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Science Forum Index » Medicine - Nursing Forum » New York Health Commission Recommendations Could Lead To Clo
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| Jan Drew |
 Posted: Sat Dec 09, 2006 9:45 pm |
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http://www.medicalnewstoday.com/medicalnews.php?newsid=57763&nfid=nl
New York Health Commission Recommendations Could Lead To Closure Of At Least
20 Hospitals In State
The New York state Commission on Health Care Facilities in the 21st Century
on Tuesday released a report recommending nine hospital closures and the
reconfiguration of 48 additional hospitals, Long Island Newsday reports
(Ochs, Long Island Newsday, 11/29). New York Gov. George Pataki (R) and the
state Legislature formed the commission last year to recommend changes to
the state's health care system, which is the most expensive in the country
(Gallagher/Carter, Rochester Democrat and Chronicle, 11/29). The state
Department of Health last year estimated that about 20,000 of the 63,000
licensed hospital beds in New York are not needed. The Healthcare
Association of New York State estimated that there are 7,000 unnecessary
hospital beds (Pérez-Peña, New York Times, 11/29). Surplus beds increase
costs for the state because hospitals are "inclined to fill beds by keeping
patients longer than necessary," the New York Post reports. The average
hospital stay is 6.1 days in New York, compared with 4.8 days nationally
(Campanile/Lovett, New York Post, 11/29). The commission estimates the plan
would increase revenue at the remaining hospitals by $720 million per year
and save Medicare, Medicaid and other insurers $800 million annually. The
commission recommends the closure of nine hospitals, including five in New
York City. The recommendations would reduce the number of hospital beds in
the state by at least 4,200, or 7%. In addition, the plan would close or
downsize several nursing homes, reducing the number of beds by 3,000, or
2.6% of the state's total.
Restructuring Recommendations
The commission's chair, Stephen Berger, said that other aspects of the plan
could have a greater impact than the closures, including proposals to
redesign hospitals through mergers, downsizing and eliminating some services
while adding others. "The reason this is a big deal is the 48
reconfigurations," Berger said. For example, the commission recommends that
government-owned hospitals in Buffalo and Syracuse merge with private
hospitals, despite different unions and governing structures. The commission
also recommends that a hospital on Long Island close its medical and
surgical beds and focus solely on the treatment of mental illness and
alcoholism, and a nearby hospital "is instructed to do the reverse," the
Times reports.
Force of Law
The commission's recommendations will have the force of law unless they are
rejected by Pataki or the Legislature (Pérez-Peña, New York Times, 11/29).
The recommendations are being handled much like those of federal military
base-closing commissions. Pataki has until Tuesday to either pass the
recommendations to the Legislature or allow them to expire. If they are
passed on, the Legislature can either accept or reject them in their
entirety. If no action is taken, the recommendations would go into effect on
Jan. 1, 2007 (Rochester Democrat and Chronicle, 11/29). Pataki is widely
expected to approve the recommendations, the Albany Times Union reports
(Benjamin, Albany Times Union, 11/29). The Legislature cannot modify the
recommendations, although lawmakers "could reject them and then adopt their
own set of closings," the Democrat and Chronicle reports (Rochester Democrat
and Chronicle, 11/29). The Legislature also has the ability to extend the
statutory deadline for approving the plan by passing new legislation.
However, $1.5 billion in federal aid would be lost if there are "statutory
impediments" to implementing the plan by the end of January 2007 (Albany
Times Union, 11/29). Hospitals targeted by the report would have until June
2008 to make mandated changes. The hospitals would be eligible for $1
billion in state aid and $1.5 billion in federal aid "to help some closing
hospitals retire debt and cover other financial obligations," Newsday
reports (Long Island Newsday, 11/29).
Additional Hospital Details
Most of the hospitals slated for closure are "relatively small facilities
with about 150 beds and are typically situated within a few miles of other,
usually larger, medical centers where the commission said patients could
easily find care," the New York Times reports. Most of the hospitals that
would be closed "do not serve poor populations, and the commission's report
said one of its primary goals was to protect health care for the poor,"
according to the Times. A number of the hospitals also have financial
troubles, including two that have filed for bankruptcy (Williams, New York
Times, 11/29). Six criteria were used to grade each hospital and nursing
home: the amount of services it provides to low-income, minority and elderly
patients; the presence of other providers in the area; the quality of care;
the amount of patient usage; financial health; and the local economic impact
of closure or downsizing (Pérez-Peña, New York Times, 11/29).
Reaction
Berger said, "The system is broken. You can patch and patch it or fix it"
(Long Island Newsday, 11/29). Pataki, who was traveling, in a statement said
that he plans to study the recommendations. The plan would have to be
implemented by Gov.-elect Eliot Spitzer's (D) as-yet-unnamed health
commissioner. The governor-elect said he would review the report and
announce whether, if he were the active governor, he would accept the report
and send it to the Legislature. Spitzer said, "Our state's broken health
care system requires drastic reform, and it is critical that we consider
these recommendations seriously." New York City Mayor Michael Bloomberg (R)
said, "When I skimmed it, it looked like they were perfectly reasonable
decisions," adding, "[W]e have to address the issue that if we want good,
quality medical care, and we don't want to go bankrupt paying for it, we're
going to have to have the resources that we need in the places we need them
and not continue to have resources that we don't need where they're not
used" (Cooper, New York Times, 11/29). Jack O'Connell, head of the Health &
Welfare Council of Long Island and a regional commission member, said, "I
was very much impressed with the deliberations of the commission, especially
with their sensitivity to the needs of the indigent population" (Long Island
Newsday, 11/29). However, Greater New York Hospital Association President
Kenneth Raske and Services Employees International Union Local 1199
President Dennis Rivera in a statement said, "This is a sad day for New
York's health care community" (Rochester Democrat and Chronicle, 11/29).
Raske added, "The closures could be readily anticipated. But the
restructuring is so sweeping, I was just flabbergasted." Hospital executives
and elected officials from around the state "denounced the ... plan and
vowed to fight in the Legislature and in court," the Times reports. Berger
and the commission's executive director, David Sandman, said they did not
expect the changes to result in any net loss of health care jobs, although
some labor and industry officials expressed skepticism about that
prediction. Commissioners also "acknowledged that they were tempted to go
further in closing or downsizing hospitals and hinted that another round of
reductions would be called for in a few years," the Times reports
(Pérez-Peña, New York Times, 11/29).
The final report is available online.
Editorial
Commission members appear to have "had the right instincts," emphasizing
"the concerns of patients rather than the state's political favorites," a
New York Times editorial states. The editorial adds that commission members
"have tried to make basic health care facilities more available to give
better and less costly care to those who now go to emergency rooms instead."
The editorial concludes, "If the recommendations can survive a Legislature
.... they will provide an excellent way for [Spitzer] to start quickly
addressing one of his top priorities: rebuilding a better health care system
for all New Yorkers" (New York Times, 11/29).
Broadcast Coverage
APM's "Marketplace Morning Report" on Tuesday reported on the commission's
report. The segment includes comments from Howard Berliner, a professor of
health policy at the New School for Social Research, and Jim Unland, editor
of the Journal of Health Care Finance (Palmer, "Marketplace Morning Report,"
APM, 11/2 . |
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| Guest |
| Posted: Mon Dec 11, 2006 10:06 am |
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It's a curious problem. In NYC, the hospital capital of the world, we have
some world class hospitals, and we have turd whirled hospitals and almost
nothing in between. The bad hospitals (just like the bad banks and bad
insurance firms) thrive mostly because the local pols want the local hospital
that can put more donations into their campaigns. (See the current state
lawsuit on federal bank regulation federalism.) The thing that bugs me is
that while the top medical inventions come from NYC, none of them seem to get
made here. They get licensed out. If the top hospitals had in-house venturing
and incubators, they would be able to recoup part of the cost of excellence.
BTW, the reason the state can close private hospitals is because they control
the purse strings - so much for them really being private.
- = -
Vasos Panagiotopoulos, Columbia'81+, Reagan, Mozart, Pindus, BioStrategist
http://ourworld.compuserve.com/homepages/vjp2/vasos.htm
---{Nothing herein constitutes advice. Everything fully disclaimed.}---
[Homeland Security means private firearms not lazy obstructive guards]
[Urb sprawl confounds terror] [Remorse begets zeal] [Windows is for Bimbos] |
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