Many Chicagoans who work or live on the South Side may have been shocked by the recent announcement that Mercy Hospital and Medical Center plans to close after more than 150 years of serving the community. We were not.
As leaders of a community health center serving many of those who will be affected by the closures of safety net hospitals like Mercy, we get a front-row view of the challenges these institutions face. An outside observer might be excused for thinking that Mercy Hospital was thriving, judging from its busy inpatient, outpatient and emergency departments, as well as its high daily average census.
But Mercy is closing or reasons that have nothing to do with demand.
Instead, we need to look at the American health care system, and Illinois Medicaid in particular, to understand how they are failing institutions that serve the poor and people of color. It is a perfect example of structural racism.
Medicaid is designed primarily to serve the poor, and its enrollees are disproportionately Black and brown. While 32% of Illinoisans are African American or Latino, these groups comprise 55% of all Illinois Medicaid enrollees.
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At the same time, Illinois Medicaid has grossly underpaid physicians, hospitals, and others who provide care to our most vulnerable residents. When the state proudly announced recently that the Medicaid fee schedule would be increased, the result was still only 60% of what Medicare pays. Worse yet, Medicaid tends to favor inpatient care over both outpatient procedures and specialty care, precisely while improvements in care have led to a decrease in the number of patients who need to be admitted to a hospital.
As a result, safety net hospitals like Mercy are on a collision course with insolvency. More importantly, the situation leaves the communities they serve in crisis, with large numbers of low-income African Americans and Latino residents losing access to vital services in their neighborhoods, particularly diagnostic, outpatient and specialty care.
It’s as close as you can get to a textbook definition of structural racism: a system set up by our government that leads to fewer, lower quality services for Black and brown communities because it refuses to pay the actual cost of those services.
If we want hospitals in our most vulnerable communities to stop closing, and lend credence to our call for an end to health inequities affecting Chicagoans of color, it is imperative that we increase Medicaid rates to cover the actual cost of providing high-quality care for all.
Dan Fulwiler, MPH, President and CEO
Carmen Vergara, RN, MPH, COO
Esperanza Health Centers
A clear choice this November
In their speeches Wednesday, Barack Obama and Kamala Harris emphasized the need for our country and its leadership to work diligently to preserve our democracy and to address the needs and concerns of every person in America.
In contrast, on Wednesday Donald Trump embraced the conspiracy-theorist group QAnon, praising their ideals and saying “They like me.” And, as if to underscore the current administration’s cavalier attitude towards the coronavirus pandemic, Mike Pence, in Milwaukee, mocked the Democrats for not holding their planned live convention there.
So the choice for voters in November is clear: Follow leadership that attempts to divide the diverse people that make up our country while trivializing America’s problems — or follow leadership that seeks to address our problems and make our country work for the well-being of all Americans.
Charles Berg, Hyde Park/Kenwood