NEW YORK, NY January 20, 2005 —The quality of healthcare you get has always depended on what resources you have, and where you live. Many New Yorkers west of the Hudson and south of Albany have to go to New Jersey for advanced cardiac treatment. Two competing hospital systems have been lobbying regulators to change this. As WNYC's Fred Mogul reports, politics has both helped and hurt the two sides get their hearing…and politics will play a crucial role in deciding what kind of cardiac care residents in this area receive.

FM: 68-year-old Rockland County resident Jerry DiColandrea has just received a clean bill of health from his cardiologist, Dr. David Brogno. But something is weighing on the patient’s mind.

JC: If I were to, God forbid, in the middle of a night have an emergency, they would force me to go to Nyack? -Brogno: No, not exactly. If you’re having a heart attack, we can bring you over to Good Sam and open your arteries now, whereas two years ago, we couldn't do that.

FM: For the last year-and-a-half, Good Samaritan Hospital in Suffern has been the only facility in this area to offer emergency patients coronary angioplasty. The procedure uses balloons or tubes called stents to open the blocked blood vessels that are a common cause of heart attacks. Good Sam, as the hospital is widely known, has long wanted to expand cardiac treatment here -- to offer patients angioplasty, not just in emergencies, but day-to-day, and to perform open-heart and coronary-bypass surgery. Dr. Brogno:

DB: The advancement of cardiac services is desperately needed in this area. The outfit that runs Good Sam, Bon Secours -- they're a charitable outfit, but they're not in the business to run out of money. And they’ve done several business analyses of the numbers in this area, and they’re upset that it's taken so long. But they haven't as of yet wavered from committing the money to doing it once we get approval.

FM: To get a licensed health facility, you have to climb through a series of state Health Department boards and committees. Good Sam applied for a license five years ago, but has never been put on the agenda until now, for a hearing early next month. Doctors, administrators and supporters throughout the community say they've been blocked by the machinations of New York-Presbyterian, one of the state's most influential hospital systems. New York-Presbyterian has one cardiac care center just west of here, at Valley Hospital in New Jersey, and wants to get another one to the east, at Nyack Hospital. Officials at Nyack and New York-Presbyterian declined to be interviewed for this story, but Dr. Eric Rose, chief of surgery at Columbia University, and an affiliate of New York-Presbyterian, laid out a vision for Nyack

ER: Our hope as a healthcare system is to partner with Nyack Hospital to develop a broader array of cardiac services at that institution. The first step for that we think would be to open a catheterization lab at Nyack, and if ultimately that were to blossom into a full-blown cardiac surgery center there as well, then we obviously we would be committed partners to them.

FM: Nyack also will make its case next month before a Health Department panel. Both sides have high-end lobbyists connected to George Pataki. New York-Presbyterian pays former U.S.Senator Al D'Amato 10-thousand dollars a month, and Good Sam pays Robert Boyle the chairman and former CEO of the Javits Center 5-thousand dollars a month. Observers say D'Amato has been successful at keeping Good Sam off the agenda. The man who controlled that agenda – and the whole application process -- recently raised eyebrows, when he departed the Health Department after many years for a new job – at New York-Presbyterian. He's now in charge of that network's strategic planning. Still, state health officials downplay the role of outside influence. They say they the approval process mohas, too, have been working for years -- trying to get Nyack and Good Sam to apply together on a combined "Rockland County Plan." Now the state has given up on this, according to Health Department spokesman Robert Kenny.

RK: It's always been a priority of the department to work with both hospitals to establish a joint venture. However, with the discussions not moving forward at the speed we'd like to see, we're going to consider these applications separately.

FM: Good Sam’s supporters admit one of the main reasons they want full-service cardiac care is profits. These procedures are lucrative, and much of what community hospitals do loses money. But their main arguments before regulators probably will focus on public health not business. Residents of Rockland, Orange and Sullivan counties have no easy access to cardiac care. Unlike their wealthier counterparts, poor patients in New York can’t travel to New Jersey for healthcare. Their Medicaid payments only work in-state. In all, New Yorkers spend about 75-million dollars annually in New Jersey on heart treatments. That money could be spent in New York, according to Raymond Arons, a Columbia University researcher who performed a market assessment for Good Sam.

RA: We found a substantial amount of people traveling across the state, going to these hospitals, and getting cardiac surgery we can't afford to lose these patients, we’d rather keep them in New York state.

FM: Public health professionals often say their top priority is "access to care." But in Albany, the watchword is simply "access." Next month, when both hospitals make their case in open hearings at the state Health Department, the public will get access for the first time, too.

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Links:

» goodsamhosp

» nyackhospital.org

» nypsystem.org

» health.state.ny.us