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Privatizing Hospitals is a Bad Idea

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In an effort to reduce the rising costs in our health care system, the final report of the Commission on Health Care Facilities in the 21st Century (also known as the Berger Commission) contains several recommendations, including privatizing the SUNY hospitals.

On page 80, the Commission's report affirms that "the SUNY teaching hospitals are important resources and recipients of public funds and subsidies" and states that "Their academic mission to train physicians and their mission to serve patients regardless of ability to pay must be preserved." Yet in the very next paragraph the Commission suggests that "Additional legislation has been proposed that would further expand operational flexibility, even going so far as to restructure the SUNY hospitals as private, not-for-profit corporations...privatization would also decrease or eliminate the need for ongoing State subsidies..."

The legislation proposed by State Senator Kenneth LaValle for splitting the Hospital and University is also a bad idea. Because these university medical centers serve as the heart of highly accredited medical schools, they have uniquely qualified experts in many specialties. Separating the medical school from the teaching hospital with its diverse colleagues will hamper medical education, research innovation, and clinical advances.

On p. 91 the Commission proposes yet another bad idea: "that Crouse Hospital and SUNY Upstate Medical Center be joined under a single unified governance structure under the control of an entity other than the State University of New York"

This is a bad idea, endangering both patient care and medical education. It is an attack on the dual mission of these hospitals: to provide quality medical care to people regardless of their ability to pay while teaching our state’s next generation of physicians. Similar proposals have been repeatedly rejected by the NY Legislature several years running.

These medical centers are key players in cutting-edge medical research. Stony Brook HSC is a leader in lyme disease research. The first study of HIV transmission from mother to fetus, the first MRI on people, and the first successful open heart surgery in NY state all took place at Downstate Medical Center in Brooklyn.

SUNY medical centers provide a key role in affordable medical education. For example, more practicing physicians in New York City graduated from Downstate HSC than from any other institution. When graduate medical education funds flow to the hospitals rather than the University (as has already happened in Buffalo), these funds are used to bolster the hospitals’ bottom line rather than furthering SUNY’s medical education mission.

These medical centers provide many specialized services not found elsewhere in their area of service. For example, Stony Brook HSC operates the only pediatric AIDS center on Long Island, and performs the only open-heart surgery in Suffolk County. Upstate Medical University provides the only designated Stroke Center in Central New York, as well as its regional trauma center and the well-regarded Clark burn unit. If privatized, hospitals would be pressured to end these vital yet expensive services.

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As public institutions, the HSC medical centers provide health care for the poor, regardless of the individual's ability to pay. Upstate Medical University in Syracuse is the only hospital in a 15-county area providing essential, high-quality health care to the indigent. Brooklyn HSC is the only academic medical center in three counties providing patient care to a diverse population of over 5 million people.

SUNY hospitals are very well managed. As public institutions, they are held accountable by the public. A recent independent study by Price Water House Coopers has shown that SUNY hospitals operate more efficiently than 75% of their peer academic medical centers. Privatizing the SUNY hospitals, with New York State’s policy makers and citizens surrendering direct oversight of these institutions, will result in a loss of accountability.

These hospitals are important to the economy in the regions that they serve. Upstate Medical University is Central New York’s only academic medical center as well as the area's largest employer, with an economic impact of over $1.5 billion annually to the Central NY economy. Downstate HSC is the fifth largest employer in Brooklyn, creating more than $800 million in revenues for the region. In 2004-2005 this medical University attracted over $55 million in research funding. Stony Brook is the largest single site employer on Long Island, generating nearly 12,000 full-time and part-time jobs, with a regional economic impact of $2.5 billion.

Changing the governance of these institutions from public to private doesn’t necessarily save money. It will, however, endanger the medical care of our poor and uninsured citizens, lay on the line vital but expensive specialized services, jeopardize affordable public medical education and medical research and imperil accountability.

The evidence shows the need to continue to allow SUNY to manage these important health care institutions and provide the highest quality medical education and health care for New York's students and citizens.

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The real problem is that these institutions have not received the funding they need in order to become self-sufficient. Privatization is not the solution. It will only destroy the SUNY hospitals and the communities that rely on them for medical care, medical education, and the economic impact of they provide. Increased state funding is the solution. I understand that NYS is trying to get out from under the burden of health care, but our teaching, research and health care institutions should not suffer as a result. If NY State can't allocate our tax dollars for research and development, education and health care, where are our tax dollars going? Will other teaching institutions of SUNY also be cut loose to sink or swim without NYS support?

Should quality health care be available only to those who can afford to pay for it, or is it a basic human right of all our citizens? Do the lives of people who cannot afford expensive medical care have less value than the lives of people who have the money to pay for it? Should hospitals, educational institutions and research facilities operate primarily to make a profit, or to carry out their mission of patient care, education, and research? Does our health care system exist to provide care for our citizens, or to make money for insurance companies?

I implore you now write Governor Spitzer to act to derail the now mandated Berger Commission's proposals and keep the SUNY hospitals and Health Sciences Centers in the public sector where they belong, before it's too late.

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Yvona Fast is an author, freelance writer, food columnist, editor, researcher and speaker. Her first book is a career guide for individuals with Asperger Syndrome or Non-Verbal Learning disability. She is currently working on her second book, My (more...)

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