title: Strengthening the safety net.
abstract: If you've ever built a house of cards or played a game of Jenga, you know how quickly an ill-timed move can destroy your goal of maintaining equilibrium. The consequence of upsetting one piece of the whole is a common metaphor many safety net providers use to help other healthcare organizations understand their role in the system. The fiscal and physical pressure on just one safety net provider can create a dangerous ripple effect in a community, threatening the stability of other area providers and access to care for the patients they serve. "We have created a complicated tension within our healthcare system," says Stuart H. Altman, Ph.D., HFACHE, professor, National Health Policy, at Brandeis University in Waltham, MA. "If any single major sector of the system is out of balance, the others will be affected in a very negative way." Depending (in part) on geography as well as local and state politics, the fate of "non"-safety net providers can hinge on the success of those organizations whose primary mission is to provide indigent care. "If the safety net fails, the whole healthcare system could potentially collapse because the remaining providers simply cannot handle all of the demand," says C. Duane Dauner, FACHE, president of the California Healthcare Association in Sacramento. The current situations in Washington, D.C., Dallas, and several California counties illustrate this domino effect Dauner describes.
authors.forename: Ellen Lanser
authors.initials: EL
authors.lastname: May
mesh_terms: D003299:Cooperative Behavior; D006297:Health Services Accessibility; D006769:Hospitals, General / Q000191:economics / Q000458:organization & administration*; D007591:Joint Commission on Accreditation of Healthcare Organizations; D017057:Medically Uninsured; D017149:Private Sector; D011640:Public Policy; D017150:Public Sector; D014481:United States