Streams

Some Brooklyn Hospitals Ignoring Advice of State Panel

Wednesday, January 11, 2012

Doctor, Stethescope, Health (Flickr: Bryan Warman)

Two months after a state panel told cash-strapped Brooklyn hospitals they should merge or reduce services in order to avoid closure, some hospitals have taken the advice — and others have disregarded it.

Kingsbrook Jewish Medical Center, in Crown Heights, is negotiating a take-over of Brookdale University Hospital, in Brownsville, Brooklyn. The merger was recommended in November by a panel appointed by Governor Andrew Cuomo.

“We cannot continue to be a stand-alone community hospital,” said Dr. Linda Brady, Kingsbrook's president. “Stand-alone community hospitals — unless you’re in an environment where you’re the only hospital – are really going to go the way of the dinosaur.”  

Other panel recommendations — all of which are non-binding — included merging Brooklyn Hospital Center, Interfaith Medical Center and Wyckoff Heights Hospital; closing the inpatient service at Kingsboro Psychiatric Center; and shifting all of SUNY-Downstate’s inpatient service from its flagship campus in East Flatbush to its newly acquired facility at Long Island College Hospital in Cobble Hill, Brooklyn.

Steven Berger, who led the governor’s advisory panel, is a private equity manager widely known for spearheading earlier efforts, under Governor George Pataki, to close dozens of hospitals and nursing homes across the state.  

Some experts are skeptical that Berger's proposed mergers will stabilize the ailing institutions, all of which serve poor communities with large numbers of people on Medicaid and Medicare -- or lacking insurance altogether. Kingsbrook, for example, has a 1 percent profit margin and $16 million in assets. Brookdale is operating at a 13 percent loss, and has $285 million in debts. Both are about 60 percent occupied.

Kingsbrook will apply for state aid for the merger, but Brady said she doesn't yet know how much. She said Brookdale will have to work out its debts with its creditors, before Kingsbrook can take it over. She expects the process to take the next 12 months.

Speaking Wednesday, after a conference on Brooklyn healthcare sponsored by Crain’s New York Business, Brady was confronted by union representatives and community activists concerned about closing or reducing large parts of Brookdale, such as the anesthesiology and pediatrics residency programs.

They echoed objections shouted by hundreds of protestors outside the Brooklyn Marriott, where the conference took place.

“This is a very difficult transaction,” Brady said. “The challenge is to keep everything alive, so it exists, so it can change.”

Many of the demonstrators outside Wednesday's event objected to the Berger panel's proposal to relocate SUNY-Downstate's inpatient beds from the historic campus to the new one, formerly associated with Long Island College Hospital.

“How are you going to conduct [educational] programs, when you have to go to LICH for inpatient services?” said Rowena Blackman-Stroud, a union representative from Downstate. “It isn’t logical at all.”

SUNY-Downstate President Dr. John LaRosa said he agreed -- and will ignore the Berger panel recommendations. So far, he said, he has not received any pressure from Albany to do otherwise.

"We acquired  LICH, because we need the teaching the space," LaRosa said. "Mr. Berger says, 'Move all your inpatient beds to LICH.' But doing that would defeat the purpose of acquiring LICH."

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Comments [4]

Dave H from New York, NY

A single-payer health care system is one in which a single-entity -- the government -- collects almost all of the revenue for and pays almost all of the bills for the health care system. In most single-payer systems only a small percentage of health care expenses are paid for with private funds. Countries that have a single-payer system include Australia, Canada, Sweden and the United Kingdom.

Single-payer is popular among the political left in the United States. Leftists have emitted tons of propaganda in favor of a single-payer system, much of which has fossilized into myth.

Here are some of the more prominent single-payer myths:

Myth No. 1: Everyone has access to health care a single-payer system.
Myth No. 2: Claims of rationing are exaggerated.
Myth No. 3: A single-payer system would save money on administrative costs.
Myth No. 4: Single-payer will provide fair and quality care for everyone.
Myth No. 5: Single-payer leaves medical decisions to patients & doctors.
Myth No. 6: Single-payer systems achieve better health outcomes.
Myth No. 7: The U.S. systems also engages in rationing.
Myth No. 8: A single-payer system will not hamper medical research.
Myth No. 9: Single-payer will save money as patients seek care earlier.
Myth No. 10: The free market in health care has failed in the U.S.

Jan. 15 2012 06:21 PM
daisy from brooklyn ny

Being an employee of Kingsboro Psych i an very concern about the recomendation to close the facility down many families is going to be affected by this,they depend on the services in the community for loved ones and think about the jobs thats going to be taken away many lives depends on it please lets try to save it.

Jan. 15 2012 06:14 PM
Debbie from Brooklyn

I am an employee at kpc closing this facilit will affect both patient an employees thousands of families depend on the services of this facility closing it would just promote more poverty in Brooklyn and crimes all the other borough has one of these facility please give this careful though it not all about money

Jan. 15 2012 08:48 AM
Steve Auerbach, MD from New York, NY

Hospitals should be located on the basis of where they are needed, not where they are most profitable. The real problem is that healthcare financing and reimbursements are based on who you are and how much money you got, not what disease you got. That is both immoral and irrational; but so ingrained the current so-called reform does not even address it. The current system promotes a distribution of care based on which patients and neighborhoods are the most profitable, which means the healthy and wealthy. Under the current system, for any given disease, the hospital and doctor get more money to treat a rich person with private insurance, then the same disease in a poor person with public insurance. No surprise which hospitals are then deemed poor and in need of closure! The Berger dont address the real underlying problem, they make it worse to line the profits of Wall Street. The solution is not to close down hospitals where they are needed the most. The solution is not to add another and unnecessary layer of for-profit skimming off of money that should go to care.

The solution is to change the financing and reimbursing, so all people and all hospitals are treated equally. These are already bare-bones places – there are no market "efficiencies" to be wrung out of the system. In fact, there are numerous studies that prove that for-profit management always lower quality of care and usually increasing costs. That is what being for-profit means: having to cut care to increase profits & satisfy Wall Street’s need for short-term quarter-on-quarter growth. Every dollar that goes to for-profit investors and Wall Street is a dollar not going to health care. A sane system of healthcare financing would promote a distribution of care based on a rational service area needs-based distribution of both hospitals and primary care facilities.

Real reform would immediately enact an All-Payer system, where all Insurers pay all hospital the same amount for the same service; such as NY had under Cuomo Senior, and which Maryland still has, proven effective as the only state to truly have controlled costs in recent years. Real reform looks to what real Democrats in Connecticut enacted, getting private insurance and Wall Street out of Medicaid. Real reform would look be to enact Single Payer system such as proposed by NY Assemblyman Gottfried and which real Democrats in Vermont already passed. Indeed, repeated independent studies show that single payer – universal publicly funded insurance financing, and the real reforms that go with it – is the only way to get to universal, high quality and affordable care that controls total costs. Some day the politics will catch-up with that reality.

Jan. 12 2012 05:13 PM

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