At a time when Brooklyn is undergoing a remarkable renaissance, with New Yorkers routinely traveling here for food, culture and housing, why is its health care in such a perilous state? As CEOs of three of Brooklyn’s largest hospital networks, we’ve seen four hospitals shut or face imminent closure. Several others are on the brink of bankruptcy.
But why should anyone care—can’t Brooklynites just travel to hospitals elsewhere? And what can be done to address the crisis and safeguard future health care services in the city’s most populous borough?
What went wrong: Brooklyn’s population is an amalgam of the well insured, government insured and uninsured. We welcome them all. But as the well insured are siphoned off to other places, Brooklyn is left with a financially nonviable mix of payers. With Brooklyn’s high number of Medicare and Medicaid patients, reduced federal reimbursement rates have taken a severe toll.
Furthermore, Brooklyn hospitals and physicians suffer lower reimbursement for services. When patients with the same insurance receive the same procedure, at times by the same physician, the care provided in Manhattan is reimbursed by insurers at a significantly higher rate than in Brooklyn, despite statistics showing as good or better patient outcomes in many Brooklyn hospitals.
Want to publish your own articles on DistilINFO Publications?
Send us an email, we will get in touch with you.
Why New Yorkers should care: If Brooklyn’s hospitals continue to struggle, the impact will be felt throughout the metropolitan area. Where will babies be born? How will people suffering strokes or heart attacks get care in time? Can hospitals elsewhere absorb Brooklyn’s mental-health patients? When quality care is unavailable in large communities, people delay seeking care and some become critically ill, increasing costs that everyone shares.
What’s to be done: Sensible approaches to the crisis have been offered by the state Commission on Health Care Facilities in the 21st Century and the Brooklyn Work Group, a task force of the state’s Medicaid Redesign Team. What they share, and what the centerpiece of any solution should be, is building a viable health care infrastructure, coordinated by a network of hospitals and ambulatory sites that will not be fiscally punished for being in an “outer borough.”
Looming changes mandated by the Affordable Care Act, such as the loss of disproportionate share dollars (money for the care of poor people), will worsen the crisis.
It is time to turn from rancorous politics to rational policies—to shift from quixotic attempts to prop up failing institutions to a strategic use of state resources to create a sustainable health care model. A federal Medicaid waiver New York has requested will go far to advance these goals, and we urge Washington to approve it.
Brooklyn has produced world-class artists, athletes, academics and entrepreneurs, not to mention equally great physicians and nurses. Now is the time for New York’s most vibrant borough to have a health care system that is the pride of our shining—and hip—city on a hill.
The authors run Brooklyn Hospital Center, Maimonides Medical Center and Lutheran Medical Center, respectively.
Date: October 6, 2013