Whether it's Dallas, Detroit or another city with a smoldering healthcare crisis, the scenario is pretty much the same: The safety net has enough holes to jeopardize the financial health of urban hospitals and clinics serving large numbers of poor people.
Despite the robust economy, the ranks of uninsured Americans continue to soar. Many of the uninsured depend on inner-city hospitals for free or discounted care. At the same time, stingy managed-care contracts and government reimbursement restraints have left many urban providers with little room to maneuver.
The Institute of Medicine has offered a relief plan. The IOM has asked lawmakers to create a competitive grant fund that would distribute $2.5 billion during five years to qualified providers. Applicants would have to demonstrate need and a commitment to caring for indigent patients. The federal budget surplus and unspent cash from the Children's Health Insurance Program would help fund the program.
An attractive feature of the proposal is the creation of an independent oversight committee to assess the health needs of the uninsured and evaluate the financial condition of safety-net programs.
Most policymakers and provider groups have concluded that the uninsured problem requires attention. The IOM plan is a good place to start.