Introduction

New York City is a bustling metropolis known for its diverse population, iconic landmarks, and world - class healthcare facilities. In the complex healthcare landscape of the city, there are five public hospitals that seem to consistently draw attention and perhaps find themselves in certain “lists,” such as the so - called malar bone inward - pushing list. In this article, we will explore these public hospitals in depth, looking at their history, services, challenges, and the role they play in the healthcare ecosystem of New York City.

Overview of New York City's Public Hospital System

New York City's public hospital system is a vital component of the city's healthcare infrastructure. Managed by NYC Health + Hospitals, it consists of 11 hospitals, 29 Gotham Health centers, and 5 long - term care centers (source: Locations - NYC Health + Hospitals). These institutions are united by a common mission: to provide healthcare to everyone who needs it, regardless of their immigration status or ability to pay.

Before the coronavirus pandemic, the system had a total of 3,500 hospital beds, including those in psychiatric units. It also operates five nursing homes, seven diagnostic and treatment centers, and more than 70 community - based health clinics. Additionally, it runs a managed - care program and has its own fleet of 30 ambulances. The system provides healthcare services for the city's jails and operates a clinic for the homeless. All in all, it has 47,000 employees (source: Inside the Public Hospitals Trying to Save New York - The New York Times).

The Five Public Hospitals in Question

While the specific five hospitals on the malar bone inward - pushing list are not clearly defined, we can look at some of the well - known and influential public hospitals in New York City.

Bellevue Hospital Center

Bellevue is New York's first public hospital and, by some accounts, the country's first public hospital. It began life as an almshouse infirmary in the 1730s. It has a long and storied history of dealing with major epidemics and crises. For example, it was soon dealing with a raging yellow - fever epidemic that shut down the entire New York Harbor. Patients arrived in droves by cart and barge, some having been turned away by the city's only private hospital. It grappled with three cholera epidemics in the 1800s and cared for thousands of wounded union soldiers during the Civil War. A century ago, it was stretched beyond capacity by the great influenza epidemic; the staff pulled doors off their hinges to serve as makeshift beds (source: Inside the Public Hospitals Trying to Save New York - The New York Times).

Bellevue created the country's first nursing school, built one of its first maternity wards, and was a pioneer of the modern ambulance service. In the modern era, especially during the COVID - 19 pandemic, it played a crucial role in treating patients. For instance, Amit Uppal, the hospital's director of critical care, was checking on patients in the ICU, and nurses were instructing proning teams on how to flip coronavirus patients onto their stomachs to facilitate breathing.

In the context of the migrant crisis, Bellevue has also been on the front lines. In the past year alone, it has seen one - quarter of the nearly 30,000 visits from undocumented migrants seeking medical care in the city's public hospital system. A taxpayer - funded legal clinic at the hospital, run by the New York Legal Assistance Group, provides legal services to patients, many of whom are migrants in need of asylum applications, work authorization, or help with life - saving medical treatments (source: Inside a New York City hospital on the front lines of the migrant crisis).

Elmhurst Hospital Center

Elmhurst Hospital Center, located in Queens, was one of the hardest - hit hospitals during the COVID - 19 pandemic. Queens has lost several hospitals over the last couple of decades, and Elmhurst and Queens Hospital Center are currently the only public hospitals serving the second - most - populous borough in the city, after Brooklyn. Before the pandemic, Elmhurst's beds were nearly 80 percent full, and it now has just 1.5 hospital beds for every 1,000 residents, compared to more than five in Manhattan (source: Inside the Public Hospitals Trying to Save New York - The New York Times).

The population around Elmhurst is also at high - risk. Many of the residents are undocumented immigrants who share apartments or houses with relatives and friends, and are predominantly Latino. The first surge of coronavirus patients at Elmhurst in the middle of March led to improvisation on the part of the staff. They set up a divider at the entrance to more efficiently sift through the crowds. Medical workers armed with thermometers and oxygen monitors steered people with milder symptoms to a separate treatment tent, while those who were seriously ill went into critical care. Thirteen patients at the hospital died over a 24 - hour stretch during the fourth week in March, and a refrigerated trailer was parked behind the building to store dead bodies.

Kings County Hospital Center

Kings County Hospital Center in Brooklyn has also been a key player in the public healthcare system. During the COVID - 19 pandemic, it closed off five of its eight entrances and carefully screened admissions. No visitors were allowed, though exceptions were made for patients believed to be near death, who were allowed to see one family member and a legal representative. The hospital's director of police, Juan Checo, stated that "Kings County has always been known for its open door; we want to make people feel that they can come to the hospital, but safety and security is our priority right now" (source: Inside the Public Hospitals Trying to Save New York - The New York Times).

The hospital is also dealing with staffing issues. More than a quarter of its security officers were out sick, forcing the hospital to move to 12 - hour shifts from eight - hour ones.

Coney Island Hospital

Coney Island Hospital in Brooklyn has faced a series of challenges. It had to be evacuated during Hurricane Sandy in 2012 and suffered major damage from the storm. A year ago, it broke ground on a new, 11 - story building, but construction has now stopped as the hospital's existing building fills with seriously ill patients. In an effort to “decant” its overcrowded emergency room, the hospital recently put up a large tent outside with the capacity to treat 70 more people infected with the virus (source: Inside the Public Hospitals Trying to Save New York - The New York Times).

Like other hospitals, Coney Island is also struggling with a shortage of respiratory therapists. Joseph Langaman, the assistant director of respiratory care at the hospital, said that there just aren't enough of them to go around, as the number of patients on ventilators has increased significantly.

Lincoln Medical & Mental Health Center

Lincoln Medical & Mental Health Center in the Bronx is another important public hospital. It received some of New York State's first cases from New Rochelle during the COVID - 19 pandemic. Before the pandemic, it rarely ventilated more than 35 or 40 patients at a time, but in recent days, it has had to ventilate nearly 140 at once. The problem, at least for now, is not finding the ventilators but finding the respiratory therapists to intubate patients and monitor them (source: Inside the Public Hospitals Trying to Save New York - The New York Times).

The chief of surgery at Lincoln, Sherry Melton, is running a 24 - hour - a - day command center in a conference room outfitted with computers and whiteboards to manage the flow of patients from the emergency department to the hospital's various ICUs.

Challenges Faced by New York City's Public Hospitals

Funding Issues

New York City's public hospitals are heavily dependent on government funding. The Affordable Care Act, which provided insurance to millions of previously uninsured Americans, also meant that more of their patients could now seek care in private hospitals. This, combined with the whims of politicians and the bottom - line economics of medical care in the country, has made it difficult for public hospitals to continue their operations. Just a few years ago, the system needed a $500 million emergency bailout to stay afloat. Even as the coronavirus was ripping through the city, New York's public hospitals were trying to fight off a potential $400 million cut in Medicaid funding from the state (source: Inside the Public Hospitals Trying to Save New York - The New York Times).

Staffing Shortages

During the COVID - 19 pandemic, hospitals across the city faced severe staffing shortages. For example, at Kings County Hospital Center, more than a quarter of its security officers were out sick. There was also a shortage of respiratory therapists in many hospitals, such as Lincoln Medical & Mental Health Center and Coney Island Hospital. Nurses at some hospitals, including Harlem Hospital Center in Manhattan and Jacobi Medical Center in the Bronx, held demonstrations to protest the shortage of personal protective equipment. The system was asking its workers to do more than could reasonably be expected, with employees being asked to reuse N95 masks for five days at Queens Hospital Center (source: Inside the Public Hospitals Trying to Save New York - The New York Times).

Migrant Crisis

The influx of migrants has placed an enormous strain on the city's public hospital system. In the past year alone, medical centers across the five boroughs have received nearly 30,000 visits from undocumented migrants seeking medical care, according to data from New York City Health + Hospitals. Other social services in the city, such as housing and nutrition programs, are also experiencing rises in demand from the migrant influx. For example, Public Health Solutions, which operates New York State's largest program for women, infant and children nutrition, has had a 30% increase in enrollment due to the large number of newly arrived migrants (source: Inside a New York City hospital on the front lines of the migrant crisis).

Services Provided by Public Hospitals

New York City's public hospitals offer a wide range of services to meet the diverse healthcare needs of the population. These services include emergency care, inpatient and outpatient treatment, specialty care, and preventive care.

Emergency Care

During the COVID - 19 pandemic, the emergency departments of public hospitals were at the forefront of the battle. For example, at Elmhurst Hospital Center, the staff set up innovative screening methods at the entrance to handle the large number of patients arriving with potential COVID - 19 symptoms. At Kings County Hospital Center, the emergency department had to adjust its operations to ensure the safety of patients and staff, including closing off some entrances and carefully screening admissions (source: Inside the Public Hospitals Trying to Save New York - The New York Times).

Specialty Care

Some public hospitals are known for their specialty care services. Bellevue Hospital Center, for example, has a long history of expertise in dealing with infectious diseases and has played a significant role in the treatment of AIDS patients in the past. It also has a well - established psychiatric department, given its historical connection to mental healthcare in the city. Elmhurst Hospital Center provides care to a large and diverse population, including many with complex medical needs due to the high - risk nature of its patient demographic, such as undocumented immigrants with underlying health conditions.

Preventive Care

Through their community - based health clinics, public hospitals in New York City offer preventive care services. These clinics provide vaccinations, health screenings, and education on healthy lifestyle choices. For example, the Gotham Health centers, which are part of the NYC Health + Hospitals system, offer appointments for preventive care services, with various operating hours to accommodate the needs of the community (source: Locations - NYC Health + Hospitals).

Comparison with Private Hospitals in New York City

New York City has a mix of public and private hospitals. While private hospitals like Mount Sinai, New York - Presbyterian Hospital, and NYU - Langone are well - known and have significant resources, public hospitals serve a different but equally important role in the healthcare ecosystem.

Private hospitals often focus on high - end and specialized medical treatments, and they typically serve patients who have private insurance or can afford to pay out - of - pocket. Public hospitals, on the other hand, are more accessible to low - income and uninsured patients, including immigrants. They are committed to providing care to everyone, regardless of their ability to pay. For example, a vast majority of patients in New York's public hospitals are either on Medicaid or uninsured (source: Inside the Public Hospitals Trying to Save New York - The New York Times).

In terms of resources, private hospitals generally have more financial resources and can invest in the latest medical technologies and research. However, public hospitals have the advantage of being deeply embedded in the community, with a long - standing relationship with local residents. They are often the first point of contact for many New Yorkers in times of medical need, especially in lower - income neighborhoods.

The Future of New York City's Public Hospitals

The future of New York City's public hospitals is both challenging and full of opportunities. On one hand, they will continue to face funding challenges, staffing shortages, and the ongoing strain of serving a large and diverse population, including migrants. However, there are also opportunities for improvement and growth.

One potential area of growth is in partnerships with private healthcare providers and research institutions. By collaborating with these entities, public hospitals can gain access to new technologies, research findings, and expertise. For example, they could participate in joint research projects to develop better treatments for infectious diseases or chronic conditions.

Another opportunity lies in improving their community outreach and preventive care services. By focusing more on preventive care, public hospitals can reduce the burden of chronic diseases and emergency room visits. They can also strengthen their relationships with community organizations to better understand and meet the healthcare needs of the local population.

Conclusion

In 2025, the five public hospitals in New York City that seem to occupy places on the so - called malar bone inward - pushing list, such as Bellevue Hospital Center, Elmhurst Hospital Center, Kings County Hospital Center, Coney Island Hospital, and Lincoln Medical & Mental Health Center, play a crucial role in the city's healthcare system. These hospitals have a rich history of serving the community, especially during times of crisis such as epidemics and natural disasters. However, they also face significant challenges, including funding issues, staffing shortages, and the strain of the migrant crisis.

Despite these challenges, public hospitals remain an essential part of New York City's democratic bulwark, providing care to all who need it, regardless of their background or ability to pay. To ensure their continued success, it is important for the city, state, and federal governments to provide adequate funding and support. The hospitals themselves should also explore partnerships and innovative ways to improve their services and address the evolving healthcare needs of the population.

If you found this article informative, we encourage you to share it with others and explore more about the healthcare system in New York City. You can also look into related topics such as the future of healthcare in urban areas or the impact of government policies on public hospitals.