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Caring for the Uninsured in New York |
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This paper estimates the costs of uncompensated care in New York during 2005, along with the governmental revenues meant to offset those costs. The first uses cost reports from hospitals and diagnostic and treatment centers in New York, budget figures for the U.S. Department of Veterans Affairs and the Indian Health Service, and physician survey data to provide an estimate of the amount of uncompensated care reported by providers. In the second, we use household survey data to provide an alternative estimate based on the amount of uncompensated care reported by the uninsured themselves. The final section examines governmental sources of payments for uncompensated care. State and local funding comes through state bad debt and charity care pools, several Medicaid disproportionate share hospital (DSH) and upper payment limit (UPL) programs (with local share for local public hospitals), state public health grants, and direct local support for public hospitals. New York State's medical providers spent an estimated $2.8 billion last year providing care to 2.5 million uninsured people. Hospitals provided $1.8 billion of this care and physicians accounted for $412 million. The rest came from health centers, U.S. Department of Veterans Affairs facilities, and the federal Indian Health Service. Seventy-two percent of the uncompensated care in hospitals occurred in New York City, home to 1.6 million uninsured adults and children. The costs of uninsurance are a social burden that would be alleviated, but not ended, by universal coverage. Some support for uncompensated care will continue to be needed even under universal coverage.
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