The recently released videotape of a woman being ignored while she died on the floor of Kings County Hospital is the kind of heartbreaking, graphic, “smoking-gun” evidence that forces the vast problem of medical neglect into our consciousness, but it is far from surprising in view of the past history of Kings County Hospital and it is far from unique to that hospital. Decades ago, when I first visited Kings County Hospital, it was already ancient and decrepit. At the time, I took in the sights and sounds and smells through the filter of thinking about it as the place where the great Woody Guthrie had first been institutionalized in the throes of his alcoholism and Huntington’s, and where the infamous Son-of-Sam, David Berkowitz, had more recently been locked up and evaluated. It was a place that had contained giants of good and evil.
Kings County is one New York’s municipal hospitals. One of hospitals that primarily serves America’s poor, who cannot afford better care. People who have money or health care coverage typically know to go someplace else. In fact, Doctors at Kings County Hospital have been accused of sending potentially paying patients across the street to a University affiliated hospital. They have been accused of doing so because they can do the same procedures on the same patients at another hospital and make much more money, but doctors have claimed that they do so because there is a better standard of care in the other hospital. Ten years ago, HCFA the U.S. Health Care Financing Administration noted serious problems in emergency care, suggesting that the hospital failed ”to provide appropriate medical screening” and that there was ”a delay in examination or treatment in order to inquire about payment status.” (Quote from HCFA Letter in New York Times). According to Wikipedia, Kings County Hospital is involved one-third of all malpractice awards and settlements from the eleven city hospitals. So this particular current tragedy is not entirely unexpected.
However, there are hundreds of hospitals in which these kinds of tragedies can and do occur. These hospitals attempt to provide a minimal level of care to people who can’t afford anything better. Of course, the individuals directly involved have direct responsibility, but unless the system that makes these tragedies inevitable is changed, lots people will continue to suffer and die without getting help, and every once in a while one will show up on videotape.