Community needs vs. hospital profits

May 18, 1993

North Arundel Hospital puts out press release after press release proclaiming its "commitment to the needs of the community." Yet on June 1, NAH will deep-six one of the health services the community needs most: a detoxification unit for drug addicts.

The reason is money.

The 12-bed program has been losing money for years, and will cost $1.5 million this year. NAH says it can't afford it, even though detox is the only service at the hospital that doesn't turn a profit.

So what happens to the 100 to 120 addicts NAH has been treating every month?

The three area hospitals that still have detox centers already have more patients than they can handle. NAH admirably pledges to treat addicts in a regular hospital setting from now on, then refer them to other agencies for help. Still, without the intensive group setting, the chances for recovery -- especially for the most serious addicts -- seem dismal.

Detoxification units are a huge financial burden on hospitals. Detox is expensive, and insurance companies and government Medicaid have become unwilling to pick up the bill. That means the hospitals must, at a cost of $2,000 for each uninsured patient. NAH is not the first hospital to decide it no longer can afford this; at least 16 state-funded or hospital-based clinics have closed in the past two years.

As health costs rise, not every hospital can or should offer every service. Anne Arundel Medical Center, for example, has sound reasons for closing its psychiatric unit: Demand is low, and NAH's psychiatric unit has room for AAMC's patients.

But when a service is desperately needed, the bottom line shouldn't automatically rule. Francis Scott Key Medical Center, Harbor and Mercy hospitals face financial problems from their detox units, too. Eventually, they will have little choice but to raise rates for other patients if the centers are to stay. In the meantime, they have decided the need is so great that they must keep the centers going.

No business can be expected to subsidize any program indefinitely. But NAH is not just a business. It is a hospital, "committed to the needs of the community."

In keeping with that mission -- and since the NAH enjoys a profit -- it should keep as much of the detox center going as it can while working with other health agencies to find a solution to this critical problem.

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