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“Under a 1986 federal law titled the Emergency Medical Treatment and Labor Act (EMTALA), hospitals are required to treat people who come to the ED presenting with an emergency medical condition, defined as a condition that, without treatment, will likely lead to serious impairment or death. … EMTALA is one of the largest federal mandates to provide services to have gone unfunded (Friedman 2011); costs instead fall on states and local health care systems.” 481

“In bringing ethnographic attention to hot spotting as a technique of governance, we find that it provides lifesaving humanitarian interventions while operating within the racialized structures of violence that produce continual life crises. The institutional rationality of hotspotting and the encounters of care that it produces illustrate the often-contradictory role of medicine in the lives of poor people: both caring and coercive, it intertwines care and violence.” 475; “we conclude by suggesting that economic investment and return are becoming a reigning logic in the governance of poverty, generating hot spots as sites of interest for both policing and health care and decentering normative assessments of deviance, illness, and social problems” 476; “Neoliberal social assistance, as it is practiced in the health care safety net, is conceptualized as an “investment “in the population, as a strategic and targeted deployment of basic resources, one that promises to generate a return on investment for the state or health system in the form of cost savings.“ 485

 The authors examine the practice of “hot spotting,” a form of surveillance and intervention through which health care systems in the US intensively direct health and social services towards high-cost patients.  Health care hot spotting is seen as a way to improve population health while also reducing financial expenditures on healthcare for impoverished people. The authors argue that argue that ultimately hot spotting targets zones of racialized urban poverty—the same neighborhoods and individuals that have long been targeted by the police. These practices produce “a convergence of caring and punitive strategies of governance” (474). The boundaries between the spaces of healthcare and policing have shifted as a “financialized logic of governance has come to dominate both health and criminal justice” (474).

The main point of this article is to look at the shortcomings of the response to the World Trade Center on 9/11/01 by the NYPD, PAPD, and FDNY. The article shows that the response was plauged by communication breakdowns between fire companies and commanders, a complete lack of communication between fire and law enforcement agencies with heavy roots in the history of the two departments, and an uncoordinated response by off duty firefighters, who swarmed the area after the attacks. The article discusses various improvements that could have been made after the 1993 bombing and would have significantly effected response on 9/11 such as the improvement and standardization of radio hardware and channels between departments, joint training drills, more rigid command durring response, and the adoption of the FEMA incident command system.

FDNY, Fire Department, City of New York
-composed of individual Engine, Truck, Ladder, Rescue, HazMat, and EMS companies, as well as other specialized units which handle most of the city's emergencies that could cause dammage to life and property. The FDNY was technically the agency in command of the response at the WTC site.

NYPD - New York City Police Department. 
-Provides law enforcement for the NYC. Police Emergency Service Units are also mentioned. These are groups which share some of the responsibilities and training of firefighters, and are familuar with technical rescue equiptment.

PAPDNYNJ - Port Authority Police Department of New York and New Jersey. 
-Responsible for providing protection at all of the major ports and entrances to NYC, incluing bus terminals, shipping docks and ports, train stations, rail yards, bridges, tunnels, and other commuter and shipping hubs.

This article is entirely about the shortcomings of emergency response, and how the history and traditions of the FDNY and NYPD got in the way of an effective response, resulting in communication barriers, an uncoordinated response, unknown and unaccounted responders, and even possibly avoidable deaths. Public health was not explicitly mentioned, as this article focused more on the efficacy of the multi-agency response itself.

“A six­month examination by The Times found that the rescuers' ability to save themselves and others was hobbled by technical difficulties, a history of tribal feuding and management lapses that have been part of the emergency response culture in New York City and other regions for years.”

''It's a disgrace,'' he said. ''The police are talking to each other. It's a no­brainer: Get us what they're using. We send people to the moon, and you mean to tell me a firefighter can't talk to a guy two floors above him?''