I am interrupting the series on the shame of book publishers for a more vital issue, affecting everyone. In a November 27 op-ed piece in ‘The New York Times,’ called ‘How Medicine Became Just Another Product,’ Senator Daniel Patrick Moynihan noted that we have, ‘in New York, a medical center unsurpassed on earth.’ It is now greatly endangered.
That’s not hyperbole. Our teaching hospitals, their faculty engaged in training doctors and in research, attract patients from around the world. And they save and transform lives of New Yorkers—downstate, upstate, and in between.
New York hospitals are already suffering financially. Indeed, they ended 1998 with an operating loss of $115 million. But after December 31, their resources may be so badly decimated that they will be forced to lower their standards of care, training, and research.
On that date, the state’s Health Care Reform Act expires, and Governor George Pataki has the power to gut or even end that law.
The funds provided under the Health Care Reform Act allow the hospitals to educate medical students and to cover the costs of caring for the state’s poor and uninsured patients.
There are now more than 3 million uninsured residents in this state, and that number has increased at a much greater rate than in the rest of the country. For example, Newsday (November 28) reports that “one out of every five Long Island residents under age 65 has no health coverage.” So it’s not only the elderly who are excluded from the Clinton-Gore prosperity boom, for which Republicans claim the credit.
The medically uninsured, as Newsday further points out, “turn to hospital emergency rooms, where medical costs are the highest, for help when they become seriously ill.”
Under the expiring Health Care Reform Act, hospitals cover their training of doctors and care for the poor and uninsured by adding an 8 percent surcharge to every hospital and laboratory bill. Since the poor and uninsured get almost all their care in hospitals—not only in emergency rooms—there is grave doubt that this city’s public hospitals could continue to exist without this subsidy.
As Jennifer Steinhauer pointed out in the November 27 Times, “businesses find this practice unfair because they feel it is ultimately passed on to them in insurance rate increases.”
In the November 28 Times, Raymond Hernandez reported that, of the monies collected through the Health Care Reform Act surcharge, $780 million a year goes toward reimbursing hospitals for payments they cannot collect from patients, usually those who are poor and uninsured.
“The second largest piece, about $540 million annually, goes to teaching hospitals to train doctors just out of medical school. A third piece, worth about $210 million, was created to provide health coverage for low-income children.”
Meanwhile, managed care companies keep decreasing their payments to hospitals. And our teaching hospitals will now lose tens of millions of federal medicare funds for graduate medical education under a last-minute switch in the new congressional budget bill that will cut money for New York hospitals. Those funds will be transferred to other states.
There has been a longtime animus in Congress against New York, and I expect, envy and resentment of the fact that a good many out-of-staters come here for medical care.
Business organizations and insurance companies have been lobbying Pataki hard to end the subsidies under the Health Care Reform Act, and negotiations are intensifying between the legislature and the governor.
Pataki’s popularity ratings are unaccountably high—especially since I doubt many people can describe his specific achievements. But his entourage is confident that he can be reelected in 2002, no matter what he decides to do about the Health Care Reform Act.
However, as Raymond Hernandez wrote in the Times, the Republican majority in the Senate “also wants to avoid a battle with the health care workers unions since they are up for reelection next year—and to protect hospitals, which are among the big- gest employers in most Senate districts.”
Credit is due the increasingly powerful health care union, 1199 (the National Health and Human Service Employees Union), which is among the leaders in the battle to prevent the hospitals from being further weakened and to save the jobs of its members.
The 1199 union and Richard Gottfried—the chairman of the State Assembly Health Committee, who is also working to save the Health Care Reform Act—must try to educate the governor, the legislature, and the largely uninformed citizenry about what will happen if the insurance companies and the business interests win this fight.
Both when lobbying the legislature and in ads aimed at the public, they should emphasize that not only the uninsured and the poor will suffer—or even die. Anyone who lives in this state may well benefit eventually from research done in the teaching hospitals and from the skills of the specialists who are trained with these subsidized funds.
A crisis in funding care and training in hospitals is taking place around the country. The culpability, as Senator Moynihan fully explains in his Times op-ed, is shared by Clinton and the Republicans. But the immediate crisis is at hand right here in New York, and all citizens concerned about their health ought to call and write their representatives in Albany before it’s too late to keep the Health Care Reform Act.
You should also remind Governor Pataki that even he is not immortal.