HHC's 11-New York City Hospital System Facing $1.8 Billion Deficit

caleb2015 · Jul 1, 2016

The city's flailing public hospitals are more than $6 billion short on cash through 2020 â€” and Mayor de Blasio's rescue plan is no sure thing to save them, an official budget watchdog found.

An Independent Budget Office report found the massive $6.1 billion shortfall exists for Health and Hospitals even after the city upped its spending on the agency by $558 million in 2016 alone â€” to a total of $2.4 billion.http://www.nydailynews.com/new-york/new-york-city-hospitals-facing-6b-shortfall-2020-article-1.2695168

DoGoodThenGo · Jul 1, 2016

New York City's HHC is a political creature, and as such no one in government has the b***s to do what needs to be done; following the example of LICH, Saint Vincent's, and a host of others the City needs to do a serious top to bottom examination of it's public health system and how it provides care.

Problem for NYC is that it promotes and or welcomes large numbers of immigrants, poor and others who either do not qualify for Medicare, Medicaid or even subsidized (Obamacare) plans, and or for a host of reasons are uninsured. For many such persons that means the various HHC hospitals and other parts of the system are their main if not only choice for healthcare.

Saint Vincent's, LICH, and now Beth Israel all had one thing in common; they served large numbers of Medicare/Medicaid patients and or those with low reimbursement rate plans. This was bad enough pre-Obamacare, but the cuts in federal funding made part of the ACA make it difficult to impossible for hospitals of last resort/charity care to remain open in their present forms, at least in a high cost area such as NYC.

Time and time again patients with *good* insurance have made it clear they will avoid "charity hospitals" in favor of the large university affiliated teaching hospital systems. NYP, Mount Sinai (leaving aside Beth Israel for now), Northwell (formerly NS-LIJ), Montefiore, NYU and a few others are all doing well to quite good. Indeed Northwell has been on a buying spree these past few years and is paying cash.

According to Mount Sinai's CEO the closing of Saint Vincent's didn't impact Beth Israel very much. So where then are all those residents of West Village, Chelsea, SoHo, Tribeca, Flatiron, Far West Side, etc... going for care?

Head of HHC gave a press conference a year or so ago basically saying that the wealthy/better off private hospitals needed to take on their share of the poor/indigent or they are going to end up there anyway if HHC goes away. Well we are about to find out if this is true.

Beth Israel is closing, and in a few years will be replaced by an over glorified urgent care facility with a separate offsite 70 bed "hospital". The latter will not have an ER and patients will be triaged at the UC. Those needing to be admitted to hospital will either go to the smaller BIH, or be transferred to one of the two remaining FS hospitals below 34th Street on the East Side; NYU or Bellevue. That or perhaps be taken to one of Mount Sinai's other hospitals (Mount Sinai UES, Saint Luke's or Roosevelt. This is the same thing that happens with Lenox Hill's UCC that opened on part of the former Saint Vincent's hospital campus. Patients who are stable enough to make the journey go up to Lenox Hill on East 77th. More urgent cases over to one of the three (now two) hospitals on the East Side; Bellevue or NYU.

According to published reports over 60% of patients served by Beth Israel were Medicare/Medicaid or some other low reimbursement insurance. My guess is that those persons will end up at Bellevue which won't do them any good.