December 1, 2006
LEAN BERGER, SKINNY SPITZER
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The Berger Commission recommends closing Cabrini Medical Center and eight other city hospitals. |
The long-awaited Berger Commission report on NY hospitals and nursing homes hit the streets this week (full report here); recommendations include:
- closing nine hospitals, five of them in New York City including Cabrini Medical Center (a designated AIDS center) and St. Vincent's Midtown;
- restructuring dozens of other hospitals statewide;
- eliminating 4,200 hospital beds (7% of current total) and 3,000 nursing home beds (3% of current total);
- expanding primary health care, home and community-based care services and health coverage for low-income and uninsured New Yorkers statewide.
New York City's HHC hospitals avoided the Berger axe, as did North General Hospital in Harlem (all serve HIV/AIDS hotspots).
Insiders say the Berger cuts could have been much worse. And both Governor Pataki and Governor-elect Spitzer publicly backed the proposals on Wednesday.
The State Legislature has until the end of December to accept or reject the hospital and nursing home cuts as a whole; under the legislation that established the Commission they can’t pick and choose among them.
If the Senate and Assembly don't act, the restructuring recommendations (just the cuts, not the expansions) will have the force of law and be implemented by the incoming Spitzer administration.
Medicaid cuts to follow - has Spitzer got guts?
And speaking of that gang of clean-cut reformers - word in the hallways of the State Capitol is that the Spitzer crew is asking NYSDOH and the Division of the Budget to recommend at least one billion dollars in Medicaid cuts as a centerpiece of their first budget proposal.
Now, there are good and bad ways to cut a billion dollars from New York's biggest-in-the-nation Medicaid program. We'd pick a direct attack on sky-high prescription drug prices and the laissez-faire approach to drug purchasing perfected by the outgoing Pataki administration.
Spitzer should (1) consolidate all state drug purchasing into a single set of contracts; (2) seek multi-state compacts with other big-state governors to create a large-scale 'buyer's club' for pharmaceuticals; (3) create a single preferred drug list - including HIV/AIDS meds - for all participating states; and (4) force Big Pharma to cut their prices for medications (to at or below that paid by the federal Veterans Administration) to make it onto the PDL.
New York could save several billion dollars a year by taking on the big drug companies, leaving Governor-elect Spitzer room to expand health coverage and primary care access (as well as implement the tax cuts he says he wants to accomplish using health care cost savings).
If Spitzer's got guts, he'll take on Big Pharma. If not, we'll see a bunch of (Pataki-esque) cuts to services like dentists for people living with HIV/AIDS and transport services for New Yorkers with disabilities. We'll see what changes on Day One.