Overview

America’s safety net health system is made up of public and teaching hospitals and their innovative primary and specialty care clinics. Widely known for safeguarding the health of all regardless of ability to pay, safety net systems know how to provide coverage, access to quality care and value to individuals and society.

Safety net health systems are always there for everyone in need—whether it is the uninsured or underinsured, or every one of us who may be in need of critical care through burn units, trauma care, and neonatal services.

But in times of economic hardship, safety net hospitals become even more critical. America’s crippled economy is threatening the health care of millions—those who are unemployed and cannot afford COBRA payments, those who have lost their health insurance, and those who have insurance but cannot afford ever increasing out of pocket expenses. Consider that during the last economic downturn, which was not nearly as severe as our current one—the ranks of the uninsured increased by 6.5 million. Many of those people were able to get needed health care only through safety net health systems. In April 2009, the Federal Reserve Board of Governors projected that the economy could shrink by 1.3 to 2.0 percent in 2009 (using a fourth quarter to fourth quarter comparison) and that unemployment could soar to anywhere between 9.2 and 9.6 percent thus increasing the ranks of the uninsured, those served most by safety net health systems.

As providers of universal access, we know the great potential of providing universal coverage through health care reform.  With the support of policymakers, safety net health systems will continue to provide universal access to the uninsured and underinsured until and after they can be brought into the general health care system. If and when universal coverage is a reality, America’s safety net health systems will become a critical partner in improving health outcomes for at-risk populations and economic value for society. As the health care providers with the strongest relationships with at-risk individuals and communities, safety net health systems will serve as an essential conduit for enrolling individuals in coverage, educating them on how to effectively use the benefits to manage their health, and teaching other providers about the special steps necessary to provide care to populations that have significant economic and social challenges beyond a lack of access to health insurance.

This is the story of America’s safety net health systems, the communities we seek to keep healthy and productive, the patients we serve and the comprehensive and high quality care we provide to all.