According to this article in today’s New York Times, several illegal immigrants and homeless in New York City are staying in the city’s hospitals for extended stays due to a state law that prohibits public hospitals from discharging patients to shelters or the street. “Patients fit to be discharged from hospitals but having no place to go typically remain more than five years,” said LaRay Brown, the senior vice president for the city’s Health and Hospitals Corporation.
While several public hospitals have a mission to serve their communities and provide care for those in need, allowing patients to stay for such an extended period of time is extremely costly to our healthcare system. “Care for a patient languishing in a hospital can cost more than $100,000 a year, while care in a nursing home can cost $20,000 or less.” But nursing homes are reluctant to accept such patients, and aren’t required by any laws to do so.
Did this slip through the policy cracks? Is this the Charlie Wilson’s War of healthcare? It appears the New York state law was created in isolation, without fully taking into consideration the consequences of its provision. What can be done? Eliminating the law would save the system millions of needed dollars in a time when public institutions already have unsustainable operating margins, but what would be the point of providing someone care then leaving them with nowhere to go and possibly suffer even worse health conditions? Perhaps policymakers can re-visit the standards they set for nursing homes and home health care institutions. But even more importantly – why don’t we just get these people insured?
