Close seven nursing homes, nine functioning hospitals, reduce at least a dozen more to the point of uselessness and eliminate over ten thousand jobs.
These were the recommendations of the governor-appointed Berger Commission, which published its report on New
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Although the Berger Commission is an appointed body of corporate executives and bankers, it has been undemocratically endowed with the powers of an elected legislative body. Its recommendations will automatically become law unless rejected by Dec. 31.
To make matters worse, the state is required to accept or reject the commission’s recommendations in full. This means that the state’s elected lawmakers are not permitted to select certain proposals as appropriate and reject other hospital mergers or closings as hazardous to the public good.
Rather than object to this blatant departure from basic legislative norms, the government has acted rapidly to support the Berger Commission. New York’s Republican Governor, George Pataki, and Democratic Governor-elect, Eliot Spitzer, immediately endorsed the panel’s proposals.
The state legislature announced it would meet in a special session and vote on the closures by Dec. 13. To seal the deal, the federal government promised the state $1.5 billion in aid if the recommendations are accepted.
The cutbacks must be put into effect by the end of 2007 once accepted by the state legislature.
Too many hospital beds?
The commission was created to solve the supposed budgetary strains of healthcare spending. Healthcare spending in New York is 34 percent higher than the national average.
Advocates for the hospital closures point to the state’s number of empty hospital beds as evidence that current spending far surpasses New York’s real needs. The Berger Commission proposal would eliminate 4,200 hospital beds. The Department of Health reports that almost 1 in 3 of the state’s 63,000 hospital beds goes unused. The Healthcare Association of New York puts the figure at one in nine.
In terms of providing adequate care, it is illogical to assert that unused hospital beds are “excessive” and deserving of elimination. The history of public health shows that the number of hospital patients and the occupancy levels of hospital beds are far from static.
In 1987, for instance, the AIDS epidemic caused a sudden and severe overcrowding of New York City hospitals.
After 10 straight years of reducing the number of hospital beds, city officials rushed to increase the hospital bed capacity to cope with the widening epidemic. Still, they found the changes insufficient. A budget proposal for 1988-89 identified an additional increase of hospital beds as a top priority.
As for the costs, a report prepared by Alan Sager and Deborah Socolar, directors of the Health Reform Program of the Boston University School of Public Health, revealed that “hospital spending … is not very strongly influenced by hospital beds.”
New York ranks second highest nationally in its hospital bed occupancy rate. Moreover, the state’s unused beds have already been built and purchased. There are no additional maintenance costs for empty beds. These elementary facts go unmentioned in virtually all the mainstream media reports bemoaning the state’s “excess” beds.
Examining “decades of evidence,” the report summarized, “even if more beds did contribute to higher costs (and more beds seem to be only a minor contributor), closing hospitals would still not save money and can even lead to increased costs.”
Why are the hospitals on the chopping block?
The Boston University report, entitled “Closing Hospitals in New York State Won’t Save Money But Will Harm Access to
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The tendency toward the elimination of hospital beds is hardly new. According to the BU report, “In the two decades from 1985 to 2004, the number of beds fell by about 193 thousand, or almost one-fifth.” During this time, however, hospital costs per person have steadily increased.
The real culprit behind these increases is the government, which has consistently opened up the healthcare system to the whims of the capitalist market. Hospitals have been privatized, downsized and closed—particularly in African American and Latino communities. Pharmaceutical and insurance companies have enjoyed the far-reaching deregulation of the country’s healthcare system to reap massive and ever-expanding profits.
For decades, the New York’s state government has tried to cut Medicaid and Medicare costs. They have achieved this by declaring one million recipients ineligible for coverage (1969), freezing the reimbursement rates to hospitals (1976) and abandoning the cost-reimbursement plan to hospitals altogether (1983).
At each step, the lobbying interests of the healthcare industry have responded with plans to shut down and downsize small for-profit and public non-profit hospitals. According to the BU report, in the late 1970s, the New York City and state governments appointed a commission to close 27 such “unnecessary hospitals.”
Steven Berger was at the center of the picture. Acting as the Director of the Emergency Financial Control Board, Berger recommended in 1977 the appointment of a health “czar” to “take the heat” for the closures. That way, the “public officeholders would be in a position to step back.” (New York Times, Feb. 18, 1977) Now, in 2006, Berger is the czar and he’s playing essentially the same role.
Democratic and Republican politicians alike have pledged their commitment to the corporate interests of the healthcare industry. It is left to us to advance the interests of the workers, the patients and the 47 million people who lack health care in this country.
A community-based political movement composed of patients, health care workers, and all those who believe in the right to affordable health care is what is needed to save the targeted hospitals.
