Here's today's New York Daily News editorial on the hospital/nursing home closure commission.
... buried in the hundreds of pages that lawmakers ratified sight-unseen was a real gem of an idea: putting the state's overweight health care system on a diet.
Cute. And we know how effective most diets are.
No one knows what this excess capacity costs in higher bills for Medicaid, Medicare and private health coverage, but it's likely to be in the billions. Carrying this weight is a large reason that New York spends more than any other state on health care, yet its hospitals and nursing homes constantly teeter on the brink of bankruptcy. Often they've been rescued with taxpayer-financed bailouts.
But we could know at least approximately what that excess capacity costs. Who's game for doing that calculation? Or better yet, (crass commercial here) paying us to do it.
The commission - Pataki's brainchild -
Or put another way, Pataki's way of sucking everyone else into what he (through the Commissioner of Health) had the power to do all along.
Pataki deserves credit for conceiving the idea, and industry officials and legislators deserve credit for going along.
Well, I suppose we could give the Governor some credit for at least bringing the underlying issue (gross overcapacity) to the forefront. But the question remains what took so long. It's not as if nobody's known about this the past ten years. As we noted yesterday, New York partially de-regulated in 1996, but it didn't de-politicize the hospital market. Being charitable, we might observe that this Commission which has emerged from and will be immersed in a political process is to offset the politics of the past decade which prevented the market from doing exactly what the Commission is supposed to do, namely reduce the size of the hospital and nursing home systems.
And credit for the industry officials? Puhleeze! First, this is a way for them to play out their political games promising protection from the Commission for their allies and punishment for all others. It's a way for them to take political advantage of what the market would probably have done anyway.
And, perhaps even more important. Isn't the implication of an institution's not being on the closure list the Commission comes up with that it should be saved at all costs? Emphasis on costs. Say the market would eventually reduce the size of the hospital system by 70 hospitals (to get to 80 percent occupancy systemwide). Then say the Commission only proposes to close 20 because it makes a political calculation that any more than that would lead to a Legislative override or because of the pressure and horsetrading. (Perhaps I should explain the rules in another post.) In the following legislative year, don't the survivors have the perfect argument for lots of "save me" money in the State budget? I sure think so.