Healing Borough’s Health System Discussed at Brooklyn Marriott

January 12, 2012 Brooklyn Eagle Staff
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Business Leaders, Hospital Administrators Attend Panel

By Raanan Geberer
Brooklyn Daily Eagle

DOWNTOWN BROOKLYN — Although the panelists at the discussion on “Solving Brooklyn’s Hospital Crisis” basically agreed with Stephen Berger’s diagnosis that the current hospital system doesn’t work, they had varying opinions about the right prescription for it.

The discussion, sponsored by Crain’s New York Business, included four panelists. They were the aforementioned Stephen Berger, chairman of Odyssey Investment Partners and head of the state Health Department’s recent Brooklyn Task Force; Dr. Linda Brady, president and CEO of Kingsbrook Jewish Medical Center; Pamela Brier, president and CEO of Maimonides Medical Center; and Kenneth Raske, president of the Greater New York Hospital Association.

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Brier and Brady were chosen for the panel because the hospitals they head are relatively financially healthy compared to several others in the borough. For example, Brier told the audience that Maimonides has “been in the black every year for 15 years.”

The discussion was held at New York Marriott at the Brooklyn Bridge. To get inside, one had to pass a picket line of protesters from several unions, Occupy Wall Street and several community organizations who warned against cutbacks. 

Once inside the Marriott, tables were arranged by institution — there were tables for individual hospitals, unions, companies that provide goods and services to hospitals, politicians, and more.

The state’s Health Department, said Berger, commissioned the Brooklyn Task Force because in the metropolitan area, Brooklyn has the greatest number of hospitals that are on the brink of insolvency, such as Brookdale, Interfaith and several others. Cutbacks in Medicare and Medicaid payments have driven these hospitals — most of them in low-income, inner-city areas — close to the edge.

Calling the city’s hospital system a “big-box network,” he said it no longer works. He called for the eventual replacement of this “provider-based system” with a “client-based system.” He has called for strengthening the borough’s secondary healthcare system — clinics, private physicians, labs, nutritionists — so that patients only go to the hospital when they need to. 

One of the commission’s proposals that seemed to draw the most flak was the idea of bringing in private-sector, for-profit companies to help manage hospitals — something that is a reality in most other states. 

Raske said involving the private sector in healthcare is “not new,” naming several partnerships on the clinic and laboratory level. However, he said, if private companies are brought in for a larger role, “these would probably be publicly traded, investor-owned companies.” They would almost certainly choose to manage hospitals that are already doing well, leaving hospitals in low-income areas out in the cold again.

Berger clarified that although his task force believes the hospital system is “over-bedded” and wants to reduce the number of beds, this will not result in a shutdown of any one hospital. It will only be done in cooperation with the hospitals themselves, he said.

On the subject of a proposed Brooklyn Health Panel that would help oversee hospitals here in the borough, Raske said that it is a good idea, but the panel shouldn’t have the sole authority to remove and “cherry-pick” administrators. “I’ve seen such commissions in the past,” he said, “and often, the people they put in are worse than the ones who were there before.”

During the question-and-answer period, an audience member asked what role organized labor would have in this reorganization process. Brier answered that the unions understand that management and labor are “in this together.” Brady added, however, that as things change, “a different set of skills” may be needed among staffers. 

In the case of hospitals, “unions” mainly refer to organizations representing nurses, technicians, social workers and the like, but Raske mentioned a different type of union — a construction union. 

He told those assembled at the Marriott that he had recently met with several construction union officials, and they agreed to lobby the state for incentives and rebates for hospital-building construction. While commercial and residential buildings readily receive such incentives, he said, hospital buildings don’t. 

Those on the dais and in the audience both complained about a lack of money in the hospital system. Brier mentioned that Brooklyn hospitals don’t have the type of large endowments that Manhattan hospitals do. And Brady said that because of late payments, underpayments and so on, Kingsbrook only receives an average of 65 for every dollar it puts out.  

“Did you ever hear of any business earning 65 cents on the dollar?” she asked. Similarly, an audience member wondered whether the institution he worked for would ever see “a 5 to 6 percent profit margin.”  

After the conference ended, this reporter asked Berger why his task force recommended that SUNY Downstate not expand services at its Bay Ridge campus — the former Victory Memorial Hospital.

“It’s not needed!” he said. “The data proves that it’s not needed!” A Bay Ridge resident later replied that people in the neighborhood strongly want an emergency room at the facility. Of Berger, she said, “He’s the one [with an earlier commission] who closed Victory in the first place.”
Speaking for the protesters, Mark Genovese, a spokesman for the New York State Nurses Association, said that for nurses, the threat of cutbacks and increasingly pressured working conditions is real. For example, he said, when SUNY Downstate took over Long Island College Hospital, it outsourced supervision of nurses to a private company. That company, he said, “ripped up the previous contract” for all items except wage levels.

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