at the hospital for needed care. And when they've recovered enough for discharge – but perhaps still need ongoing care in a nursing home or rehabilitation facility – the hospital may not be able to find a facility to accept the patient. Many post-acute facilities provide charity care and otherwise work with patients who are uninsured or underinsured, and I applaud them. But even with their efforts, there remains a systemic lack of access to care for many of these patients.
Rock Center spoke to Ashish Jham, a professor at the Harvard University School of Public Health, who estimated that there are tens of thousands of these patients stuck in the nation's hospitals with no clear place to go.
I don't share this tale to protest hospitals' role as our society's healthcare safety net. It's an intrinsic part of hospitals' mission and they willingly accept the legal and moral obligation. But it is important to understand this problem and the tremendous burden it places on our hospitals. That safety net role requires adequate recognition and financial support from government and other healthcare stakeholders.
Unfortunately, with the continued uncertainty surrounding health coverage in our nation, this problem – like these permanent patients – could be with us for a long, long time.