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There is reality behind it though. I don’t know anything about NYC, but Cook County is a complete public health system with clinics and a lot of offerings. Optimally, most counties should have a county health department, but some states have cut them back drastically. When I worked for a state department of health, there was a scandal because they had dramatically cut back services at the same time we were having an increase in HIV and TB cases. I had a family member who worked part time as a provider at a clinic who was let go.
It's been the same formula since the early 1960s. Dr. Kildare is set at Blair General Hospital but has a picture of Los Angeles County Hospital and Ben Casey another TV show is set at County General Hospital.
The tension, drama, and friction between learning and teaching in a large hospital brings all that drama together. It's a proven formula. Patients perceive that care to be free. They seek all of their treatment at ERs.
There was a patient walking into the laboratory for a urine pregnancy test. We asked for a doctor's order or prescription and they didn't have any. Our policy at the time from Risk Management was that we would need an order from a doctor for any tests whether it is a waived test or not. I told them we could not do it and suggested they go to any drug store and buy one themselves and they said that they were told it was free and didn't need to pay for it. We sent them to the clinic.
Community clinics were set up to lower the burden at hospitals and they are and were sliding scale payments.
As far as cutbacks go then look at all of the mental health cutbacks and many people that were in mental health units ended up flooding the jails. They essentially transferred the cost and made it a crime to be mentally ill.
County (Public) hospitals are hospitals set up with government funds to serve the underprivileged mainly those without insurance and on Medicaid. Anyone can use the hospital so it isn't exclusive to them but they are the default hospital for those who can not pay and are subsidized by government. Most are associated with medical schools and so it is a heavy teaching setting.
Some of the challenges of county hospitals are noted in the link below.
OK, that makes sense. So this kind of hospital has "county" in the name? Otherwise, how would you know?
After I wrote this OP, I remembered I was in Chapman Hospital in Orange, CA in the late 70s. We were self-employed making good money and uninsured (being so young, never gave it a thought). A social worker came around (broken ankle) and asked if we had insurance. I said "no, I'll just pay". But she said, "We have a system for uninsured, so you won't have to pay". I was stunned. We weren't destitute at all. I guess this was Medi-Cal, or was this a "public hospital"?
I would say it was a California thing, but 10 years ago I had a kidney stone in CA and it would have killed me without treatment (said the urologist) but San Clemente Hospital would not admit me without running 2 credit cards for a down payment, then we had to pay an enormous amount. Guessing it was not a "public" hospital.
OK, that makes sense. So this kind of hospital has "county" in the name? Otherwise, how would you know?
After I wrote this OP, I remembered I was in Chapman Hospital in Orange, CA in the late 70s. We were self-employed making good money and uninsured (being so young, never gave it a thought). A social worker came around (broken ankle) and asked if we had insurance. I said "no, I'll just pay". But she said, "We have a system for uninsured, so you won't have to pay". I was stunned. We weren't destitute at all. I guess this was Medi-Cal, or was this a "public hospital"?
I would say it was a California thing, but 10 years ago I had a kidney stone in CA and it would have killed me without treatment (said the urologist) but San Clemente Hospital would not admit me without running 2 credit cards for a down payment, then we had to pay an enormous amount. Guessing it was not a "public" hospital.
My take which is solely my opinion is that public vs private hospitals is one where private implies privately owned and has no contractual relationships with government to provide care for indigents via MediCaid programs like Medi-Cal. Just about all will accept Medicare patients but those are both optional if one is talking about private hospitals or institutions. At one point, and I don't know if it's still true that Mayo Clinic was rejecting Medicare patient.
Public hospitals are owned by government usually municipal like NYC Healthcare or the state. They also get state and federal money. Since they get that money then people assume it's free care. People who don't have money are channeled there into those systems set up by city and or state governments.
California has 24 public healthcare systems. These are county-affiliated systems and five University affiliated medical centers.
For Orange County I see only UCI as being government-owned. I see Chapman Global as being proprietary owned meaning privately owned.
Apart from actual specific hospital systems there are programs and resources that one can apply for to pay for hospital bills if they ended up in a private hospital. Those funds are made available for people usually through government programs.
Don't hold me to any of this as like I said that is my understanding.
I just love this Netflix series and they reveal some hard truths about medical costs in it.
Of course, I know the hospital is fictional, but several times it is alluded to as being a "public" hospital where people can get treatment for "free" but no one realizes they don't have to actually pay. It's like a secret.
Are there public hospitals like this? In the U.S., I never heard of one.
My area has what we call "the charity hospital." It's mainly where people on Medicaid go, although Medicaid patients are accepted elsewhere, too, maybe only when the Charity Hospital doesn't perform those services. I'm not sure.
Probably some (many?) areas don't have a separate hospital for those on medical aid, preferring instead to mix them in with other types of patients at the other hospitals. Or maybe our state funds "charity" hospitals, whereas most states do not? Not sure.
OK, that makes sense. So this kind of hospital has "county" in the name? Otherwise, how would you know?
After I wrote this OP, I remembered I was in Chapman Hospital in Orange, CA in the late 70s. We were self-employed making good money and uninsured (being so young, never gave it a thought). A social worker came around (broken ankle) and asked if we had insurance. I said "no, I'll just pay". But she said, "We have a system for uninsured, so you won't have to pay". I was stunned. We weren't destitute at all. I guess this was Medi-Cal, or was this a "public hospital"?
I would say it was a California thing, but 10 years ago I had a kidney stone in CA and it would have killed me without treatment (said the urologist) but San Clemente Hospital would not admit me without running 2 credit cards for a down payment, then we had to pay an enormous amount. Guessing it was not a "public" hospital.
It is usually what is called a “safety net” hospital and gets much of money through government subsidies. As MLG pointed out, this can be a county/city operated hospital or a university system. Chicago’s county hospitals are actually called Stroger and Provident, but many nonprofit hospitals also provide charity care. For example, I think that University of Chicago is the trauma center for the south side. I think it only recently added one and until then, the south side was largely a desert for people who needed trauma care. A lot of hospitals in the south part of chicago and suburbs have either shut down or drastically reduced services over the years. Cook County converted one south suburb hospital into a clinic about 10 years ago and now I think it’s closed down entirely. I think the one main hospital in that area now is operated by U of C.
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