PUBLIC HEALTH SHORTCHANGED
In the pursuit of (what else?) money
In 2009 Brooklyn Streetcar Artists’ Group (BSAG) was invited to establish and maintain an art gallery in Coney Island Hospital by James Saunders, Vice President of Public Affairs. New to the hospital and unfamiliar with the area, James felt, as many do, that art could be a positive element in the healing process.
In addition to being Executive Director of BSAG, I was well established in the area, having been closely involved with those in the amusement and residential communities of Coney Island (see Coney Island a Personal Relationship) as well as adjacent neighborhoods during the ongoing Bloomberg rezoning. James was always hands on help preparing our exhibitions and openings whereas I often spent time in his office sharing concerns and needs of the community.
Community Advisory Board (CAB)
At the time, Marty Levine was Chairman of the Community Advisory Board (CAB). Appreciating our work and aware of my activism, he asked me to apply for membership and with James’ urging as well, I submitted my application. Thus, health care joined my repertoire of city services in which I’ve been involved.
Taking my seat at the table in 2011, Marty had been term limited as chair. At meetings he’d sit next to me and fill in details. An ongoing issue, addressed while chair, had been that of public money provided to private hospitals despite denying care to those they deemed unacceptable, primarily the uninsured.
Addressing the issue in 2010:
Public health has been an integral part of New York since before the nation was founded. Overseeing eleven acute care hospitals, five long term facilities and several other health care locations throughout the city, New York City’s H + H today administers to all, regardless of insurance. A patient entering a private hospital is stabilized and, if the financial standards of the facility are not met, transferred to a public facility. Yet, taxpayer money is provided them at a much higher level.
Powerful lobbies
With health becoming a major moneymaker in this country, care too often takes a back seat to the money it brings in. Powerful lobbies (see Corporate Lobbies) operate on all levels of government to assure that income is optimized whether or not they provide services to all. As noted in the letter, this is surely a civil rights issue. We are paying for services denied.
Non-profit
Whether or not publically administered, all hospitals in New York State are mandated to be non-profit. However, different rules apply and individuals and associated business are very capable of reaping profits and other benefits.
Indigent Care Pool (ICP) abuse
Although an Indigent Care Pool (ICP) was established in the state in 1964, it has been applied to much greater benefit toward private institutions than those in the public sector that actually serve the greater number of those in need. The following studies by the New York State Department of Health in 2015 tell the story. Note how public hospitals are unacceptably shortchanged.
Health vs. money
But this is not the only abuse of public health care in New York today. Hospitals have been closing for years because of lack of funds or value of property. Major institutions like St. Vincents, serving Greenwich Village, and Long Island College Hospital, serving many of the communities of Brownstone Brooklyn have been lost to developers.
The imminent loss of all beds in Kingsbrook Jewish Medical Center is just one more among the many small safety net hospitals lost, primarily in disadvantaged neighborhoods. Other neighborhood hospitals, those that can sustain financial viability, are being gobbled up by the giants that today dominate the health industry.
Certificate of Need (CON) process abuse
In 1964, New York established the Certificate of Need (CON) process to provide an opportunity to engage community residents in these decisions. A 2018 study funded by the New York State Health Foundation found that the process lacks transparency, consumer engagement and sufficient oversight of health care providers.
Loss of beds
Since the turn of the century the number of hospital beds in New York State has decreased by over one third, many of them in the city. Needless to say, this vastly increased the catastrophic results of the pandemic. A disaster for all became that much more so for people without means.
Money dominates
As money has dominated every aspect of our lives, necessities are diminished for those without. Health care should be a right for every individual, yet quality care is based on one’s finances. As the wealth gap grows, too many are left behind to grasp at the remaining crumbs.
As we talk about the wealth gap; as we talk about the right to excellent health care for all; we elect those who cave to the lobbies; we complain when things don’t work out…and people die.
Additional source information
Martin Levine
FUNDING CHARITY CARE IN NEW YORK: An Examination of Indigent Care Pool Allocations
NYS Health Foundation, March 2017
EMPOWERING NEW YORK CONSUMERS IN AN ERA OF HOSPITAL CONSOLIDATION May 2018
Disclaimer:
All content and views expressed on these pages are mine alone and do not reflect those of Brooklyn Streetcar Artists’ Group (BSAG), its members, directors, affiliations or any other person or organization, including those affiliated with Coney Island Hospital and NYC H + H.
7/2021