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Dennis Andrulis

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Public hospitals may become an endangered species. Not only are public hospitals disappearing from inner cities across the country, they are disappearing from the suburbs as well.

While we all may read more about the impact of public hospital closures on inner cities, the fact is we are also seeing the potential for an impending access crisis in suburbs with high-poverty populations. These high-poverty suburbs exist disproportionately in California, Texas, and other areas in the south.

As the number of public hospitals continues to decline, the concern remains to what extent non-profit and for-profit hospitals are taking or will take on greater responsibilities as safety net providers, and to what degree their focus is on attracting the healthiest of Medicaid patients, leaving the sickest and costliest patients to the care of the remaining public or major safety net hospitals.

But we did get the general sense that they were either shutting down, facing a major downsizing in operations, or being consolidated.

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