To the editors:

As an African-American physician providing care in a Chicago inner-city emergency department, I was heartened to see your focus on the critical condition of an urban hospital [Neighborhood News, August 24]. However, the article may mislead many to wistfully shake their heads at yet another source of malaise affecting only the not-so-fortunate of our cities.

Indeed, though they are the most profound examples, the problem stems far beyond the “poor” and those suffering the ravages of crack: the “working poor,” the recently laid-off, the young underinsured, the aged, and the future wave of the baby-boom elderly.

While federal and state governments are desperately seeking to trim already inadequate health care reimbursements, the nearly 50 million Americans with little or no health care insurance will flock from urban hospitals which are closing, one-by- one, into facilities which serve the more fortunate. Their portal of entry will likely be the emergency department, which is the only entity mandated by federal law to provide care to all who need it.

Perhaps the most frightening and eerily prophetic quotation warns of a future with “no hospitals south of Northwestern to the city limits.” I hope that the Reader will choose to look at the health care crisis in a way that explores meaningful alternatives, than to simply propose as an “obvious solution” the troubled Canadian health care system.

Neil E. Winston, MD


Emergency Medical Services

Jackson Park Hospital & Medical Center