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U.S. Hospital Base Disintegrates; Army Medical Centers Inadequate

Aug. 6, 2009 (LPAC)--Community hospitals--the baseline healthcare network in the United States--continue to suffer closures, from the combined impact of the collapsing economy, and opposition from Washington, D.C. to national public health. Updates on the latest closures are given below.

This situation is exacerbated by the fact that military base medical facilities are also below-standard. They are not meeting even active-duty military needs, let alone standing in reserve readiness for the flu pandemic, nor any disaster emergency, as has been U.S. policy in the past.

Of the 36 Army base medical centers, fully 26 cannot meet the needs of the military right now, according to a late 2008 Army survey, reported last week by USA Today (July 31-Aug. 2 weekend edition). "Army records show that 26 of its [36] medical centers, hospitals and clinics are unable to meet Pentagon standard requiring that 90% of patients get routine care appointments within seven days. Those are the worst results since the start of the wars in Iraq and Afghanistan. That's a 13% increase from 2006 in the number of medical facilities umable to meet the standard....

"The Army doesn't have enough doctors to provide care both to families and soldiers at home and to those in combat," according to those in charge, including Gen. George Casey, Army Chief of Staff, Col. Ken Canestrini, who is in charge of improving the situation, and Col. Jonathan Jaffin, Director of Health Policy and Services, for the Army Surgeon General, Lt. Gen. Eric Schoomaker. Among the stopgap measures, Schoomaker has authorized 12 medical centers to hire more primary care physicians, and has ordered that soldiers and families can go to off-base care centers, even if it costs more.

The on-base medical center at Ft. Bragg, for example, has "not met the routine care standards since 2005. Bragg is home to the 82nd Airborne Division and special operations forces that have been fighting in the two wars constistently."

To go "off base" for medical treatment, means in many localities, to seek care in communities already short of hospitals and facilities.

New Hospital Closures

In many states, there are closures underway of both whole institutions, as well as specific specialty facilities. While workers and patients may be shunted to other facilities in the area, or dumped; meantime, there is a rapidly worsening net loss of beds and staff in the U.S. medical care delivery system overall, for both routine and disaster/emergency needs.

As of 2007, there were 4724 community hospitals in the U.S., down by 20% from 5904 in 1980--the peak of the build-up of hospitals, on a county-grid basis, to provide a Hill-Burton standard of 4.5-5.5 beds per 1000 persons. Now, only three out of 50 states have anything approaching that ratio in their counties.

* NEW ORLEANS. On Sept. 1, the New Orleans Adolescent Hospital (NOAH, which also serves adults of any age) is set to close, which among other things, will shut down the city's only public hospital with a dedicated mental health unit (with 35 beds). At present, the city has only 170 inpatient beds for the mentally ill, located at seven hospitals, which is way down from 400 such beds at 10 hospitals four years ago.

* SYRACUSE. In the nearby New York town of Hamilton, the Community Memorial Hospital will close its baby-delivery unit as of Sept. 1, because of financial constraints and lack of obstetricians. Women will have to go to the more distant facilities in Utica, Syracuse, Oneida and elsewhere. The physician shortage in Upstate New York is bad, and is acute in the Mohawk Valley, where the supply of doctors fell 4% just between 2002 and 2006, according to the Center for Health Workforce Studies at the State University in Albany.

* TOLEDO. On Sept. 1, the Toledo Hospital will shut its Drug and Alcohol Treatment Center, which has operated both in-and out-patient services. The 20 staff members are seeking work at other facilities in the ProMedica Health Care System. The patients are being referred to a 42-bed facility in the region, operated by Arrowhead Behavioral Health, a company based in Tennessee.


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