When a patient reaches the point where further treatment only prolongs the costs and the agony, his doctor does everything in his power to make the patient comfortable and prepare the family for the inevitable.
But when it’s the hospital that has no hope of getting better, suddenly the decisions are determined by politics instead of good medicine. And that’s the problem New York’s next mayor will have to deal with — particularly in Brooklyn, where at least five local hospitals are simply not financially viable.
That’s the considered judgment of Stephen Berger, who has probably spent more time trying to solve the state’s health-care woes than anyone. And at a recent Crain’s New York forum, he said the crisis is growing more chaotic each day.
Unfortunately, the leading candidate for mayor has made preserving bankrupt entities such as Long Island College Hospital and the Interfaith Medical Center a signature issue. In fact, it was largely Bill de Blasio’s activism on behalf of stopping the LICH shutdown that propelled him to the front of the mayoral race.
As a result, Berger lamented, LICH’s future is “being played out as a political and, Lord help us, judicial football.” What de Blasio and others must understand, he says, is that “hospitals are part of the health-care system, not the health-care system.”
Consider: Fully 30 percent of Brooklyn hospital beds are empty on an average day. Nearly half of all emergency room visits do not result in patient admissions. One in seven admissions could be averted through high-quality community preventive-care clinics.
Moreover, labor costs account for 70 percent of local hospital operating expenses. And fringe benefit costs are an unsustainable 50-plus percent of base salaries. To put this in perspective, it’s nearly twice the national average.
Meanwhile, New York is the only state that bars private-equity firms and publicly traded companies from operating or even investing in hospitals. It’s a deal the unions love: Cost-conscious private firms are less likely to roll over for their demands than non-profits, which continually feed at the taxpayer trough.
But as Berger argues, costs have to come down and private capital must come in if New York is to free up resources for community investment and shift emphasis to preventive care. That may not be popular — but it’s critical for meeting the health care needs of this city. And avoiding tough choices by stoking voters’ fears about hospital closures, adds Berger, “is not a plan.”
Tell that to Bill de Blasio.