This article analyzes profitability patterns across major DRGs to uncover how academic medical centers rely on high-margin elective procedures to subsidize unprofitable emergency and critical care. Using Medicare cost data, it quantifies cross-subsidization ratios and outlines strategic implications for hospital leaders navigating financial pressures. The findings highlight fundamental tensions between mission and margin in today’s healthcare environment.

With a growing population of immigrants in the United States, limited English proficiency hinders access to medical care. Effective communication is essential for patients to describe their symptoms accurately and for healthcare professionals to make informed diagnoses and treatment plans. Even if consent for a physical examination and compliance with diagnostic testing is obtained despite the language barrier, monitoring a patient 24/7 is often not feasible. During these times, patients are instructed on the causes of their symptoms and the necessary care for relief. In surgical cases, understanding post-operative instructions is crucial to avoid infections and complications. Misinterpretation due to language barriers can delay treatment, potentially worsening symptoms and leading to increased healthcare visits and costs. Effective communication between medical professionals and patients is vital for appropriate care and building a strong physician-patient relationship.