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Case study: Detroit med school carries $50M/year in uncompensated care

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Wayne State University
urban medical center
uncompensated care
Medicaid
Indigent Care
Detroit Medical Center
Affordable Care
academic medical centers

If you're an urban medical school, you expect to care for a high volume of the city's struggling poor and uninsured patients. That's particularly true in Detroit, where Wayne State University cares for 70 percent of the city's estimated 200,000 residents. About 750 Wayne State University Medical School physicians take care of these patients, whose numbers continue to grow as cuts continue among the city's manufacturing, auto and other industries.

All told, roughly 75 percent of doctors treated at academic medical centers are uninsured or underinsured, according to Wayne State's assistant dean of Community and Urban Health. The school puts the cost of uncompensated care--including free care provided by doctors and care for which they haven't been paid--at about $50 million per year. Not only is Wayne State struggling, Detroit Medical Center is suffering financially too. DMC, an eight-hospital system, gives about $200 million in uncompensated care each year in Detroit, including care for more Medicaid patients than any other hospital or group of hospitals in the state.

While the city does pay for some indigent care, through its three primary care facilities and three specialty clinics, its funding is scarce, limiting its ability to help poor patients avoid expensive ED care, and some care is covered by the Voices of Detroit Initiative. But otherwise, many of the urban poor are left to rely on a system that may not be there forever to support them.

To learn more about Wayne State:
- read this Chicago Tribune piece

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Chicago hospitals steer uninsured to affordable care

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Only after our healthcare system crumbles, as our financial system has crumbled, will the government step in and begin infusing the funds and other resources needed to fix a broken system. A system that unethically and immorally exploits doctors-in-training. Our society has much to learn.

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