Tim Tai, Senior Photographer

“All you are to them is a number,” Richard Lewis, 64, explained to me on the corner of Temple Street and Chapel Street in downtown New Haven.

He feels let down by the healthcare system — and he isn’t alone. While the issue of healthcare accessibility has become prevalent across the United States, solutions may exist right in New Haven.

“I’ve been around this block once or twice…and this here is a total disaster.” He points to hit right leg, cut below the knee and wrapped in bandages. “I should have never lost this.” 

According to Lewis, who’d originally visited St. Raphael in 2015 seeking treatment for a spider bite on his foot, his surgery had been performed by a doctor in his first year of medical school.

 “I took him to court during the pandemic… so I’m just waiting for my number to come up now to go up and get the check.” 

The surgery was one of many, starting with the bite and ending in an amputation in 2017 as a result of what Lewis explains was miscommunication and neglect between student and patient.

 “As long as you’re a number, and you’re in the system, you’re in and out…they don’t do nothing in between.” 

Lewis’ case has not yet been published by the Vermont District Court, where he claims it took place.

Goals Left Unreached

On January 1, 2016 — not long after Lewis’ first surgery — the United Nations fully initiated its 17 Sustainable Development Goals (SDGs). According to 2024’s Sustainable Development Goals Report in the United States, Goal 3 — Good Health and Well-Being — has remained particularly stagnant. 

For Connecticut in particular, this has meant, among positive indicators such as improved mitigation of non-communicable diseases and HIV prevention, several others have seen little to no progress at all. 

Distinguished among these is healthcare treatment, a sign of progress left unreached and on the decline as of 2020. Another indicator, percentage of uninsured population, remains at less than 50 percent of the target rate. 

Yale has since embarked on a mission of raising awareness for the SDGs by conducting biennial assessments on faculty publications and their relations to each goal. 

According to a recent study, high participation has been attributed to SDG 3, with 51 percent of core faculty and 71 percent of university departments and programs are involved in research pertaining to the goal. 

With its budget, dedicated researchers, and overwhelming influence, why, then, has this issue remained so prevalent?

Cash Over Care

 To Frederick David Watts, a 1972 Yale alum turned New Haven nomad, the issue is clear. As a student, Watts learned how industries were formed and destroyed. “I believe in capitalism…but unless it’s honest…it doesn’t work…without ethics…it doesn’t work.” 

He believes that health care must be “made local,” attributing a lack of access and care to a de-emphasis of patients’ holistic needs in the medical industry. 

Lewis — in agreement — explained how, despite the unification of local hospitals under the Yale name, distance remains between the institutions. 

This, he asserts, limits the accuracy of care to local populace and replaces specializations specific to the region with “corporate care,” which, to Lewis, has proven more expensive and less effective for the people it’s been designed to help. 

“Yale has taken over this town… [they’ve] bought up St. Raphael, Millford, Bridgeport Hospital; they’re in the process of buying two other hospitals right now.” He argues this branding veils healthcare under a prestige which permits higher costs. 

Yet, he explains, “They’re [all] Yale, but this Yale don’t talk to that Yale…so there’s no kind of communication for healthcare.”

Yale New Haven Health (YNHH)’s acquisition of Manchester Memorial Hospital, Rockville General Hospital and Waterbury hospital in 2019 — an expansion which, to low-income New Haveners and a study published in September 2018 by “The Quarterly Journal of Economics”, has been attributed to steeping prices and declining quality of care. 

This is following a severe financial loss of $240 million for the Yale New Haven Health System (YNHHS) in 2022, which forced a layoff of 155 administrative positions, putting New Haven residents out of work and furthering disparities in access.

“The Yale New Haven Health System has cut down on a lot of jobs. A lot of those are going to be, you know, not the doctors…[but] the people here in New Haven who are working there,” Tristan Hernendez, the News’ editor-in-chief and political science major at Yale University, tells me.

He referenced a previous story covered by the News regarding layoffs at the YNHH daycare center as a result of 2022’s deficit. “Yale University does get federal money, to my knowledge,” he speculated. 

He’s correct; YNHH receives public subsidies. This means they, along with public health institutions such as Trinity Health and Hartford HealthCare, were affected by the drop in federal aid following the COVID-19 pandemic, costly temporary labor during that time, inflation, and lack of reimbursement for Medicare and Medicaid.

Surprisingly, Hernandez cites the latter pair as possible remedies to a growing problem. “Yale’s like, sometimes it’s like a company,” he elaborates, 

“I don’t really see a way in which, you know, a private business would not have to at least think about the dollar sign to stay in business.” 

He cites a lack of insurance coverage for low-income and even undocumented populations as a large factor in inaccessibility, reiterating that the policies surrounding financial aid extends beyond the realm of Yale and YNHH.

“It’s an issue that’s very prevalent here in New Haven because of the population, but it exists [in] a lot of places.” 

If the aid given to YNHH disappears, cutting costs in other areas of the university’s budget may risk diminished income and benefits for the university’s faculty and staff, given this is where 64% of its budget is expected for the 2025 fiscal year. 

So what can be done?

Local Solutions for a National Crisis

The Global Health Justice Partnership may have the answer. In 2012, the initiative was established by the Yale Law School and Yale School of Public Health to promote health justice through research and advocacy. 

The organization started progress with New Haven’s Downtown Evening Soup Kitchen (DESK) towards drop-in centers for low-income populace. 

These are low-barrier and multipurpose centers where low-income and homeless populations can turn to for drug recovery, mental health support, housing and food  insecurity, transport access, and job security.

With input from DESK clients and consideration of community needs, such solutions may present opportunities for the specialized care beyond healthcare still sought by Lewis and Watts. 

With a focus on issues which lend themselves to ones of greater severity with time, such solutions may stop more serious health complications before they start for communities most vulnerable to its ramifications. 

Of course, this is but one of many solutions yet to be fully enacted. 

What’s been discovered so far, however, is that when care, whether through rehab or professional training, food assistance or merely someone to listen, reaches the populations by which it’s most needed, those same populations may not suffer the brunt of a recovering healthcare system.

Yale New Haven Health and faculty of the Global Health Justice Partnership were unavailable for immediate comment.