As Hospitals Close Children’s Units, Where Does That Leave Lachlan? (2024)

Diogenespdx (Portland OR)

And your point is ? ? ?Hospitals, esp. the non-profits, have a fiduciary duty to earn as much as they can. And this requires them to charge ungodly amounts for what they can, and reduce costs as much as possible by limiting services delivered.What don’t you understand about the American system? Just be grateful they don’t charge for air in America . . . Yet.They’ve figured out how to charge for water – just poison it so the peeps have to buy the conveniently bottled type at $3000 per thousand gallons. ( But if the price goes up a nickel, that’s a 3% increase on average, they’d have to charge an extra $300 (10%)). (carrying charges, you know)It’s the American way.Your choice. No one says you have to live. Capitalism doesn’t promise luxuries to all, just the tippy top of the pyramid.Course, if revenue drops because of a decline in customers, they’ll have to raise the prices again. It’s their fiduciary duty.

76

B D Duncan (Boston)

A hospital is a business not a charity. Sometimes you have to make changes about the products you offer consumers in order to remain competitive.

7

Steve Andrews (Kansas)

Once again, the notion asserts itself that laissez-faire capitalism left to itself will make everything right. It only makes things right for capitalists and the dogmatists of the Chicago School, and even fails at that sometimes.The notion that capitalism, by itself, will derive the greatest good for the greatest number is hokum. Through all the economic theories and economic systems that have ever existed, we have always been human beings first. Economy must always come after our existence, not before it, unless the purpose is to destroy our existence.

60

Mildred Rutstein (New Jersey)

It's horrific reading this article and it's simple. If a hospital receives local, state and or federal tax dollars it should be mandated by law to have a minimum amount of pediatric beds and pediatric ER care by a pediatrician. There should be a requirement to serve all the population in the hospitals geographic areas. High quality triage could also benefit both patient and hospital by finding the "best fit for care" facility. The financial support for Hospitals and Health Care for all its citizens should at the very least be as important in this country as supporting the military and situations outside this country.

48

Liz (Brown)

I am a pediatric ER nurse and this article is 100% accurate. Children aren’t the money makers and they aren’t small adults. I’ve worked in a mixed (adult+peds) ER and a pediatric-specific ER in a stand-alone pediatric hospital and the differences are very obvious. And it’s not just the wall decor…inserting an IV in a baby may take 4-6 tries in an adult hospital, whereas in a pediatric hospital only once. I left the mixed ER after one too many mistakes that caused pediatric harm and death. As a pediatric group we advocated for more training for the non-pediatric ER nurses, and management wouldn’t allow it. No time, budget, etc. Go to any mixed ER and most physicians and nurses are afraid to care for children because they aren’t comfortable with them. They avoid them. I always encourage my friends and family to take their kids to a stand-alone children's hospital if they have access. It’s awful that parents have to even think about where to go in an emergency. Unfortunately many hospitals claim to have a “childrens hospital” within the walls of their larger adult hospital but it is NO comparison to a stand-alone. So many false claims and advertising are made by these hospitals. Be careful of those too, parents.

116

Jesse Hackell (NY)

Wow. I remember the time when pediatric services were necessary for a hospital because their presence supported the more lucrative OB services, which in turn brought families to a particular hospital for their surgery and other profitable services for many years. But with the highly paid bean counters now in charge, every line item must be profitable or it gets cut. This may well prove short sighted for the hospital. But it may prove fatal for children. Too bad kids no longer matter when $$$ is at stake.

46

JasonH (NYC)

No one mentions how this is another example of boomers robbing future generations for their own benefit. They always make sure they have whatever benefit they need but when it come time to look out for the next generation the money is never there…

33

tiddle (some city)

"...a wish: for a pediatric hospital bed in northeast Oklahoma."Solution: Move to a Blue state. They usually have better services, more vibrant economy, though of course the price of admission would not be cheap. Sad, but true.

37

health before wealth (US)

a pure example of western state of affairs, put our future generations at risk.

7

Buck (Flemington)

This is what we get when healthcare is a for profit industry. Universal healthcare would be a natural solution.

51

Charles Johnson (Indiana)

One out of every six or seven hospitals in the country is Catholic. There are quite vocal in caring for unborn children and insisting that they be brought into the world, even at the expense of the mother's life, if need be. Where are they when the lives of those children are at risk after birth? More pro-money than pro-life, it seems.

94

Barbara (Montague MA)

Health care before profits. Health care before profits. Repeat ad nauseum until it sinks into every single American's brain. Health care not be profit-seeking, but a public utility. A nation that squanders its children's health so that fat, bloated investors can make even more money is doomed.

25

Robert (Chicago, IL)

Having spent over 40 years in healthcare delivery and management, I can say that this is a very shallow article. When a pediatric giant like Shriners Children’s New England says that it is closing its service, you know that something other than profitability is driving it. There are shards of reality in this article but it fails to recognize that the overall demand for inpatient pediatrics services has dropped in the last two decades thanks to medical progress. That prompts the question of what to do when kids need care an there are not enough providers who have continuous experience to treat them on an inpatient basis. The US lets the free market make those decisions in random ways instead of setting up intelligent triage and care networks but that's a statement on the value of life when the military budget s more important that the startling overall decline in the health of the population (the US is now over 30% obese and 20% of children are obese by 18). This is not a problem without a solution but the solution is not to build and staff expensive and unused peds beds in general hospitals.The US has clearly stated its priorities when it let the market determine that the salaries of the two specialties that have the greatest influence on the nation's future - pediatrics and public health - have the lowest average salaries of all specialties. The highest salary? Also indicative of American values: plastic surgery. Such is the Kardashianization of America.

66

Tawaki (Detroit, MI)

All you need to know is Medicaid, it's reimbursem*nts and healthcare ran by accountants.60 year old needing a spendy cardiac work up vs a 2 year old with croup. The pencil pushers know which calculation brings in the most bank.But are we surprised? Our country treats children like trash the moment they draw their first breath. Kids in affluent families have a decent change to get their needs met. The rest of us, good luck and God bless.

34

AFR (New York, NY)

And yet we are a country that sends billions for weapons in Europe without even blinking. If the US would stop its wars around the world, currently the unthinkable one against Russia, we would be able to have a livable society at home. Eisenhower warned about this decades ago.

11

Anne-Marie Hislop (Chicago)

So much for the 'best medical system in the world.' When are we going to get a universal government run system? Most of this is about profits. A few days ago an article detailed ways private insurers were padding the billing of older adults on Medicare claiming conditions the patient never had or no longer had or making to seem worse than it was. Our "best" system is very broken. How many have to die or suffer because of politics and money?

30

Maria Saavedra (Los Angeles)

This is so sad to see though unfortunately, predictable. When you tie profit to healthcare, sadly, this is the result. The health care system is broken, it is hard to work within it so I have chosen to work around it-giving expert Pediatric advice 24/7 to those with urgent Pediatric needs virtually via tinypediatrics. This can help alleviate the strain on ERs that often care for kids with non-emergency issues-they end up in the ER because their pediatrician is not available, rural location etc. We absolutely cannot blame the parents for using the ER for this-a 104F fever at 3 am can look frightening. There usually is no one to call! Pediatricians are overbooked right now and many are leaving the field. Every state should have a high quality Children's Hospital and yes, Pediatric services should be available for emergencies in all health care settings. This is a no brainer. Children are our future, we cannot deny them high quality, available, affordable (should be free) healthcare. To be honest, working this way has led me into a financial crisis. It is not sustainable in this healthcare "market". It is though what I believe in.

16

JS (Maryland)

The more of this article I read the more upset I got! Someone else on here said there needs to be a children’s bill of rights and I wholeheartedly agree!

12

Doc (USA)

What! Can it be that the invisible hand of the free market hasn't fixed these problems?

20

John Vesper (Tulsa)

I, too live in Broken Arrow and my wife has much of her healthcare through St John's. Since Ascension took over, the collection notices, have frequently arrived prior to the bill, or the the due date on the bill!

23

Tautologie (Washington State)

A sure sign of a failed state is one that refuses to provide proper hospital care for its youth. And here we are.

48

WS (CA)

When it comes to hospitals, why isn't the refusal to treat children--making profit more important than saving the lives of very, very sick minors--against the law?First we do no harm. Not so much when making millions is the only end goal.We need a legal bill of rights for children, ASAP.I'm furious--just like you.

29

Anne (NJ)

Yet another example why profit should have no part in health care.

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Nicole (Illinois)

How can a parent find the information about our own local hospital’s pediatric readiness?

5

Let's get real (OK)

Examine where the money goes in the hospital biz.Search online the salary range of your local hospital administrator, the surgeons and general practice doc drawing salary from that hospital and the upper level RNs and PAs.Along the wealthy coasts, you'll see mid - upper 6 figure salaries, often with bonus for those below the chief administrator and department heads. In the middle of our nation salaries are proportionately lower, but excess by the region.In short, there is ample greed to go around. . .sadly at the expense of the most defenseless amongst us: Children.

12

Dorothy Wiese (San Antonio)

This ties in to the Medicare Advantage mess.

8

Paul Ruszczyk (Cheshire, CT)

What drives me nuts is seeing tv ad after tv ad for this hospital and that hospital - all non-profit by the way. With jingles no less. How much does it cost to produce those ads and run those ads? How much less could the hospitals charge if they did not run the ads? Not to mention the ads and barrage of mailers for Medicare Advantage plans. How many of our health care dollars go to ads for hospitals, health insurance companies, actuaries, claim reps, drug commercials, etc, etc.? And we sacrifice this poor boy on the altar of "no socialized medicine for us."

23

Liberal In A Red State (Rainbow City)

My expertise in my healthcare career is NICU/PICU. ECMO and Transports. Over 35 years. And I have really bad Asthma. I'm an RRT.Picking up a child in an ER for transport to my PICU? The ER Docs literally hugged us because they didn't know what to do with a child. How many times I intubated those children because Docs had never done that before? Many times. How many times did I and the RN save a child because we knew what to do.In the past two years I've taken care of Covid patients and quite a few were babies and children.Having Asthma my whole life and being intubated because I died once not being able to breathe? My expertise is the choice I needed to take for a career. Respiratory Therapy.My empathy is through the roof. And I'm elite in my field. If you were in trouble? Believe me you'd want someone like me on your team.I retired(age 66) a few months ago. Within a month my former employer was begging me to come back PRN. And still calls me. Its my experience. And these hospitals realize somebody like me is gold no matter what age.NICU/PICU ARE the hardest units to work in. We have to know so much. We have to react very fast to a baby or child crashing. Stress of course. And those of us from MDs to Unit Secretaries? WE love what we do. We are always short staffed. Always. And it's getting worse.The only answer I have:UNIVERSAL HEALTHCARE. No such thing as non profit hospitals. There ALL for profit. GET THE BEAN COUNTERS OUT!!!!!!

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AJPeabody (Long Island)

All is as it should be. Money talks, nothing else matters. A money-losing hospital will treat no one if it fails financially, so it must amputate the money losers. Too bad, so sad.And think of how much money could be saved if the difficultly ill children die instead of reaching a very expensive adulthood.The solution is, of course, known. Pay all health workers a salary, pay all the bills from tax money, and be like the rest of the civilized world.

15

vacciniumovatum (Seattle)

If you have children under 18, it's time to leave places that have no decent inpatient pediatric option at your disposal and move elsewhere.It's especially upsetting that Tufts Children’s Hospital in Boston and Shriners Children’s New England have or will close their inpatient units. It's not like they're filling those beds with adults.Or are they?

6

SW (Central Florida)

This, dear friends, is what happens when a healthcare delivery system is driven by a bottom line profit margin, the rest be dammed ! I’m all for fiscal balance and a reasonable profit margin but as someone who ran a non-profit community hospital it became abundantly clear to me that the direction of healthcare delivery, in this country, was/IS not sustainable. In addition, with a primary focus on margin, we were/are moving too far away from providing care in the best interest of the patient and certainly NOT patient centered. I have no solution, I feel for the clinical folks who continue to provide the best care they can in untenable circ*mstances.

19

Keen Observer (NM)

These hospitals/systems should lose their non-/not-for-profit status immediately. Maybe that'll cut into their profit margins. For the love of God, can we get the Wall Street leeches out of our healthcare? How do these hospital administrators live with themselves.

20

Kay Barbara (San Diego)

It's about Hedge Funds buying up hospitals, cutting staff and now cutting out hospital care for children. Am I correct?

9

MLChadwick (Portland, Maine)

Dobbs makes sure that fetuses with awful problems must be born, whether or not their fleshly containers (I think of these as women, even as people) live in an area that has a pediatric unit to care for them.I know the anti-abortion folks leap with joy whenever they read about the kids' agony and their parents' terror and anguish. How proud they must feel!But think: They're also harming already-born and deeply loved kids like Lachlan. After all, the more desperately sick kids get forced to be born post-Dobbs, the fewer beds for him. If pregnancy enforcers think of Lachlan, might they notice how deeply evil they are?Nah. Others' pain is their gain.

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Waiting (Boston MA)

Coupled with the overturning of Roe vs. Wade, this is absolutely ghoulish. We are about to have a lot of sick babies, and less resources than ever to care for them.

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bj (Florida)

We are all just profit centers Nothing more

11

F/V Mar (ME)

"The steepest decline in pediatric inpatient beds was in rural regions, where large health systems acquired community hospitals and consolidated pediatrics to one campus." These red state voters...

14

Mary Sweeney (Trumansburg, NY)

So at some point a bunch of suits sat around a table and coolly discussed dumping the little kids. Just imagine that scene. But it isn't just the suits. It takes a lot of cooperation to support this level of callousness. Why do the medical professionals who work at these hospitals put up with this? Why do any of us put up with it? Note that not only is this behavior toward children outrageous beyond words, but also that if adult tests and procedures are so lucrative, maybe some of them are unnecessary and are being pushed just to create a cash flow, not because they're the best options for patients. Broken, corrupt, greedy--it's exactly this sort of disgusting behavior that makes some people mistrust vaccines. A for-profit model is designed to create profits, not health. We have to decide which is more important. So far profit is winning.

12

Joe (Middletown)

For profit healthcare is what puts the US behind so many other nations and why universal healthcare is close to impossible in this country. The greatest country in the world, unless you get cancer. It’s a bastion of abuse, just look at the price for two generic Tylenol.

12

Ceilidth (Boulder CO lol)

The only people for whom it's a no-brainer to close pediatric beds are the hospital administrators who can only see money and have no conceptions of service. Only in the world run by greed that more and more is American medicine does this make sense, but then again hospital administrators are paid very highly for that greed.

12

Ellen Tabor (New York City)

For-profit medical care should be declared a crime against humanity. Because that's what it is.Lobbying should be illegal. It is all lies, meant to enrich the rich and impoverish the poor.Citizens United is neither.Our country is a failure.

21

Diogenespdx (Portland OR)

Reminds me of a wonderful inner-city hospital in the 27th largest city in the US, whose vaguely Egyptian name, complete with pyramid-turned-into-seement-fishin-pond, (come’ n listen to my story bout a man named Jed) shall remain anonymous, with, with, oh, let’s see, mmM emphisis (did I spell that right?)A hospitable hospital named after some major religious group dedicated to the teachings of the New Testament who found that treating the least of His left them with less profit in caesar’s gold and so decided the thing to do was to open a brand spanking new one with all the bells and whistles out in some white-flight, well-to-do suburb. (Well the first thing you know, . . . the kinfolk said, Jed, move away from there. there’s crude white gold in them thar burbs.)Well, it wasn’t as simple as simply building a new one. There was a limit as to the number of beds allowed in the county, so the only thing they could do was close the inner-city one leaving the inner-citizee’ans to fend for themselves relying on the ol’ adage that God takes care of those who take care of themselves.And to spread their largesse even further, declining to be responsible for the disposal of the old hospital, they charitably donated it to the city as a biotech center that was impossible to rehabilitate into a biotech center, but that was now their problem. Win-win for the hospital. God will sort out the rest.Health Care for Profit. What can go wrong !

10

How Much Is Enough? (NJ)

I wanted Bernie. Eery dem who voted for Biden should look in there mirror. It’s a moral issue.

4

Diane (PNW)

Another reason why the U.S. needs a system of socialized medical care.

9

Ashley (Texas)

There should be a law requiring a certain number of beds be reserved for pediatric patients. This is appalling and these hospitals should be ashamed of themselves and their greed.

6

Brad Baker (NYC)

Life in America just gets more difficult, even whenyou have a couple of bucks. Something stinks in our great Nation. Could it be , oh maybe Capitalism ?

10

Colin (Vancouver)

I cannot even believe that your whiteness cannot understand that for profit health systems are a marker for premature death, poor outcomes and dissatisfaction. Canada is 35 in Who primary health outcomes. The US is 40th.Awaken and stop the madness....look to Europe.

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Island Dweller (Seattle, Wa)

Zero trust in the healthcare industry They allow pregnant women in crisis die in hallways to please their Republican godsAnd now money is of more value than childrens livesShameful, greedy monsters is what they have become

8

Quiet American (Offshore)

No doubt the hospital’s executives received their bonuses for meeting their KPI’s.

8

JMR (WA)

Reading articles such as this leaves me feeling furious yet helpless. I'd love to know what the average citizen can do. Over and over again, we vote for politicians who promise to change the system and, over and over again, they are stymied by the opposition. I think this country is going to hell in a hand basket.

11

Jonathan Penn (Ann Arbor, MI)

Like anyone with a touch of empathy, I read articles like this and recoil in horror.The pandemic revealed what this article further emphasizes- the current hodgepodge of public and private insurances simply does not work and has not worked for the past fifty years. The distortions in care and inadequate provision of necessary care are the result and they are unacceptable.Once and for all- Medicare for all. NOW.

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AG (Tallahassee)

The way the private healthcare industry continues to predate upon the average citizen, it cannot go on. Sooner or later, the people will reach their breaking point and demand the same rights as citizens in other developed nations.

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Christine (Durham, NC)

In Colorado, Ellen Roy Elias, MD, professor of pediatrics and medical director of the Special Care Clinic at Children’s Hospital Colorado, and Dennis Roop, PhD, professor of dermatology and director of the Gates Center, are attempting to assemble a comprehensive Ehler's Danlos Syndrome (connective tissue disorder) center offering coordinated patient care while also leading the research & development of future treatments. This interdisciplinary approach would likely prevent Lachlan from needing hospital visits. We need more creative collaborations like the one between The Gates Center, Children's Hospital Colorado, and the CU School of Medicine.

20

KG (NYC)

AND PSYCHIATRIC AND GENERAL HOSPITALS ARE ALSO CLOSING PEDIATRIC UNITS. WHERE ARE FAMILIES SUPPOSED TO GO? A QUICK VISIT TO THE PSYCH ER, ENDING WITH A PRESCRIPTION IS NOT SUFFICIENT.

20

Anothrurthling (Cali)

Blame the GOP for fighting tooth and nail against a national healthcare system. Remember they only care about babies when they’re in utero. Once they are out here they are on their own

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Doc 6 (Lancaster PA)

We, the American people set the benchmark prices through our HHS agency called CMS. We could fix this issue overnight by changing the fee table to reflect our American values…that we value our children and motherhood. Put sanctions on hospitals that hoard their tax exemptions. I love the NYT emphasis on reforming healthcare but why do you give the government a free pass? Obamacare was a great idea until all the insiders warped it into the monster that we see today. You emphasize the number of new enrollees but you avoid talking about the tragedies directly connected to that, high deductibles for the working middle class, shuttered rural hospitals, blocked portals of entry for basic care. You NYT reporters should pay a visit to CMS and ask why they have issued so many healthcare monopoly waivers (ie the 2018 ACO waiver authority). Unlock this and all your other stories will click together like tumblers on a safe. Where is that story?!! I got it. CMS is too boring. Just understand. Most evil his hidden in plain sight as something banal.

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Mohammad (Sacramento)

This is ridiculous! We have a duty to our kids, to our future, reading this about how it comes down to money just shows the direction this country is headed... profits before morality and ethics

13

Teresa (Berlin)

Beyond despicable.

12

M.A. Heinzmann (Virginia)

This article should be a "must read" for the pro-life crowd. The "all lives matter" sloganeers need to understand that "all profits matter" the most to hospitals. Cutting pediatric beds due to their lesser profitability vs. adult beds clearly demonstrates that new and younger lives matter less than adult lives - all because of lower profits.Will the next evolution of hospitals be to only hire mercenaries for all staff positions to assure that every treatment, service, and procedure is profitable?

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Annabelle (NZ)

Our prime hospitals are public, often allied with university medical schools. The medical people can and do work in the private sector. It’s a more reliable mix and it gives professionals options.

2

JerseyGirl (Princeton NJ)

All the folks decrying out horrible healthcare system. No argument from me -- but you have to realize that this is exactly how a "national healthcare" system works as well. There are so many dollars to go around. They're going to spend them in the way they consider maximally efficient. That means (as just one tiny example) that not every hospital is going to have a pediatric department (Or a cardiology department, or an obstetrics department, etc.) This happens everywhere.

8

Karen (Denver)

This is, ultimately, the problem with for-profit medical care. Medical providers may well WANT to provide service to these children, and to every other underserved medical population in the country - but they can't, because their employers value profit over patients, as demonstrated by the issues in this article.It also demonstrates the problems with overspecialization; what Lachlan, and many others like him, of all ages, needs, is a generalized care specialist who can oversee and coordinate his care - but again, such people are often not sufficiently profitable.It is well past time that the US joins the rest of the First World nations in providing universal health care, which includes the preventative care and general care specialists needed to prevent and manage illnesses. In the long run, such care is less expensive than anything else - but on a case-by-case basis, when a insurance company looks at a gastroenterologist specializing in sequential colonoscopies over a chronically ill patient like Lachlan, they will take the former. That needs to end. But under the current setup, there is no incentive to do so.

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Christine (Durham, NC)

Unfortunately, this article neglects the desperate need for Ehler's Danlos Syndrome (EDS) clinics in the United States. There are 13 different types of EDS. It is a multi-system disorder requiring a multidisciplinary approach—as evidenced by Lachlan's need for a cardiologist, immunologist, and gastroenterologist. Lachlan's parents also need training and support for the ongoing management of this disease. The current healthcare system in America is criminally siloed into medical specialties which prevent the kind of interdisciplinary approach that would keep Lachlan out of the hospital in the first place. Toronto, for example, has such a clinic-GoodHope Ehler's Danlos Syndrome Clinic.

13

Elizabeth Bennett (Arizona)

What kind of a country are we that places football players salaries way above ensuring basic hospital care to our children? Awarding so many sports figures with more than 100 $million seems obscene when children like Lachlan need to be transported hundreds of miles by their already stressed out parents for treatment for their chronic diseases. How could hospitals claim that they can't afford to maintain pediatric units? My heart breaks for Lachlan's mother, who has far more strength than any burly football player!The vitriol with which so many Republicans greet the idea of universal health care is outrageous, especially those voters who will justify any expense to promote their love of sports.America sometimes seems like a country with too many overgrown bullies showing incredible ignorance. I was recently shocked by an intelligent Republican grandmother whose response to my comment that universal health care worked in Canada was "they can't get doctors to work--half the doctors in Montreal refuse to practice"? The scariest part of this is that "true believers" usually cannot be convinced to change their minds when presented with facts. Democrats must vote in November!

23

Jason98144 (Seattle)

In the wealthiest nation in the world we should be able to care for every child who needs care. This is exactly though the market responding to incentives. Up Medicaid rates by the same as Medicare ones and let’s see if that works. If we are going to insist on using the private sector to provide health care then we have to provide it with the incentives to provide it. And in this case, the willingness to pay is there, the services aren’t.

7

Guenevere (Kona)

I have only read the headline and tagline so far, but had such a visceral reaction to the horrors contained therein I had to come here to commiserate. What kind of backward place values profit over lives of children. We deserve every bit of suffering that will (eventually) come to the wealthy nations as we destroy the environment and civilization.

8

DLP (Spain)

All I can say, after reading this article, is that for the"richest" country in the world to treat their future adults like this, is disgusting. Having read some of the comments I sincerely hope that the article is biased, one sided and untruthful. (But I've yet to be fully convinced that it is) I live in Spain, some people in the USA would call it a socialist country, maybe they'd be right. But I can tell you with 100 �curacy, that no child, not even a child of an illegal immigrant, would be treated the way this article suggests some American children are being treated. If Spain (not a super rich country by any means) can have such good health care, then I simply cannot understand why the ultra rich USA doesn't have better health care for ALL its people. Good luck with the future, you'll need it.

24

Iron Man (Nashville)

How can anyone who votes Republican say they value children’s lives? A plague on both houses, though: Democrats - both voters AND local-to-national representatives - need to STEP UP!

5

alice (us)

I wouldn't say the reason is stark ecomonics. I'd say it is STARK GREED.

29

Jack be Quick (Albany)

When it comes to health care in the US, it's all about the Benjamins...

9

ZAW (Near the Gulf of Mexico in Texas)

I’m no healthcare expert. Just an architect. But I’m convinced Healthcare is one of the few places where free market capitalism just doesn’t work. And this is yet another example of it..You can’t shop around for the best price when you’re out cold in the back of an ambulance..Insurers can’t price risk the way they do with property insurance. Poor people can easily get illnesses that are very expensive to treat..Regulations are important. You can’t expect competition to weed out the dishonest and the underperformers, because their patients may well be dead!.And now we find also that branches of medicine with lower profit margins for hospitals are inevitably going to have shortages. Like pediatric emergency care..The terrible thing is that if you acknowledge that free market capitalism - while it works marvelously for most business sectors - is particularly I’ll suited to healthcare, there are too many people on the Right who immediately lambast you as some sort of Marxist. They hurl insults while children die. It’s a sad state of affairs.

31

Sandra (Virginia)

Between corporate hospitals focused on profits and insurance companies scamming the system, we, the people, suffer. The whole darn system needs to be remodeled so it focuses back on health and care.

14

Dr B (Nyc)

And so it seems the relentless march toward desecrating our medical care accelerates once again, this time sacrificing our precious young to the greed of insurance companies. Makes me ill but I can’t afford to see a dr!

6

Purple Patriot (Colorado)

The profit motive does not have a place in the delivery of medical care to people who need it.

12

Suzanne (AZ)

The profiteering so-called health care system in this country is criminal.

11

LauraK (NJ)

It is always incredible to me that one of the wealthiest countries cannot proper care for its citizens. It is equally incredible to me that republican senators, who are so willing to scream for fetal rights will not lift a finger to help children that are here.

17

NJB MD (Ohio)

The fundamental question is whether healthcare systems or hospitals should be making a profit from the illness of human beings.

7

RN for change (Portland Maine)

Our hospitals are straining and breaking, along with the people who work in them, because hospitals do not put their patients first. For profit and nonprofit alike they are accountable to boards who demand a business model that prioritizes the bottom line not the patient. Large hospitals intentionally use predatory tactics on small hospitals that serve rural and poor communities to get a larger share of patients forcing closures of less profitable units (such as pediatric and psychiatric) in those hospitals and sometimes entire hospitals altogether. Fewer hospitals mean fewer beds in an area. In trying to grab all the revenue generating patients they are unable to provide care for the total population they serve by simultaneously increasing the size of the area and number of patients they serve. Ever sat in an overcrowded ER waiting for care or to be admitted? Ever wonder what takes your caregiver so long to answer your call bell? It's easy to blame the doctors, nurses and CNAS. Sure there are always some in any work setting, but most of us are doing all we can to provide the best care possible in a healthcare system that is fundamentally flawed. Hospital executive salaries balloon and yet they would have you believe that it is staff salaries that break their budgets. This is the largest part of their budgets but it is also the largest portion of essential personnel. When your life is at stake, you probably don't want someone in suit showing up at your bed or operation.

32

Fran (Houston)

This seems to be a variation on a theme: the main purpose of (so many of our) hospitals is to maximize shareholder value. Just watch the excellent mini series Five Days at Memorial to see how Tenet Healthcare responded to pleas for help from the hospital as it was flooded during/after Katrina. It is cruel under any circ*mstances and especially so as the GOP is now pushing for a federal forced birth mandate with no thought on how they will take care of the children born as a result of their mandate.

15

Pamela Jenkins (Dallas, TX)

As long as profit is a driving force in medical care these heartbreaking decisions will be made. Usually by hospital being acquired by huge corporations that are not part of communities. Profit and patient will never work for the benefit of patients.

26

Debbie Minter (Carmichael, CA)

Including Shriners Children's Hospital in this article is misleading. Shriners serves only children. So while it may be true that one of their inpatient units is closing, it is certainly not for more "lucrative adult beds" as the article suggests. It is however, indicative of the need for hospitals to make business decisions to stay solvent and in the case of Shriners, move towards centers of specialized care.

8

BabySurg (Santa Barbara)

A few points-1. If kids had breast cancer, prostate cancer, diabetes, and so forth...and voted, resources would be different.2. Hospitals may be "non-profit" but they are NOT "non-margin". 3. Taking care of kids creates warm PR pics for a community and a trustee board...but that's it. 4. The solvent children's facilities survive on endowment income, not facility fees.

16

alex (Indiana)

The tone of this article is highly biased, and the information presented one sided.The thesis is that hospital corporations have a moral obligation to provide all health care services to all comers. Since the article focuses on pediatric patients, the article makes a strong case. But health care is more complicated than the picture painted here. If a hospital is forced into bankruptcy and closes, it will provide health services to no one. Around the country this has happened to many hospitals, and the communities they used to serve often suffer greatly. Hospitals forced to close include both rural institutions, and facilities in poor urban areas.In the US some hospitals are in it for the money, and many of their executives (and some physicians) are paid high, sometimes outrageous salaries.But many other hospitals struggle to survive and are forced by basic economics to close some services. This article does not distinguish.Two other issues which this article does not mention are certificate of need (CON) laws, and the country's out of control malpractice laws.CON laws, which exist in the majority of states, prohibit hospitals from expanding or offering many services without regulatory approval. The approval process is usually expensive, time consuming, onerous and often political.Exorbitant medical malpractice judgements have forced hospitals to close; a single lawsuit verdict may force a hospital to close its doors. The country badly needs tort reform.

20

Realist (Ohio)

Old retired doc here. Increase all the misfortunes reported here by an order of magnitude when it comes to children's mental health. The canary in the coal mine.The for-profit model, whether in its not-for-profit disguise or overtly capitalist, is no longer compatible with even barely adequate medical care. When patient care is limited for all but a very rich minority, there is no longer an adequate population base to ensure high standards and innovation. Eventually the richie-riches will drown in their own bathwater. After the rest of us.

60

Annie (Wisconsin)

When I began my pediatric practice, I did everything- patients in the hospital for diabetes, asthma, pneumonia, newborns in the nursery, consults in the ED. Now our local hospital closed the birth center, virtually no children are admitted inpatient, and the ED never calls. Just in ten years!

20

Karen (California)

Decisions need to be made about which hospitals in a given area need to provide services to pediatric patients. Some federal agency (the Joint Commission???) should get involved. If those hospitals refuse to provide those services, it should cost them. Of course, those hospitals should get help with funding pediatric units.

6

PA Loretta (Southern AZ)

Our local ER closed because too many people had no insurance & were coming in with advanced disease that could have been mitigated by earlier intervention. So instead of traveling 15 miles to an ER, we now have to drive 82 miles into Tucson or via helicopter. Can u imagine what a one hour helicopter ride costs the taxpayers?Why we allow republicans to deny us universal health care while members of congress enjoy premium care always vexed me. My parents have Medicare and Plan F and seem to be very happy with their coverage. My Dad had a total knee replacement which medicare covered (no argument). He was able to go back to work and pay taxes into the system instead of relying upon Soc Security. It doesn't take a rocket scientist to calculate that early intervention and universal care will SAVE the taxpayers money. The LOSERS to such a system are the insurance companies and their lackeys in congress.

40

Jenny (Boston)

A powerful article. As an emergency medicine physician, these closures have been painful.The second-to-last paragraph of this piece is particularly telling--a mother trying to advocate for her son, shouting at an emergency physician. So often, we are caught in between a full emergency department and a full hospital with nowhere to transfer and cannot provide the care our patients deserve. It's extremely difficult when the only scapegoat is the doctors/nurses in the room, and not the suits who make these decisions.

67

Dih (MI)

I don’t think for-profit is necessarily evil and nonprofit is necessarily the best model. I think just like all other for-profit institutions, the managers need to draw a line on how far one should go in pursuit of money. We can’t rely on governments and News media to be the solution to individual conscience.

3

kirk (montana)

This is the Republican dream. For-profit healthcare at it's most profitable. No ethical obligations to society, just pure dollars for the wealthy. If you cannot afford it, you die or suffer.If you give your vote to Republicans, they will take away your rights and your democracy and quite possibly your life.

48

Salix (Sunset Park, Brooklyn)

Welcome to the wonderful world of for-profit medicine. No wonder the rest of the developed word looks at us askance. Disgusting - but right there with the focus on fetuses but dismissive of kids already born.

42

Andy Jay (Denver)

Yes sir, private health care, ain't it great.

16

Licy H (73103)

I don’t understand why Lachlan isn’t being treated at the Oklahoma Children’s Hospital in Oklahoma City. It’s part of the Oklahoma University Health Sciences Center and affiliated with the OU Medical School. It offers the best pediatric health care in the state and has the best PICU unit in the region. Instead of sitting in the St. Francis ER for five hours, his mother could have driven him 90 minutes south and gotten him the care he needed. To write about the scarcity of pediatric beds in Oklahoma without mentioning that there is an entire hospital with 246 beds including 34 PICU dedicated to the health care of children is irresponsible journalism. https://www.ouhealth.com/oklahoma-childrens-hospital/

23

Sean Malloy (Kentucky)

Not caring for children “a no brainer”, Doctor?I would agree that no brains were involved nor hearts.

10

Kat (DC)

Some care so much about fetuses - too bad after you are born. Actions speak louder thanempty “pro-life” rhetoric. Birth is forced, treatment after is a cost center to be eliminated.

41

Vicki (Columbus)

And we wonder why women are increasingly rejecting motherhood.

26

Nobody (Nowhereville)

Two points.1) The CEO of ascension, Joseph Impicciche, JD, MHA, made over 7 million dollars in the last year reported by Propublica. 2) Google the 'leadership' team of Ascension. Lawyers and M.B.A.s. That says it all.

55

Carol A. Cummings (Middletown, Rhode Island)

Insurance companies run the show….and are certainly not opaque! Doctors work-now…for insurance companies…not their needy patients.Research…read …research…you must be in charge with documented information…always…in ALLWAYS!

8

Wendy M (MA)

it's like we don't care about kids once they are no longer a fetus.

34

Claudia (CA)

The sub-head alone: "adult beds are more lucrative than childrens' beds" says all anyone needs to know about what a miserable country this is.

26

mag (NC)

I am absolutely stunned at this poorly-researched article--and I've been there, keeping a community hospital peds unit open, safe and thriving. The word "specialist" is only mentioned once in this article--and yet that is undoubtedly 99% of the problem. Very, very few children are hospitalized each year. (Why omit that % and actual number? Or other factors that have greatly reduced the need for pediatric hospitalization, like the record low post-2008 birth rates or advancements in pediatric medicine that mean most kids rarely—if ever—need hospitalization?) Kids who require hospitalization these days require multiple rare pediatric specialists--just like Lachlan--and kids like Lachlan have needs completely different from what adult specialists can offer. Because so few kids have these needs, pediatric subspecialists are rare—and even if they weren’t rare, the average daily census of just a handful of kids on a community peds unit can’t keep their skills up. (The same is true of peds nurses, respiratory therapists, phlebotomists and on and on.) Sorry, NYT--this is a ridiculously poorly-researched article that either reflects a failure to understand that the rare child who requires hospitalization is not just “a small adult” for whom any doctor or nurse can provide care, or an intent to hone in on hospitals as the greedy bad guys. This whole issue is about the specialists; if they aren't available, no community hospital can offer safe care to complex pediatric cases.

16

Ginger (Alaska)

Why have we allowed hospitals to become corporations?

9

Vicki Ward MSN (Barnard, VT USA)

They came for the Blacks and I did not say anything.They came for the Jews and I did not say anything.They came for the Indians and I did not say anything, since I was none of the above.Then they came for me and nobody was left.. YOU recall the sentiment. HOW LONG WILL IT TAKE FOR AMERICANS to revolt against this for profit medical industrial complex????????? When MDS/Politicians deconstructed mental health care in the 1990s, when MDs brought MBAs into healthcare to make more $$$ and control the system as highly EDUCATED NURsing was asserting its place, mental health care devolved into homelessness, private prisons ($$$$ for politicians to pay their friends to run a 'business' with our good ole tax money) and a few federal health clinics. Even with health insurance most folk are pushed out of healthcare by high copays, high deductibles, but still pay monthly premiums to business. Then you get sick and they charge you MORE!!! Then you try Medicare Advantage cause it sounds so good, the payments are initially less, it pays for the gym, and when you get sick they will not pay to TREAT YOU!!! Now, we are seeing the further CULL of medical services to children, who the US has been ambivalent toward policy wise for decades. WAKE UP!! Time for boycotts, stop buying non essentials, stay out of the crowds, socialize at home with trusted others,. The entire system is run by Corporations and the Very rich, called the OLIGarchy. They redirected all levers of power.

9

PJ (Alabama)

Decades ago, some of us critical care nurses (adult care) lamented the lack of even a 4-bed pediatric critical care unit in our town of 200,000, with 3 large hospitals. The answer we were given: “There’s no money in kids”. Disgusting then. Disgusting now.

27

Katie (San Francisco)

This strikes me as a moral failure.

12

Lou51 (Western Australia)

What a sad, sad, country you have become.

22

Nikolai (LA)

Hospitals have been put into the capital markets, that’s why there was such a bed crunch in the thick of Covid pandemic.

3

Leon (Ny)

When hospital charge you parking for visit a sick friend, we knew …is not compassion in a non-profit hospital

11

J (USA)

There are plenty of places where the profit motive makes sense. Competition among firms can do great things. There is no doubt that for many goods and services, profit seeking is a great way of doing things.The profit motive is just fundamentally at odds with health care. In many cases you want there to be some slack and inefficiency in the system so that the capacity is present when people actually need it. This means that maybe some operating rooms go unused or maternity wards aren't full, or health care personnel aren't scheduled in 5 minute increments. The flip side is that, since people get sick and need medical attention at indeterminate times, you have the ability to roll with the punches. I recall when Obamacare was being debated there was a lot of FUD about "waiting months to see a doctor", "rationing care", and "being denied healthcare by faceless bureaucrats".Well, it can take 3-6 months to get in with a specialist, and you get 20 minutes with them when you finally get in. Elder care is a rationed joke designed to suck people dry after they have spent a lifetime paying into Medicare. Companies are over-billing Medicare to the tune of billions a year (alternatively : "embezzlement" or "fraud"), and cost managers in faceless insurance companies make decisions on medical care all the time, hiding behind form letters. Premiums go up and up, care goes down and down.This system is hopelessly broken. End it. Prosecute the thieves who are embezzling public money.

11

Anna (Brooklyn)

Sorry kids, Oklahoma republicans only care about the ‘unborn’ children.Now you’re in your own.And many of your parents and grandparents are voting red to enable this.

27

MTP (Ohio)

and of course abortion is banned in OK.We are a failed state that doesn't even know it. I can't wait to leave

12

XXX (Somewhere in the U.S.A.)

For states that have refused Medicaid under Obamacare, the Medicaid reimbursem*nt rate is 0, i.e., as low as it can get.

13

dijit44 (Trail, B.C., Canada)

Where are any, "conservatives," (Douthat) who are sure Republicans care about the many more poor and invalid children pro life will create? Haven't they been claiming looking after all those lives, rather than preventing them is the proper, and only, "Christian," way to go?

8

Louise (USA)

There's another more insidious threat, independent hospitals are being bought up by the Catholic industrial medical complex, and what happens then? These hospitals impose their Catholic doctrines which pose a direct threat to women's healthcare... So, any women not matter her faith will have to abide by Catholic doctrine, principles, posing potentially life threatening consequences, for a woman who's pregnant, needs birth control etc. These hospitals too because they are not for profit, don't pay property taxes on their hospital properties or their medical office properties depriving cities of needed tax revenue...All the while promoting themselves as supporting "dignity", "Social Justice" etc.

15

JCAZ (Arizona)

In this country, often healthcare / insurance companies are penny wise but pound foolish. If they supported more upfront care, it would cost them less down the road.Another issue that families face is the cost of having loved ones in hospitals that aren’t nearby. A friend’s family has had to deal with. Both an infant and a senior had to go to a medical center 5 hours away for procedures. This involves hotels, transport for the patient. It adds up quickly. In the 1980s, I worked for a company that was headquartered upstate NY, they offered “Angel Flight” seats on their corporate planes to families that were seeking care in NYC hospitals. I wonder how many companies still do something like this.

8

margaret koscielny (Jacksonville, fl)

A country whch does not care for its children; a country which kills its children in schools and nurseries; a country which abuses its children in homes and in public places, is a country which is failing at the most basic level of humanity.This is the price that children are paying for a country run amok on Extreme Capitalism. Materialism will never bring the joy one exeriences observing the life and development of a child. How do we cure the money and profit sickness which many people and businesses-hospitals have which put our most precious resource in danger?

17

DVR (MD)

So why is the federal government disincentivizing inpatient pediatric care? Why don’t they raise Medicaid reimbursem*nt rates to hospital to cover for the needed pediatric care?

3

steve schaffer (oakland, CA)

It's the same old story ever since the government began to grow and offer money. Our for-profit system grabbed the easy and cheap and left the difficult and not-so-profitable to the public. We have seen this economic strategy for years. Is anyone with half a brain surprised in the least?

5

Deirdre (New Jersey)

Profits over people - even in the non-profit worldTell me again why voting for republicans (who have no agenda other than judges and obstruction will make anyone's life better?You just can't be needed in a red state that didn't expand for the ACA. They don't care about you and they want you to move - that was the whole point. they just don't say the quiet part out loud.

8

Yvonne (Austin)

The only hospital that has my respect and my money was founded by Danny Thomas - St Judes Children's. Danny always looked at things from the right perspective. Children, parents & siblings with a sick child need your CARE, not your GREED. All hospitals should convert to his model and let our donations fund the best of them. Compete to be the best, not the most profitable and your dignity can be restored.

6

Frank López (Yonkers, NY)

Difficult story to read with relatives with young children but half of Americans are more worried about trump's legal troubles and his insistence that we, blacks and browns, are the cause of their problems that they can't find time to listen to politicians who argue that certain services need to be provided by their governments. Today is pediatric wings, tomorrow will be women's.

7

Jeff (Boston)

America has huge healthcare problem. This article shows that our for profit healthcare industrial complex is a dysfunctional mess by design. It's inhuman, treating children as comodaties is appaling and I would say violates basic human rights. On the other end of the healthcare dysfunction the NY Times had an article about the Medicare Advantage insurace scams, I mean corporations. From the article: "New York Times review of dozens of fraud lawsuits, inspector general audits and investigations by watchdogs shows how major health insurers exploited the program to inflate their profits by billions of dollars."

8

Meena (California)

Well, vote blue folks. No point in wondering what is going wrong. Pay attention to the elected leaders in your state and open your eyes to everything they are destroying. Of course best course of action is to move to a blue state for immediate relief. I wonder what it will take for all these red state folks to come to a realization that they have been voting against their own interests for a very long time.

11

Pseudo (New York City)

Shriners are supposed to be taking care of children, if you believe their ads. Yet they are closing a inpatient pediatric unit? Are they closing the hospital or just giving up on kids?

4

Jeff (Boston)

America has huge healthcare problem. This article shows that our for profit healthcare industrial complex is a dysfunctional mess by design. It's inhuman, treating children as comodaties is appaling and I would say violates basic human rights. On the other end of the healthcare dysfunction the NY Times had an article about the Medicare Advantage insurace scams, I mean corporations. From the article: "New York Times review of dozens of fraud lawsuits, inspector general audits and investigations by watchdogs shows how major health insurers exploited the program to inflate their profits by billions of dollars."

3

BB (Califonia)

As a physician, these are hard words to write, but the only solution may be to de-fund health care. With more and more money going to bureaucratic nonsense and spent implementing actual BARRIERS to care, we need a system that pays for ALL or NONE of our essential care. There are 2 solutions - clean out the mess our society has made by changing the rules (which will never happen because the financial culprits own too many politicians) OR remove the incentives that encourage our system to treat profits while injuring patients. That incentive is MONEY. The federal government needs to become the SINGLE payer for essential care (or needs to mandate that each state is the single payer ...with non-complying states receiving zero federal funding while non-compliant). If this is too extreme and we truly wish to have a purely capitalist market-driven profit-based (rather than care-based) system the solution is the same! Remove all third party payers from health care (those providing minimal services that could actually be called "care") while collecting premiums, co-pays, and deductibles that amount to bureaucrats taxing our citizens. And we pay our OWN bills - then society can decide how much it wants to spend on health. Maybe we only deserve blood pressure medicines & casts for broken bones. Maybe we have a right to more - or nothing. BUT nothing rational will happen until the current system is dissolved - as messy as that will be. Real reform is just NEVER going to happen here.

11

Carolyn (Seattle)

Just another example of disease treatment for profit.

1

Jeff (Boston)

America has huge healthcare problem. This article shows that our for profit healthcare industrial complex is a dysfunctional mess by design. It's inhuman, treating children as comodaties is appaling and I would say violates basic human rights. On the other end of the healthcare dysfunction the NY Times had an article about the Medicare Advantage insurace scams, I mean corporations. From the article: "New York Times review of dozens of fraud lawsuits, inspector general audits and investigations by watchdogs shows how major health insurers exploited the program to inflate their profits by billions of dollars."

1

NYCEDDOC (New York City)

“Adult Beds are more lucrative than “children’s beds” substitute the “Adult” and “children’s” with every resource in healthcare and you will come to the crux of our failed system. We have a for profit health care system, this will bring only profits not better healthcare outcomes. “Obama care” was just a bandaid where we the people continued to pay private companies to give limited healthcare to those who can’t afford insurance from for profit insurance corporations. Ie it’s government funding to support for profit institutions. With each new regulation every for profit entity:Hospitals, private Labs, insurance companies, pharma etc etctries to figure out a way around each rule to get more profits while giving less care. Until we go to a completely public system where the goal is improved outcomes, that we pay for out of general income tax we can not create a system where we will have the best health outcome for the lowest cost. For those that don’t want the “government “ to control your healthcare I would ask why do you feel a CEO of a healthcare corporation will have your best interest in mind? That is who controls every healthcare decision right now.Given the power money gives these for profit systems I fear it is to late….we will continue to have the worst healthcare care of any modern country while spending the most.

3

Fellow Citizen (America)

America spends twice as much per capital as other first world countries and has by far the worst overall health status; longevity among its dominant, privileged white citizens is actually declining. A shockingly high percentage of hospital systems, including Kaiser, are credibly accused of over-billing Medicare to the point of outright fraud totaling many tens of billions. There is no community mental health system and we see the results in the armies of indigents sleeping on the streets. Adolescent suicide has increased by more than 50% in the last decade as kids feel mounting extreme insecurity and cannot get therapy. Now highly respected academic medical centers are turning their backs on low-margin patients - our children! How much more evidence do we need that market-driven health care simply does not work? In my career in health insurance, I saw countless “masters of the universe” types driven by greed and ego, turning health care management into competitive games, cynically obsessed with “winning” according to the only score that counts - dollars. Doctors and nurses are burning out at alarming rates; many have abandoned patient care. America degrades into an ever more brutal, cruel, rigged system that works for the well-fixed few and fails everyone else. We need a national health care system. Republican dogmatic aversion to government solutions not withstanding, anything would be better than this sorry, sordid mess.

8

Chevy (South Hadley, MA)

This is right out of those apocryphal stories from the former Soviet Union in which, when factory management, criticized for not meeting its quota, switched to making more pairs of smaller children's shoes.At least the children in that scenario were well-shod and better off than what's happening in America!

4

Other (NYC)

At what point do we finally say "enough." At what point do We the Sheep finally realize that we are being fleeced.At what point do we tell billionaires to stop stealing from us, our families, our paychecks, our economy, & tax revenues.The idea that pediatric care can be closed because it's "more profitable" to care for adults is stomach-turning.The fact that we accept this is mind-boggling.We subsidize billionaires. We allow them to drain our companies dry so there's nothing left for innovation, take productivity gains earned by employees for themselves (stealing from employee's wallets) we pay a third of every "philanthropic" donation in lost tax revenue (yes, you paid for that Opera house too). as they ride on our backs, they say they should get debt financed tax cuts (which our grandchildren will be paying the interest on) because they are the Makers!! And we lowly sheep are just Takers.They spend billions on PR to make sure we stay in awe of their amazingness as they rob us blind. Amazon, which pays $0 taxes (Bezos also pays $0 & yes you helped buy him that superyacht) -instead of paying their employees a decent wage, they run multi-million dollar ad campaigns saying how great they are to their employees.What a farce.We first need to stop drinking the Kool aid. Then demand healthcare for our children & that billionaires cannot close pediatric care for more profitImagine billionaires closing all fire stations near your home, just so they make more money.

16

LIChef (East Coast)

Almost weekly, there’s a story about corruption and deficiencies in the US healthcare system and yet our elected representatives barely lift a finger toward solutions. That’s because they — and we — are held hostage by providers, pharma companies, equipment makers and insurers. It is similar to the way we are held hostage by the gun lobby. Conservatives have to tell me how it constitutes “freedom” when we are shackled to these greedy special interests.

4

Carr Kleeb (colorado)

We are a country filled with smart people that have incredibly faulty systems, perhaps our medical delivery system is the most dysfunctional. And yet, year after year, it gets worse. We have elected officials who are supposed to regulate and advocate for us, doctors who swore an oath to do no harm, and communities filled with "not-for-profit" hospitals. Everyone in this chain is profiting from the current situation or they would be speaking up. Another case of Silence=Death.

2

XXX (Somewhere in the U.S.A.)

Yet another way in which the U.S.A is Number One! I'm getting tired of all this winning.

6

Chris (California)

Over 20 years ago I worked in a hospital as a respiratory therapist which had no pediatric department. We got a very sick two year old who had been a preemie and was sometimes on a home vent. This kid had a tracheotomy and since we did not have a ventilator suitable for a child that age we asked his dad to bring in his home unit which he did. He was OK until he was transferred. I was appalled at the time, but the stories I read here make that look like nothing.

6

Independent American (USA)

Should they regain control of Congress, Republicans plan to make MORE cuts to Social security. So, if you're looking for them to fix our failing healthcare system - forget about it. Just die fast is Republicans' prolife philosophy!

9

mag (NC)

I am absolutely stunned at the lack of research for this article--and I've been there, keeping a community hospital peds unit open, safe and thriving. The word "specialist" is only mentioned once in this article--and yet in the units mentioned, that is 99% of the problem. Very, very few children are hospitalized each year. (Where is that context? That percent, number? The impact of record-low US birth rates since 2008? The peds advances that mean the vast majority of kids will never need hospitalization?) The kids who require hospitalization these days also require multiple rare pediatric specialists--just like Lachlan does--and kids like Lachlan have needs completely different from what adult specialists can offer. Because so few kids have these needs, pediatric subspecialists are rare—and even if they weren’t rare, the average daily census of just a handful of kids on a community peds unit can’t keep their skills up. (The same is true of peds specialty nurses, respiratory therapists, phlebotomists and on and on.) Sorry, NYT--hospitals have issues, but this is a poorly-researched article that either reflects a failure to understand that kids who require hospitalization are definitely not just “small adults” that any doctor or nurse can care for, or an intent to hone in on hospitals as the greedy bad guys. This entire issue is about the peds specialty doctors and staff; if they aren't available, no community hospital can offer safe care to complex pediatric cases.

4

Lee Mei (West Coast)

I come from a country with universal healthcare and it's mind boggling how so many Americans refuse to vote for what every citizen deserves. So much financial stress and mental burden is taken off your shoulders when you and your family's life and death is not reliant on your employment.For profit healthcare here in America is immoral and inhumane.

11

Deb (Ny)

Closing pediatric units is literally killing your young.Humans don't do that.This is what happens when business takes over health care. The rats in business suits come out. When NYC was in the midst of the Pandemic and nurses were dying along with the patients they were caring for, the fat cats at Mr. Sinai were sitting in their Florida homes sunbathing.Shareholders would have more money if they fired the CEOS and let a robot run hospitals. It would certainly be more humane

5

Mike (Peoria, AZ)

"Adult beds are more lucrative..."Well, there you have it, the root problem in most of our healthcare issues in this country: greed. For-profit healthcare isn't healthcare, it's a lie.Stop the scams: Universal Single Payer Medicare for All. ASAP.

7

Ken Aaron (Portland, Oregon)

You hear from the pro private health insurance crowd that they want the freedom to choose any doctor etc. As long as they have their choice, they are fine. Notice its only about them and their choice, and no one else - like the kids in this story.1 in 7 hospital beds are in Christian hospitals, and they are reducing pediatric beds. How Christian Capitalist of them. But don’t ask for abortion services, their religious beliefs matters more than your health.Perhaps the Hippocratic Oath needs to be updated to “First make a profit”. “First do no harm” is quaint, but in this world of “I Me Mine”, its so outdated.

3

Tom (Cedar Rapids IA)

Not just, "Where does that leave Lachlan?" Where does that leave the hospitals in 30 or so years, when there are no more lucrative chronically ill patients? Think about the long term, Mr. Hospital Administrator: you need sick people.

3

DavidJ (NJ)

We are too much at the mercy of big business, or should I say, the Republicans. As John Kerry once said to an audience of beleaguered citizens. “I’m sorry you cant have the same medical benefits as Congress.”

5

Robert (Out West)

I liked this article very much.But I’d have liked it even better if it had given a shout out to the REASONS we have more and more kids with respiratory diseases, which include wildfire smokes and molds after floodings, and the large&growing numbers of preemies with lifelong medical problems who we, “save,” and then forget all about.And I’d like to see an article on the implications of these cutbacks and closures for an even-worse piece of shamefulness: we don’t even take care of the simple things poor kids, and rural kids, need.Checkups. Shots. A pair of glasses, a dental visit. Clean tap water; a sewer system that isn’t a toilet, a pipe, and a creek. The lead removed from their homes (yes, still a thing), a decent place to live, play, go to school. Oh, and food would be nice.You ask me, the real scandal is that we don’t do the basics.

8

Amelia (PNW)

Maybe we should set healthcare policy based on the reasonable desire to address the needs of the population instead of the needs of a handful of people to become rich beyond belief

29

Daniel (Pittsburgh)

The article alludes to but maybe doesn't make very explicit that there can be a very big difference in care in a pediatric unit within an adult hospital and a freestanding children's hospital. It's not just the number of beds, but the subspecialists available and the expertise in less common conditions.

8

Your call is important to us (California)

This is heartbreaking. The other day, a Times article about scamming seniors via Medicare "Advantage" insurance plans. Now this.When my son was diagnosed with a serious medical condition at age 11, I was so grateful that we could take him to Stanford Children's Health. At that time, I was employed and had gold-plated employer sponsored health insurance. Then I also got sick and had to stop working. To my relief, I learned about California's substantial safety net for seriously ill children: California Children's Services. My son could continue to receive the same excellent care as he did before I lost my private insurance.I'll always be eternally grateful to California and to Stanford Children's Health. This experience made me so much more aware of how your location in this country can have a dramatic effect on your level of support in a crisis.

26

Dawg01 (Seattle)

America has the most expensive health care on earth. According to the WHO, our outcomes compare to Morocco - Morocco. This piece suggests why that may be true. Sad.

20

Ted B (Prospect Heights)

My memory stretches back all the way to 2019-2020, when one major politician was calling for universal healthcare. In response, an entire Democratic primary season was devoted to explaining why we couldn't have universal healthcare.I hope times have changed. Medicare for All is such common sense, it's maddening. Imagine the stability of knowing a hospital wouldn't need to close do to lack of profits. The relief from untying health insurance from employment would be palpable across the land. Freedom, autonomy, and entrepreneurship would all increase if we recognized our shared responsibility to make healthcare universal. The next time universal healthcare is on the table politically, let's embrace it.

21

Doug (vt)

At the very least, hospital systems should be completely regulated by the state. These hospitals take massive amounts of taxpayer dollars and tax breaks and are virtual monopolies in many areas. There is no reason why the shouldn't be essentially government run.

19

L (Loc)

This is pretty on brand for America. Look at what we’ve done to funding for public schools.

32

Luke Ratzlaff (Kansas)

Hospitals should not make profit-driven decisions. Prisons and police organizations should not make profit-driven decisions. The military should not make profit-driven decisions. Consumer goods and services companies (and only those companies) should make long-term profit-driven decisions.Capitalism is a powerful hammer, but not every sector is a nail. Individuals have different tools for different tasks, and society should have the same.

22

Let's get real (OK)

The conservative state and federal judges including SCOTUS, have all but entirely banned female reproductive medical care. The economic model instituted by Reagan is simply stated, 'the sole responsibility of a corporation is to maximize profits' (Chicago School of Economics).Therefore it make perfect financial sense to cut back child healthcare; thereby increasing the childhood mortality rate, while simultaneously forcing a higher birth rate. This is precisely what early America looked like: Large number of children because few survived childhood.

18

Jules (California)

My adult daughter decided not to have children. I am glad. The icing on the cake would be if she and her husband decide to emigrate to a more humane country. Isn't it interesting that as more wealth funnels to the top -- influencing policy with billions -- the more the U.S. becomes a trashier, more crass place to live.

48

Gustav (Durango)

This is corporate medicine at its worst, and it will continue to go downhill from here. The American Medical Association has a lot of explaining to do, this happened on their watch.In my 34 years of pulmonary/critical care, I have watched how MBAs with no medical experience whatsoever have taken over every decision in a hospital and no longer listen to anything the nursing directors or doctors are asking for.If you are shocked this is happening, you should be. And time is running out. Wait until the tsunami of baby boomers gets into their 80s and 90s.

41

polemics (albany, ny)

48 counties in Illinois have no pediatrician at all? This is unfathomable, and heightens my parental gratitude for the PICU that is a mile away from home.

12

Ron B (Boston)

The effect trickles down as well. Hospital systems without pediatric beds cannot train new pediatric doctors. So you get fewer pediatric doctors locating in these areas. Fewer pediatric doctors are going to move into town, etc. And, by the way, pediatrics is also not one of the higher-paid specialties (for the same reason that the hospitals are closing the pediatric beds.)

32

Justwonderin (Seattle, WA)

Profits before all else, this is capitalist medicine at its very finest!Please don't say the words; Socialized Medicine", those words have been very adeptly utilized to frighten enough people to keep those profits coming in.How is everyone needing private health insurance not a form of socialized medicine? Everyone puts their dollars in a pool of money to pay medical bills. (With a little left over for the insurance industry.)

16

NZbronco (Auckland)

What hospital chain is this Oklahoma religious hospital part of? I am guess Providence, the hospital chain that imposes its religious doctrine on female patience and denies services, which sends debt collectors after poor Medicare patients whose bills are already paid, or, according to the Seattle Times, hires a neurosurgeon who is known for his high productivity by overseeing three operations simultaneously and cutting corners. This is what we get when consulting firms and MBAs shape the operations of "not for profit" religious hospitals. Providence is my primary medical provider and I ask questions of my providers whenever I see them. Their common response is "we know that because we work here." This is a huge flaw in the American system of health care.

23

ekq (here)

Hospitals should not be profiting from people's illnesses. The idea that there are fewer pediatric hospital beds because they are less profitable is horrific. The American medical system is broken.

42

dlinovaz (Tucson)

Where are all the Republicans taking on this issue? They're focused on burning books, and threatening school board members and teachers for presenting children with truth and reality. The GOP will always blindly support the vile concept of for-profit health care, even if it harms their kids.

46

Big Boomer (San Francisco)

In America's healthcare marketplace, money is not just the most important thing, it is the only thing.So sad.

44

MHW (Raleigh, NC)

Eisenhower warned of the military industrial complex and we have been living with it since his time. It led us into the Iraq War and Afghanistan (think Haliburton) and consumes 3.5% of our GSP.I finished medical school 40 years ago this coming December. I have seen the rise of the medical industrial complex, which is sapping our economic and actual physical strength - it consumes almost 18% of our GDP. We spend more than any developed nation on health care and our health is poorer (old news). There are so many vested interests in the status quo that our craven politicians do nothing to help our country and our people - Obamacare being the one large exception. How much worse will the situation have to become before The People cry out for a coherent solution that reduces cost;takes some of the profit out of health care for insurance companies, drug companies, and others who are reaping vast profits;treats health care givers (including doctors) better; andmost of all, yields better health care for Americans?

39

BenT (Chicago)

This is not just a problem regarding inpatient pediatric bed availability for kids who need hospitalization. As a pediatric surgical specialist, I have an increasing problem finding hospitals which will allow me to do surgery on younger children or children with any significant chronic condition, because there is no inpatient "backup" unit, just in case of a needed postop admission. Truthfully, I've never had to admit one of my outpatient patients, but the absence of an inpatient unit means I have virtually no options on where to operate. Yes, a large percentage of my patients are Medicaid. That's not their fault!

112

Deirdre (New Jersey)

My daughter has a very rare condition. We went to numerous pediatric GIs for ten years with no answer. Once we got into CHOP in Philly we tested for 90 days, received a diagnoses and a plan. Even though she is over 18 now they still talk to her - we are forever grateful.When you have a sick kid you need to live near where they can get help. We would move if we had to.It shouldn’t be that way but some conditions are very rare and other physicians don’t know how to treat. That was our case.

43

MB (PHX)

It's time to take the non-profit status away from hospitals that make these decisions based on profit, which is just about every hospital in the country.

69

B (Virginia)

"More than a third of children in the United States are enrolled in Medicaid....Health policy experts say an important solution would be to encourage hospitals to care for children by increasing Medicaid reimbursem*nt rates."One-third is a lot of children from a lot of poor families.Both Medicare and Medicaid reimbursem*nt rates are dismal.Many providers accept neither (or accept only existing patients not new patients whose insurance is Medicare or Medicaid).These are longstanding problems.Politicians of all stripes cannot agree on what to do in a comprehensive way.

24

Dianne (USA)

The healthcare system in the US is broken. But let’s definitely not deal with it, and not deal with any of the causes of the huge increase in chronic disorders children get from exposure to the toxic environment, and also make sure that women can’t get an abortion even if the fetus they are carrying shows prenatal signs of permanent and possibly terminal disability. No, what we need is to give the ultra wealthy another tax cut, and let hospitals and health insurance companies get away with charging obscene prices for necessary care, while making life miserable for the sick, young and old. That’s the USA these days.

56

WhiteBearLake (US)

Where are all the anti-abortion organizations and why are they not advocating for better treatment of children's health?Wouldn't it be fabulous if all these children had the same health care given to the children of members of Congress and the Supreme Court?Ted Cruz are you out there?

83

Jeremy (Cleveland)

To add insult to injury, many of the hospitals mentioned in this article are nonprofit charities who have the nerve to ask for donations on top of their tax exemptions.I've sampled the financials of these so-called nonprofit hospitals: they actually make very very big profits every year.It's all a massive scam, and somehow the American people are letting this happen.

62

Snarf (CO)

The language has even changed at the hospital administration level. ‘Patients’ are now ‘customers’, and ‘communities’ are now ‘markets’. And they’re shameless about it; the emails they send and the ‘town hall’ staff meetings are full of MBA-speak. Any compassion you feel in healthcare is coming directly from the provider in front of you, holding back the sharks.

36

Deirdre (New Jersey)

Europe and Canada and Australia are laughing at our greed and stupidity.You think you hate socialism until you get sick and you need care and it’s not available where you live at any price or not to you.Socialized medicine is the only way to go - we just need to get over the fact that “those people” are going to get care too. I consider that a plus.

60

RB (Bay Area, CA)

Awful. Just awful.

13

SD (Connecticut)

Be very afraid for these children: if a gunman does not get them, the for profit medical system will! Medicare for all! Vote people!

25

Josh (Atlanta)

Dickensian.

19

ribbit (United States)

But of course the Republicans, who care about children only when they're fetuses, will not lift a finger to change the for-profit medical system.

50

Julie (New York)

We should only allow not-for-profit hospitals in this country. It wouldn't fix everything, but it would help a lot.

6

Brian (MA)

You can judge a society on how it treats it's less fortunate, it's elderly, and it's young. The US is not looking great these days.

27

mwk (Boston)

This is why "for profit Hospital" should be an oxymoron only. And NOT a real thing.

9

AL (India)

It's stories like these that make me apprehensive about emigrating to the US, despite several opportunities and despite my deep, deep appreciation of American people.

7

yr buddy (malden)

Welcome to America, land of the free. Home of democracy, justice, equality and opportunity (for whom?).

5

Geggle (Mercersburg PA)

I have worked in Healthcare for over 15 years, and have seen the horrendous profits of this Frankenstein system. Everywhere are people making money, profit and getting rich. The only exception is the nurses that do all the work. But the end result is cases like Lachlan. This horrible approach to healthcare needs to end. People are literally dying and going bankrupt to protect existing business interests. Time for a one payer system.

18

Nostradamus (Pyongyang DPRK)

As far as health care goes we have become a failed state.

10

Proud Liberal (Netherlands)

So, let me get this straight. Deny women the right to an abortion to protect life. Then, deny these children and their families access to healthcare (such as dedicated pediatric hospital units), health insurance, education, affordable food and affordable housing. And if a desperate child/teenager commits a crime, let them rot in jail without any hope of rehabilitation. Meanwhile, drain these crucial services of capital or shut them down entirely to pursue more profit. The hypocrisy is appalling!

70

NYer in WI (Waupaca WI)

The Governor of Oklahoma is more interested in ceasing care for transgendered kids than trying to solve a real health crisis that is evident in this story. Politically going after "low hanging political fruit" is not going to help or benefit the majority of Oklahoman families.

17

Jason (New Jersey)

having a health care system based around the profit-motive is an absolutely insane and evil

12

Nancy Croteau (Virginia)

The MBA group is doing a bang up job of providing health care in the United States. The market economy can't even provide for children's health.

4

Talbot (New York)

No hospital beds for kids? Because they don't generate enough profits?That's so sickening I'm having trouble thinking straight.

68

Chip (Wheelwell, Indiana)

This is a country that leaves the vulnerable to their own devices. The elderly during Covid, school shootings. This is dog literally eat dog capitalism with children succumbing to their fate as hospitals overdiagnose healthy adults to put them in lucrative hospital beds.

14

LG (Manhattan)

This headline shows how normalized the utterly immoral profit driven approach to health care in the US. When will the media make the immorality the news? I guess profit driven media can only be complicit.

13

MJ (Ohio)

We are very fortunate in NE Ohio to have 3 world class pediatric hospitals. Univ Hospitals of Cleveland/ Rainbow, Cleveland Clinic Children’s and Akron Children’s Hospital. How can Tufts even call its hospital a childrens hospital if it closes its in patient beds??? For shame.

14

Linda Camacho (Virgin Islands)

Hospitals need money in order to survive. If people would pay their bills, which many do not, then there would not be such a bad crunch.

4

Spencer (St. Louis)

My institution, on the advice of some "consultants", moved a number of pediatric resources to the adult facility, making it more difficult to care for the children. It's all about the bucks.

7

Olywa (Washington)

Disgusting. Hospitals and health facilities should not be for profit. Just appalling. Thank you for bringing this into the open. Now how can we force a change? Next article written?

7

DK (South Delaware)

Rural areas are horrible places to live. I lived in GOP controlled Wyoming County Pa . Our town of Tunkhannock Pa just lost its ER on 7/1 /22 and the patients have to go with their one ambulance to Scranton and Wilkes Barre pa 35 minutes away. Then is you have a severe heart attack you go right to a funeral director. What a place to live. The GOP leadership did not help save the hospital so what good are they. I live in South Delaware we have a 24/7 ER and it is a Democratic state. Wyoming county residents move out to save your health.

27

Will (Seattle)

Hospitals chasing lucrative beds is a national travesty, the fact that we are still so much OK with institutions directly boosting profit margins on whom they choose to treat is a disgrace.

12

Mark (El Paso)

“…….to boost profit margins.” ??? A society that allows for institutions to profit off of health care is profoundly sick.

28

Wesley (Fishkill)

Yet more evidence that "health""care" in the US is nothing but a convenient way for overpaid hospital administrators and insurance executives to pad their pockets. If the people that run our "health""care" system cannot make ethical decisions, the government needs to step in and do it for them.

13

Elliott Arluck (Bridgeport CT)

Disgraceful plain and simple.We need healthcare and single payer now for all.

18

Kasper (Camas.WA)

There is no healthcare system, a coherent and coordinated network of institutions dedicated to improving health and directed by those who have dedicated their careers to providing excellent and compassionate care. Instead, we have a healthcare industry, a competitive, adversarial and purely transactional business sector managed by hedge funds, Wall St. and self enriching CEO’s without any grounding in clinical practice.

14

JoAnne (Georgia)

Adult beds are more LUCRATIVE??!

12

Khoi (Texas)

Pay attention and vote, people.

16

AnObserver (Upstate NY)

There has to be a special kind of administrator who would close a pediatric unit in a place called "Tufts Children’s Hospital".

20

Alex (New York)

This is what Democrats need to run on.

12

Anne (Portland OR)

So much for “non profit” hospitals!

6

Deirdre (New Jersey)

If you live in bootstrap America and in a state that didn’t expand Medicaid - you may need to leave that state for medical care.When OK railed against the ACA, they also turned down all kinds of fundingSo if you are sick- you need to leave.Because in bootstrap America - no one owes you anything- you need to live in a blue state that cares if you need care.

16

c (Pennsyltucky)

Peds beds are not money makers because kids don't have Medicare and Medicare doesn't give $$$ for any peds residents or fellows.

10

Roberta (Greenfield MA)

Disgusting example of the consequences of corporate greed. Shame this doesn't happen to an insurance company CEO. I'm not a communist by any means, but the reality is that if Lachlan were in Cuba he would have access to the medical care he needs.

10

Independent American (USA)

What a disgustingly perfect example of how LOW America's healthcare system has sunk in the name of profit. So, the next time some Republican liar tells us "universal healthcare" will result in long lines and subpar care; tell them that's already been happening here! We just have more people dying because of it and/or living in poverty because of every FOR PROFIT hospitals and their doctor affiliated businesses/offices are gouging us at every opportunity they possibly can. And our health insurance companies are in on that con, too!

9

Alvin (Harlem, NY)

When I read articles it confirms for me that America is no longer a democracy. Companies run our country and have oversized influence over politics and legislation. Universal healthcare for all children and adults should be guarantee.

27

Nancy (Maryland)

I am so very sorry for the challenges faced by these children and their families. My heart goes out especially to Lachlan and his courageous mother. I hope this NYT article focus on this problem helps the Democratic funding bill move through its committee.My other thought: Now that Republicans are passing laws left and right (no pun intended) to make abortion illegal and force women to give birth to so many children, the GOP should start focusing on health, social and economic policies to help all these children and mothers, like access to healthcare, childcare, better education to name a few…But I wouldn’t bet on it.

12

Susan Wensel (Spokane WA)

I think that for a hospital to be accredited, a certain percentage of its beds should be designated as pediatric beds. After all, children live everywhere in the United States and need medical care for illnesses and injuries large and small. People are suffering as health care companies chase the all-mighty dollar - and many, if not most, of these hospitals are supposed to be non-profit. While they are allowed to make a profit, that's not supposed to be their driving motivator!

9

HJC (Canada)

Disgraceful and obscene. What has our world become? Not enough men and women with integrity. Biden is brilliant, one of few. Children, seniors...for god’s sake, country wide health needs protecting.

7

Marcus (Lisboa, Istanbul, Charleston)

Health care for profit and health insurance are immoral, we are a backward country in this respect and so many others. Vote like your lives....oh never mind, we all know its never going to change without a revolution that will never happen, we have been carpeted by the system and are no more than economic slaves to it.

14

CaryMom (Cary NC)

I thought I could not be more disgusted with the vulture profiteers in the medical hospital industry. Now they are eliminating medical care for children because they can get more money for other services. They are sacrificing children for an extra buck. Can we stop this sick twisted insanity and just get medicare for all? At least for the children? The leaders in this industry are just disgusting.

13

true blue (east)

What a country; ban abortion ; endanger pregnant women and sick children.

12

Angelica (PA)

When medicine is about money no one wins except the venture capitalist.

10

BA (Milwaukee, WI)

As our entire medical system works to become nothing more than a money making machine, it is obviously the patients that will suffer. But clearly no one with power cares about this. The large "health systems" have very close relationships with politicians, patients like this fragile child have no power. Good luck, Lachlan. You're going to need it.

8

Cynthia Kegel (Chicago)

We need a single payer system. Capitalism in medicine doesn't work for ptients and families, but only for the capitalists.

10

Linda (Colorado)

Yet another result of our broken, profit-driven so-called health care system. Democrats, when are you going to do something about a national single-payer system?

5

Ron (Paris, France)

This is what happens under predatory capitalism, such as in the USA. I live in France, and we do not have these problems.

14

Marti (Denver)

Medicine should not be for profit, and neither should healthcare insurance. When UHC is more concerned about its responsibility to its stock holders than its patients, people die.

10

PAMMAP (FL)

This is what happens in a capitalistic society when lawmakers (and hence corporations) have no allegiance to their constituents (in this case children who don’t vote). It’s not right.

8

Sixofone (The Village)

That a hospital would shut its pediatrics unit in order to make more money tells you everything you need to know about private medicine and its relationship to the profit motive, and especially, how unacceptable it is for a society that aspires to be mentally and emotionally healthy (never mind physically healthy) to be saddled with such a system.Profit-driven medicine is a major building block of dysfunctional societies. It's also just plain immoral.

8

Deirdre (New Jersey)

Most of these hospitals are non profits and as such should provide services for all. It's time to yank their non profit status and government funding and give it to an organization that is willing to serve the community.And as for the ginormous executive salaries? No. Just stop

10

Lisa (MA)

To Lachlan’s mom: you are a hard won warrior. I am so sorry for the mountains you and Lachlan have to climb to receive the care he needs. May you continue to have the strength for the battle ahead. How lucky is Lachlan to have you as his mom.

10

Edward (Wichita, KS)

Where in the Hippocratic Oath does it mention maximizing profits for Hospitals?

9

Karen Kressenberg (Reno)

This is what you get when you choose a for-profit healthcare system. They’re behaving “rational to the system”. It’s the system that’s the problem.

9

John Mullowney (Ohio)

"adult beds are more lucrative"The whole story behind health care in AmericaIt could be reduced to "more lucrative"

12

Kathryn E Wechter (Rockport,MA)

Yet one more reason that healthcare should NOT be in the private sector!

14

Susan R (Dallas)

When medicine becomes about profit, this is what happens.

7

Eugene (NYC)

Red states Blue states.We have a number of children's hospitals in my Blue town of New York City.

5

sookie (Arkham MA)

Oklahoma City has a couple of top-notch children's hospitals, an hour from Tulsa. Wonder why they haven't gone there or why it wasn't mentioned.

Neal (AZ)

America First! Especially the richest America. I know Trump, McConnell, et al don't care much, and certainly the CEO's of major institutions don't, but for all the rest of us? What are we saying to the world, and to the the future, when we can say, quite accurately, "...as institutions look to boost profit margins, pediatrics ... are cut". For myself, the reaction is shame and anger.

9

CarolSon (Richmond VA)

Let's all thank the GOP, ONCE AGAIN, for depriving Americans of things every other civilized country has - and has had - for decades now. Good public schools, universal healthcare, efficient mass transit, just starts the list. I'm so sick of it. For so many people, living here is worse than living in some third-world countries.

18

mich (li, ny)

This heartbreaking story, when added to what’s happening with women’s abortion rights, requiring women to have more children, and these children may then have no hospitals to go to when they are ill, is the perfect example of how the Republican Party devalues life once it is born. more than any other article I have ever read this seems pretty clear. Vote Democratic in November, because ALL of our lives depend on it.

16

CD Chase (San Diego CA)

What’s a “no brainer” is that hospitals should be able to treat who shows up.

6

Shayne davidson (Ann Arbor, MI)

If Republicans truly believed in “right to life,” America would have nationalized health care. Instead we have a party dedicated to the right to make money. Point this out and you’ll be labeled a Socialist.

18

Wonderweenie (Phoenix)

Only happens in profit driven American health care.

8

MJ (Ohio)

We entrust the people most precious to us, our children and grandchildren, to pediatricians. These docs are the worst paid docs in medicine. Worse than family docs, worse than internists. With the cost of medical education so high today who could afford to become one? How would you pay your medical school debt?

8

Robert (Out West)

Incidentally, pretty much every rural hospital in the country suffers from some version of this problem. Can’t get funding, can’t get docs, can’t get nursing staff, and so on. The local tax base can’t support it, the state lege won’t support it, the Feds can’t pick up the whole tab, and the private companies can’t make enough dough. It’s pretty much the same in inner cities. And few of these families have the resources to schlep kids around endlessly.Plus which, the brief comment about respiratory disease seasons lengthening and intensfying is correct. guess why? Then you add in wildfire smoke and so on…And then we get to all the “miracle babies,” we “save,” and send home…and the way that elderly adults with chronic conditions wolf down resources.It’s all fixable, but anybody who tells you it’d be cheap is a liar.

11

Flo (Brooklyn)

The strength these parents need to have on this journey is astonishing. It the weakest who are made to suffer the consequences of the heartless profit machine.

5

Frank (Raleigh, NC)

Good ole America! With its grand exceptionalism and profit motive for all.

11

Wallace F. Berman (Chapel Hill, NC)

Is there anything more convincing that our healthcare system in this country is broken? Where else in the world would we be discussing this atrocity? We have lost all sense of reason when the only factor used to provide access and care for any people is based solely on the profit which can be made off of them. People are not commodities to be bought and sold. Their well being is not a means for getting rich. Many of these same people who close healthcare facilities especially for children are the very same ones who want more children to be born. They withhold all forms of birth control on some illogical religious grounds and deny a women’s right to choose and yet want to eliminate funding for child care, education and now healthcare. Are we becoming that truly dystopian? Are we really beyond all rational thought? We are not only losing our democracy, but also our humanity.

19

Buttons Cornell (Toronto, Canada)

The reality is the USA puts a price on human life, and does not care for those of insufficient wealth.Actions speak louder than words, and in its’ actions, the USA really just wants those of insufficient value to just go away and perish. To stop being such a financial burden. Thoughts and prayers will be send. Government policies at all levels – federal and State – as well as corporate habits make it crystal clear that they only want to cater to the whims and whines of the wealthy, whose lives are so much nicer when they are spared the tax burden of helping to pay for the heath care of the lesser classes.Can’t afford life? Move to a country with universal health care.

19

Jen (Midwest)

I searched Google for a children's urgent care when my daughter had an ear infection. I called my insurance and they told me to go there.We got there, and the building was closed. A doctor came out and told us it had been turned into an optometry clinic.The nurse at the general urgent care was very concerned because my daughter's oxygen level was reading low. The device was too large for my daughter. The PA fiddled around with it to get it to fit and got a correct reading. This is such a small example, but this is why it's important to have facilities dedicated to children. They can't receive proper care when nothing fits them.

35

Anna (Bellingham, WA)

"So as institutions look to boost profit margins. . ." There's the heart of the problem with health care in America. Health care should not be a for-profit enterprise. Period.

48

chris87654 (STL MO)

This is the result of providing increasing earnings for CEOs (stock options) and share holders vs providing care for patients.It comes at a bad time as long-term effects of covid on kids are showing up.

24

Melian (CT)

Glad there is finally some attention to this issue. This isn't just a pediatric issue, but more obvious in pediatrics because of the starkly lower reimbursem*nt rates for kids. Once hospitals in an area start to close their specialized floors/units, usually one remaining hospital becomes the go-to for that service. That allows them to have a near monopoly and in turn charge more and advertise themselves to be "the best hospital" in the area for that service. For patients, they choose to go to the "best hospital", and start avoiding the other hospitals, further driving both profits and patient safety lower to the hospitals that choose to keep their floor open, until even a hospital that didn't intend to close their specialized unit down will have to close it anyway as it becomes untenable to continue. Once this loop starts, hard to stop.

10

Les (Bethesda)

Everything that is wrong with our health care system is encapsulated in this question: "They’re asking: Should we take care of kids we don’t make any money off of, or use the bed for an adult who needs a bunch of expensive tests?” Health care should not be primarily about making money. Period.

60

Issac Basonkavich (USA)

The US ranks 11th in the top 11 high earning nations, in quality of health care. It is substantially lower than the other 10 nations. The other 10 nations treat healthcare as a service, with the focus on improving the quality of healthcare and controlling costs. The US treats health care as a consumer product, the only nation that does this. The focus in the US system is to maximize profits for investors and CEOs, who make over $20,000,000 a year, administering over 1,200 health care insurance companies. They do this by charging for health care as high as the market will bear. Administrative costs in the US system account for 30% of health care costs. Administrative costs in the 10 higher quality systems account for 5% to 7% of health care costs. The average American pays over twice as much as those in the 10 countries with higher quality health care. These premiums of over twice as much go to employ hundreds of thousands of parasites with CEOs making tens of millions a year. The sad reason why neither the Republican and the Democrat representatives will do nothing for their people is that the health care insurance industry pays them through political contributions, to maintain the status quo. Yup, we're number one alright.

41

Joanne Roberts (St. Paul MN)

It is unfortunate that the reporter captured only one side of this issue. In fact, children are indeed not small adults, and children’s hospitals around the country are actually growing their services to in order to replace an obsolete model that is being mourned here. The concept of an all-services general hospital in every community is obsolete. Strong pediatric services can be delivered to rural communities, while assuring families have access in centralized high-quality inpatient services. Strong children’s hospital systems are doing this. See Washington State and Minnesota as examples.

8

Lesley Gordon-Mountian (San Francisco)

Mahatma Gandhi’s powerful words define this horrific situation: ‘the true measure of any society can be found in how it treats its most vulnerable members’. Clearly our society is ailing morally and physically if it is no longer able to care for its future - our children.

50

Let's get real (OK)

America has the best medical care money can buy. . .and without money there is no medical care. Thank you Mr Reagan for promulgating Trickle Down Economics whose basic principle is: Business's sole purpose is to increase share holder value.

26

Postmotherhood (Hill Country Of Texas)

Unnecessary joint replacements are repeatedly “done” to my friends and acquaintances. They ask for physical therapy and at least one doctor honestly responded that he made no money from a PT referral. And thus a child suffers (and elders also suffer unnecessary pain from unnecessary surgeries) so hospitals can profit?!?

23

JGSD (SAN DIEGO, CA.)

Is it surprising that the capitalist system puts profits before any other considerations? Socialism values everybody, employs everybody who can work, provides social security for everybody, not just seniors.

33

manfred marcus (Bolivia)

Closing pediatric beds so to enhance their profit margins? You are kidding, right? Hospitals, however much guided by their CEO's to enhance their already generous income, have no right to remove care for children, just because they can. There is no justice here, let alone some compassion for the least among us, so to atune to health care's dictum of "First, do no harm". All these hospitals that call themselves non-profit, and supported by outside sources, ought to do better...and try to do what they claim to be doing, patient care; and children must be included, perhaps even preferentially. That is also the right thing to do!

16

SridharC (New York)

Most pediatric units are empty and I don't think it is just economics but also competency. If you never manage patients in the inpatient settings you cannot retain clinical competency.

5

fafield (NorCal)

When will ths country wake up and do what is so obviously necessary; get the profit thugs out of our healthcare system and recognize that heathcare is a fundamental right for all citizens and legal residents? Not soon sadly as we continue to focus our political energies on the ego of one person and continue to have the very best congress that healthcare and big pharma money can buy.

63

Whitman (FL)

A modest proposal: Medicare for children (their good health is an investment that will yield social and economic dividends far into the future), eliminate Medicare Advantage for old people, and limit payment to hospice care for any old person expected to live less than two years.It only makes sense morally and socially to devote resources to those whose lives are ahead of them rather than to those who have mostly had their moment in the sun.

27

JSC (Out West)

As a parent I always thought it was a good thing that there were more and more childrens-only hospitals? They are a much more pleasant environment for the kids and the practitioners are much better at triaging children. Outside of the most rural areas, wouldn’t it be better to expand that infrastructure than maintaining pediatric beds in regular hospitals?

3

jhelmer1 (Providence, RI)

re-“They’re asking: Should we take care of kids we don’t make any money off of, or use the bed for an adult who needs a bunch of expensive tests?” said Dr. Daniel Rauch, chief of pediatric hospital medicine for Tufts Medicine, who headed its general pediatric unit until it closed over the summer. “If you’re a hospital, that’s a no-brainer.” What an indictment of the whole system that a hospital that is charged with providing care and whose providers take a Hippocratic oath would behave this way. Taking care of kids who live in the communities where the facility/providers live is, in fact, the no-brainier decision. We have in fact lost our brains if pediatric closures make sense. We need SINGLE PAYER. We need to STOP funding (insurance money and state/federal payments and sweetheart deals)a system with these sorts of unethical incentives.SINGLE PAYER isnt perfect but it will be far more ethical and more centered on the care we need- cheaper too! Now that should be a no brainer. For shame in a country that claims to value kids but actually treats them abysmally. Imagine better and then Demand better!

54

LIChef (East Coast)

I’m not surprised to see this kind of development in Oklahoma. These red state locations traditionally make the popular lists of best places to live or to retire, but people don’t realize that their low cost of living comes with far fewer amenities and a mentality that would deny basic social services to anyone but the wealthy and well-off, including innocent children.For example, in Florida — you know, the state with no income tax — all homeowners are looking at massive increases in their insurance premiums and huge reconstruction costs after the hurricane, thanks to their climate change denial, poor building practices and the fact that many didn’t have flood insurance. Some insurers are leaving the state.I’ll stay in expensive New York, thank you, where — however fractured — we have healthcare services up the wazoo.

100

ellena (las vegas)

At one point in our history it was deemed that certain things were too important to be left to private, profit-driven, "capitalist" and "free-market" interests -- those being health, education, and welfare. Since the formation of the cabinet-level department there have been forces fighting to dismantle, destroy, and siphon the government funds that flowed to those entities. Guess which? (Anyone else remember when "W" wanted to "privatize" the national parks?)

34

Dan (Southwestern, Ut)

Years ago my late father-in-law was diagnosed with mesothelioma after spending days in a hospital to determine that diagnosis. In a legal deposition for monetary relief for the asbestos-caused condition an attorney representing the defendant asked what Dr. So-and-so did for you.My father-in-law responded during the day many physicians would poke their heads in the door or peek at the charts, ask how he was doing and they would bill Medicare and his retiree insurance for the five minute question.Thus, the cash cow that adults and seniors have become for the for-profit medical service industry that has been created.

53

Rachel (SoCal)

Some of these hospitals are non profit and fundraise for childrens care. Time for the IRS to step in and enforce their status or revoke it.Non profits must serve a public good so if these hospitals are shifting focus to profit then they need to be taxed on it.We need to demand that the new funding for the IRS puts a team of auditors on these hospitals. This is wrong on so many levels.

55

J. (Here and There)

This article is the best indictment I have seen of the American medical system. It’s not “health care”; it’s a business model to extract profit from peoples’ misery and misfortune, and profit to be made to benefit investors, top execs, private equity and other stakeholders in the delivery of medical care to people. It the Republican Party cares so much about life, why don’t they care that pediatric care is non-existent in parts of our nation? If hospitals are closing pediatric units for more profitable enterprises, why not strip their so-called non-profit status and tax them? Why on earth are we not doing what every advanced country does and transition to a form of universal health care? I raised a family in a country that had universal health care and it was far better, more accessible, and more affordable than on this country. If only people here truly knew the bill of goods we have been sold in order to enrich profiteering at the expense of every American’s health.

179

Nurse Eddy (Miami)

I laugh out loud when someone tells me the US has the best health care system in the world. I ask them if they read the report on Medicare Advantage plans which are worse than medicare and have a history of charging the gov for tests the patient didn't need or didn't receive.Did they ask their GP how many minutes their insurance company allows the Doc to spend with each patient? 12 minutes is the average I hear.Did they read where republicans voted AGAINST Biden's plan to lower prescription drugs because they are so beholden to campaign contributions? Did they ask why Americans pay more for insulin that anywhere else in this world?Lying and deceptive ads have risen to an art form. It's not just Trump and his Magas.

381

Cowboy Marine (Colorado Trails)

When will the majority of Americans clue-in to the fact that the whole point of this country has become to make the 1% richer?

151

BG (Texas)

The US has the most profit-driven healthcare in the world, and the most expensive with not so good healthcare for many people. Those with top-notch insurance and the wealthy elite get some of the best care in the world. Those without such connections get their medical decisions made by insurance executives looking to drive profits, not doctors. I have a young friend who absolutely would be dead now if she had lived in a red state like Alabama or Mississippi or any one other several states with poor healthcare for the masses. But she had the resources and connections to get into a federal trial program that saved her life. The majority of us must make do with profit-driven healthcare. Why do we tolerate this? Is it so important for us to fund the excess profits of the insurance and drug industry? Of the Catholic and other nonprofit hospitals that refuse medical services to the public yet get to take taxpayers’ money for providing medical care. It’s long past time to try universal healthcare by expanding to Medicare for All. Other less rich countries can afford better, less expensive healthcare. The US can too. We jus need to stop using our money to pay for profits for private industry instead of medical care for everyone.

43

Trudy (Wexford, PA)

This first article I read is so depressing, I cannot read another one. Be aware the excising of health care and health facilities has been ongoing for decades. It started with a call to get healthcare under control. Standards for review of healthcare were devised and organizations were created to monitor cost and care while improving health care. Noble goals that soon were pared down. My first experience with the standards was over 45 years ago when I was discharged with a three day old newborn after a difficult delivery. I was barely able to walk or care for myself. Luckily, I had help from my mother and MIL. Five years later, with 2 toddlers at home, an emergency C-sanction, and both mother and MIL deceased, the three days was an “unnecessary luxury” that staff - not my own ObGyn - admonished me about. This does not compare to the mental anguish alluded to or the physical suffering of ill children and their parents as described in this article. Rather, it is a warning that there is more disruption in the pipeline. Telehealth has a place but it is being touted as the same as seeing a physician. Nurse practitioners are gate keepers even for highly specialized doctors. Now “neighborhood hospitals” are cropping up. Promoted by out of state monies, using the logo of local health organizations, the medical officer checks in with the patient while sitting in the mid-West. NYT - do not let this be a solitary story. Investigate the healthcare systems!

39

sob (boston)

Parents move all the time to seek what is best for their kids, be it better education, safety, neighborhood or healthcare. We are not able to give the high level of medical support for all patients all the time in every location in the country. Time to rethink the costs and common wisdom of what is reasonable and cost effective.

6

LS (Austin, TX)

Most if not all of the hospitals named in this article have non-profit status. Strip these "non-profits" of their non-profit status since clearly they are making profit oriented decisions when they decide to close children's units. The moment they face paying property tax versus having a children's unit they will relent. It is insane that a hospital named "Children's Hospital" would eliminate their children's beds in favor of adults and that the county in which they are operating would allow them to continue their non-profit status.

165

Dan (Southwestern, Ut)

First do no harm. Part of the oath physicians take.But, in these days of seeking the most profit at the least cost, or, profiting from those who are “gold mines”-the adult and senior-the temptation and profits cannot be dismissed (I’m a relatively healthy 73 year old so the hospitals won’t make much from me).My wife and our daughter both worked in a children’s hospital and were proud of the service they provided to the children-a vulnerable segment of our society.But, in the quest for the dollar at the expense of the public the dollar will always win.

23

LG (NYC)

As a pediatrician, I support children’s hospitals and specialized centers that really know what they are doing. Distance is a problem in rural areas, so outreach and satellites are a must. Many places just call any pediatric unit a “Children’s Hospital” so one should check out the institution including such things as medical school affiliation for the best care for any child with complex medical needs.I realize that many cannot relocate easily for economic and social reasons., but parents of a child with major medical needs should try to live nearer specialized medical centers.Having trouble understanding why a medically fragile child would have had covid four times? Did the family make an attempt to adhere to mask and all other preventive requirements? Yes, the vaccine does not work as well in the immunocompromised but it does still have some value. Advances in asthma care have made it now uncommon for children with asthma to be frequently hospitalized, if his care optimized. Sorry, something off about this BTW I am not personally familiar with the Children’s Hospital at St Francis, but it seems has much more to offer for pediatrics than Ascension Medical Center. Oklahoma Children’s Hospital has an excellent reputation, and is only about an hour away. The family should really consider connecting with OCH- sounds like little Lachlan needs better care.

83

JenD (NJ)

The idea of pediatric specialty hospitals shutting down their inpatient units makes my head spin. It sounds like something I would read in The Onion. But it is horribly true.

27

Zoomie (Houston)

One thing to keep in mind, for a period of two years, most of these inpatient units were significantly underutilized because children were home, masked-up and not getting sick at nearly historical norms. Coupled with financially-strapped hospitals who were short-staffed, cutting back on underutilized hospital services most likely made a lot of sense. Not excusing it but I am just adding a perspective that the article omits.

11

Edward B. Blau (Wisconsin)

When I practiced subspecialty pediatrics in sparsely populated central Wisconsin, my patients often had to travel three hours to see me.But there are two sides to this coin, the results of any patient-physician contact often depend on the experience of the physician. How many patients with these complaints or this illness has he or she seen and treated?Another problem is the birth rate is decreasing and in many areas, young people leave for metro areas for work and amenities further decreasing the number of children in the area.In Wisconsin, the Republican legislature has repeatedly refused to expand Medicaid despite the Federal government subsidizing over 90% of the cost.I believe every person deserves affordable, quality health insurance. But if it is completely funded by government taxes then funding is dependent on the will of the governing party.In England, the Conservatives have bled the NHS dry hoping to push people into privately funded health insurance.Is there one cogent person who does not think Republicans here would do the same thing?

60

Daren Connor (Portland)

Yet another distortion introduced by the complex/bewildering healthcare system that we find ourselves trapped in, feeling evermore like quicksand (or a tar pit - pick your analogy).

12

The Littlest Who (Whoville)

Tufts Children’s Hospital closed down it pediatric unit?Hmmm. What is a children’s hospital without a pediatric unit? We have entered an absurdist world.I am reminded of a headline about the American economy as a whole. Something like: Americans are suffering in this economy but the health of the the American Economy is strong.So, the absurdity. What good is the economic health of a hospital, or the economic health of a nation , if those who are supposedly served by the hospital or nation, do not benefit? Or worse, made to suffer more?If the pandemic—- the world shutting down— did not center us on what is important as a community and as a nation, I do not know what it will take.

37

AnObserver (Upstate NY)

The notion of "for profit" medicine guarantees people will die. A few years ago there was a plague of small hospital closures in rural America forcing people to drive for hours to find an ER. Now we're seeing children being abandoned because they're not as profitable to serve. If that is not a clear indicator of an utterly broken system I don't know what is.

74

dlb (washington, d.c.)

The Greatest Generation has faded away and left us without values of decency, ethics, or integrity. Woe is America, sliding further and further downhill.

29

Eve (Chicago)

Let's all take a moment to reread Article 25 of the Universal Declaration of Human Rights (to which the United States is a signatory) and contemplate the ways in which this country has been violating it for decades.

23

Paul Miles (Akron Ohio)

Weird, the childrens healthcare systems here in Ohio can’t seem to stop growing. Akron Childrens in NE Ohio and Nationwide childrens in central Ohio have been building and acquiring continuously for the last 10 years. I don’t know how many inpatient beds they have but the buildings are massive and everywhere. This article touches on something I have been saying for years- people with complex medical needs should not be living in rural areas far away from the services they need to survive. No matter a child or an adult. There has never been adequate access to medical specialists in rural areas.BTW how does a medically fragile kid get Covid 4 times? There is no reason that should happen.

51

Susan (NH)

Another sign of the “quiet” war on children in this country-reducing access to food, quality education, clean air and water, safety from guns and healthcare.This is a nightmare for chronically ill children and their parents.As a chronically ill child myself I was saved by our local hospital many years ago. I can’t imagine the alternative.A just, moral society puts its children first.

110

Publius (USA)

Thanks Biden, Hilary, and GOP voters. Here’s what you get every time you believe the lies that we don’t deserve a nationalized healthcare system that puts people before profits. Lachlan’s suffering is on your hands.

11

Socrates (Downtown Verona, NJ)

The United $tate$ of Greed treats humans as profit centers, not as human beings, thanks largely to 'free-market' Robber Baron extremists who peddle the claptrap that healthcare is a consumer good...as opposed to a basic human right.The USA's 17% of GDP corporate healthcare rip-off system is one of the greatest economic crimes against humanity.Take a bow, Republican Party; you built this, sustained it and refuse to reform it or bulldoze it.And Americans continue to suffer and die from it.

199

Blue Danube (Florida)

Oklahoma is a deep red state with Republican leadership successfully selling booth straps in lieu of a safety net FOR YEARS. I don’t know what to tell you, kid other than ask your parents and their friends why they vote the way they do.

72

Pat (Cleveland OH)

47

David in Le Marche (Italy)

I can hardly bear to read this article. Oh, of course, what could be more normal than hospitals letting children like poor Lachlan die so they can make more money treating old folks in need of expensive interventions and tests. Only in the USA.This is the NYT, so I assume the facts here are basically true, but this situation or tendency or cold, hard, economically practical choice or whatever the hell this is is a total obscenity. Thank you Obama for giving it a try and making the US healthcare system the subject of political conversation. And thank you Joe Biden for at least trying to improve the still inadequate care provided by the ACA, Medicare, Medicaid etc. Thanks, even, to the Clintons for trying, and big thanks to Bernie Sanders for having forever fought for universal, single payer health care of the sort every other rich (and some not so rich) country enjoys and would not trade for ours even if we paid them. We do this to ourselves because there is really something wrong with us, I think.

232

Kathy May (New Jersey)

Another example of how "valuable" our children are to us. Keep having those babies.

139

Mi (Mi)

This is what happens when kids are trained to. E leaders and go to Ivy League universities. They lose humanity! Let’s educate our kids to put people over profits! Sorry to say but our country is on the decline!

8

Nmtm (Battle Creek)

My grand child less than a year old fell resulting in a head injury. She was transported by ambulance to the local Acsension hospital. Diagnosed with a fractured scull, but with no pediatric unit, she had to be transported by ambulance to the next Ascension hospital 40 miles away. However, there weren’t enough pediatric transport ambulances so she had to wait until higher priority pediatric patients were transported before she was transferred. She was injured at 6:00 pm, didn’t get to the pediatric unit 40 miles away until 3;00 am. Profit over care. Thank goodness she was ok, but head injuries need immediate treatment, not 9 hours waiting in an ER without appropriate care. Health care and capitalism do not mix.

205

Michael Branagan (Silver Spring, MD)

Smart move by hospitals: Future sick adults, more lucrative. Of course the real sick adults in this case are the ones shutting down the pediatric wards.

14

Socrates (Downtown Verona, NJ)

"suffer little children"The USA's radical, faux-religious, oligarchic Republican right-wing enjoys another day at its corporate, 'for-profit' healthcare rip-off office denying healthcare to millions while worshiping the God of Mammon.This wouldn't happen in a civilized country, but thanks to the USA's 'free-market' healthcare national disorder, healthcare is a luxury consumer product, not a basic human right.Thanks, Greed Over People party....and thanks, faux-Christian voters who religiously support this medical misanthropy.

315

Deborah Duerr (Ewing, NJ)

Don't you just love our capitalistic, for-profit healthcare system? Another demonstration of how much America really cares about its children.

33

Outer Space (New YorK)

Thank god - children grow ultimately out of childhood. Someone told me I must not have children in the United States.

6

Donna Williams (South of Boston, MA)

It's a bad idea to shout at the doctor who is trying to help you.

16

Socrates (Downtown Verona, NJ)

The greatest 'for-profit' healthcare corporate rip-off system in the world enjoys another day denying healthcare to Americans in need.And guess which states still have not expanded Medicaid under the ACA to give their citizens a chance at getting healthcare ??Alabama, Florida, Georgia, Kansas, Mississippi, North Carolina, South Carolina, South Dakota, Tennessee, Texas, Wisconsin, and Wyoming......and Oklahoma only implemented last year after years of screaming against it....they are all Republican faux-Christian states.Thanks, Greed Over People party.

129

California (California)

We have had to make use of pediatric hospital units. They are invaluable. There needs to be intervention before such units are cut. Leaving health care to profit motive is disgusting.

8

Newton Guy (Newton, MA)

For-profit healthcare makes as little sense for a civilized society as electing judges.

6

MDMD (Baltimore, Md)

This is a county of huge wealth and resources. We can give adequate support to our small citizens who need help. WE simply must redistribute the wealth sequestered by the greedy 1%. I have come to believe much of our social unrest is due to this cause. The ultra-wealthy with their disgusting life style (just look at ads in the Wall Street Journal) must start to pay their fair share. But they are clever: turning the poorly educated and undiscerning into their foot soldiers, yowling for "freedom" under the leadership of Trump and his ilk. At some point, they will break the camel's back and just blast off in their spaceships.

14

Let's get real (OK)

Thank you President Reagan for initiating the USA's now ever-expanding drive to increase profitability and privatize essential services, both at the expense of the public. The program you promulgated was nick-named 'Trickle down economics' (properly supplyside). Our economy has been trickling down since you began this economic approach and now we are about out of 'trickle' .

46

ma77hew (America)

An example of Capitalism working perfectly.Profits over children’s lives.In the supposed wealthiest country in the world…..We will end capitalism or it will end us.

36

CV Danes (Upstate NY)

This is what happens when the MBAs take charge.

73

JHM (UK)

Very sad state of affairs. I hope this changes, or perhaps they can move to a more "dare I say, liberal" state. Children must be cared for.

9

Richard Waugaman, M.D. (Potomac, MD)

This is what we get for allowing greedy corporations to take over our hospitals. Most hospitals used to be non-profits that put patient care over revenue.

57

hen3ry (Westchester, NY)

Profit is more important than care. If it wasn't clear before, Lachlan's story makes it crystal clear. In addition to the normal worries that accompany a child's illness the family has to worry about being able to get the appropriate care soon enough because hospitals are doing the no-brainer and closing pediatric units. Calling it the profit motive is kind. It's crass and cruel.

19

Bleex (7th House On The Right)

I had no idea about the extent of pediatric closures. Best wishes to Lachlan, mentioned here, and all the others affected. Parents must be beyond frustrated.

10

Brian Jackson (London)

Colossal failure of leadership on the part of health care executives. Healthcare does not exist to make money; it exists to take care of people. The CEOs and boards of the hospitals mentioned in this article are ignoring their community mandates and have no business running these institutions.

21

Storms01 (Lebanon, PA)

American health care will not be fixed until profit is removed from the system. Health care is a necessity, and should not be run as a greed riven profit center.

122

Anon (NJ)

As a parent, this is truly frightening. Healthcare in this country is just so unbearably broken. Any efforts to fix it are stymied in Congress. I had a strong conviction in my youth that ordinary people could fight to fix things but lately I am just not so sure.

40

Jeff and Mary (Needham, MA)

A few observations from as retired doctor...1. In the US, we staff and plan hospital capacity to average, not to peak use. 2. We do not plan for surges, with extra capacity, because that fallow infrastructure does not earn revenue.3. We do not staff for surges, either with extra people on call, or with a plan to reduce elective care in order to accommodate the urgent/emergency care. That would cost too much revenue.4. States, the Feds, even cities are incompetent to calculate the optimal numbers of beds to serve their populations, and government can't force private or independent charitable hospitals to work in a plan to provide for regional bed needs. 5. Once a service or inpatient unit, especially an expensive one (like a pediatric ICU) is lost, it is never regained. It is very difficult to restore the people to staff such a unit, especially the physicians.6. Hospital administrators are generally the last people to realize that their cuts to services are irreversible, lead to physician and nurse burnout, and are disastrous to the region they serve.

575

KMC (Down The Shore)

Medicine was once a profession and a calling that existed to serve the community and the individual patients. Hospitals were run by medical professionals dedicated to that mission. Hospitals are now nothing more than avaricious businesses run by management who need not have medical backgrounds with the sole goal of maximizing profits and increasing the bottom line. Some are now for profit corporations while others remain nonprofit entities but that status is a fiction. This situation is intolerable and exposes us for the craven society we have become. If we cannot solve this problem and quickly our future will be as bleak as the most dystopian fiction imaginable.

245

Lenny-t (Vermont)

“… Adult beds are more lucrative than children’s beds. So as institutions look to boost profit margins, pediatrics are often among the first services to be cut.”This tells me everything I need to know about the American health system.

714

Cassandra (Troy)

Story tip, NYT: It’s not just pediatric care that’s being thrown under the bus to make a buck. My physician brother here in New England is medical director for several nursing homes. He is paid by a large regional healthcare system. They just shuttered all geriatric care offered in the nursing home. That is, if Grandma is needs a physician while in the facility (which, by definition she does), there isn’t one anymore. Not cost effective. More appallingly, the healthcare system was pulling the plug on medical care without informing the patients or their families, which I believe isn’t legal (under Medicare?). Time for national healthcare.

441

Lisashap (MD)

So, this is the conflict when our healthcare system is based on for profit companies. Money will always win. At some point we need to face this fact and we need to ask ourselves if this is what we want. Of course, most people only want something different when they themselves have to suffer. We have lost our ability to empathize with others and to make choices for the greater good. At the very least we should decouple healthcare from employment, so people have more choices about where to work and are not staying in a dead-end job just because of the healthcare. We are now dealing with profit conflicts in our for-profit hospitals and practices, and religious conflicts in our religious based hospitals and practices so much so that I think we can say we are not really getting the healthcare we need or want. This must change.

97

John Lipkin (Eugene)

Too many managers focused on the bottom line. Too much management by spreadsheet. Not enough attention to community needs. Pediatrics, psychiatry, are early casualties.. A for profit system pays attention to cash flow. A universal healthcare system could pay attention to patient flow..and need locally.

86

CYin (Malaysia)

It's simple, healthcare in the US has always been running on a for-profit model. We need to change that on a national level.

235

Vicky (South Dakota)

Yes. No wonder it's called the health care "industry," as if patients are commodities. I'm shocked about Shriners. Their TV advertising paints a very different picture.

74

renee (New Paltz)

Health care in this country is ridden with financial issues causing the difficulty described in this article. Bottom line concerns deserve consideration, but our policies are not addressing them with any plan to ameliorate them. I have found information regarding private equities investing in health care, thereby increasing privatization of traditional medicare. Most people are unaware of why medicare advantage is a bad bet for the future of health care. I live in New York and advocate for the New York Health Act - at least my state might have universal health care. National universal health care is a pipe dream.

19

Archer Crosley (McAllen, TX)

Healthcare is a profession, not a business. When we understand that and insist upon that, then we can begin to rein in the runaway and misguided policies of the MBAs who increasingly run hospitals and other healthcare organizations.

109

KC (DC)

This is absolutely atrocious and exactly why we need to break up big medicine and go to universal healthcare. Healthcare should never have been a for-profit industry and it’s obvious that monopolization of practices and hospitals across the country has lowered the quality of care while increasing costs and now it is literally putting our lives and our children’s lives at risk. When will we say we’ve had enough of this race to the bottom?

735