By Penny Mintz
Newsday, the Long Island daily, ran a story on January 16th (entitled “Southside Hospital upgrades emergency room, creates more parking”) about a Northwell hospital in Bayshore that is expanding its emergency room five-fold and has been opening a new hospital unit every seven weeks for the last 18 months.
Instead of enlarging and modernizing hospitals in NYC, 20 hospitals have closed since 2000. Beth Israel Hospital is next up on the chopping block. Why is a large, full-service hospital feasible 40 miles outside of Manhattan but not within the city? Do suburban hospitals get more generous Medicare and Medicaid payments? Unlikely. Do insurance companies approve more treatments and pay higher fees 40 miles away? I don’t think so.
It cannot be that people in NYC—and specifically in Lower Manhattan—are in less need of the health care that a full-service hospital provides. Indeed, according to Mount Sinai’s most recent Community Health Needs Assessment (CHNA), released on December 31, 2017 (in compliance with federal regulations) Chelsea, Clinton, and the Lower East Side are medically underserved areas. It won’t get better when the 800-bed, full-service facility is replaced with a 70-bed facility and various urgent care centers.
The accuracy of health assessment is one of the issues that the Progressive Action of Lower Manhattan (PALM) is focused on in its efforts to save Beth Israel Hospital. PALM agrees with Judy Wessler, a longtime public health advocate, and Lois Uttley, Director of MergerWatch (an organization which advocates for health care policies), that an independent assessment is needed. According to Wessler, the CHNA prepared for Mount Sinai/Beth Israel (MSBI) was not done from a community needs and public health perspective. Wessler asserts that when hospital researchers prepare an assessment, they do not reach out to the most vulnerable people in the community, those who depend on the clinics contained within full-service hospitals. Ambulatory care facilities limit access because they decline Medicaid, Medicare, and/or various private insurance. Thus, ambulatory and urgent care facilities are not equivalent replacements for a hospital.
Lois Uttley has been analyzing the 128-page CHNA prepared for MSBI, which concludes that, “People are overwhelmingly satisfied with the availability of health services in the area.” Uttley points out, however, that the CHNA contains evidence that plenty of residents are not satisfied. The CHNA poll reached only people with internet access, and even then a significant number voiced concerns about access to physicians and hospitals, particularly for the elderly and those on Medicaid.
PALM believes that our public officials must demand an impartial needs assessment. To that end, PALM is organizing a Community Coalition to Save Beth Israel that will schedule meetings with elected officials to get their active support for that and other hospital-related strategies. So far, the Downtown Independent Democrats, the 504 Democratic Club, the Urban Justice Center, the Commission on the Public’s Health System, MergerWatch, and Chelsea Reform Democrats are members. Others have expressed interest as well.
Anyone who wants to join and strengthen the coalition should contact me at firstname.lastname@example.org. Please put ‘Beth Israel Coalition’ in the subject line. Or, come to the next PALM meeting on Tuesday, February 27th at 6:30 p.m., at the Seafarer’s International House (15th Street and Irving Place).
As for why full-service hospitals are closing in NYC but growing elsewhere, perhaps the explanation is grounded in the value of the real estate on which they sit. I’m not saying that I know that with any degree of certainty. I’m just sayin’…