The basic problem is this: many large private hospitals in New York City accept money from the state and federal government, and are thus required to treat Medicaid patients as well as patients with private health insurance. Sounds like a reasonable tradeoff, right? However, many of these hospitals have two separate systems: one for patients with private insurance and one for patients on Medicaid. This two systems are wildly different in quality. The main hospitals provide some of the best healthcare in the world, and patients are treated by attending physicians, while the clinics tend to be much poorer: overcrowded, with long wait times, and staffed by overwhelmed residents and interns. Heath outcomes – the key metric in determining quality of care – are wildly different.
The systems leads to perverse results like a person who happens to have private insurance heading to the hospital to get treated for bronchitis, while someone with breast cancer has to wait 5 months for a diagnosis at a clinic, during which time that cancer has a chance of metastasizing.
And guess what? In NYC, there is a strong correlation between type of health insurance and race. Go into the clinic, and almost everyone is a person of color.
Obviously, this is not the same kind of intentional discrimination that we saw in the Jim Crow South – no one thinks that racism is the motivating factor here – but a number of communities in the city see the echoes of Jim Crow in this unjust system. Intentional or not, race cannot be a determining factor in how long it takes to have a tumor looked at. And that, of course, can mean the difference between life and death. In the aggregate, this has enormous impact on a community that is already facing a major health crisis (by one measure, the Bronx is the least healthy of New York’s 62 counties).
We are helping NYLPI and Bronx Health REACH generate media to support their campaign to change the laws on this issue to guarantee access to quality care to all New Yorkers, regardless of their kind of insurance or the color of their skin. We will be posting media soon.