Long Island Hospitals Face Fiscal Trouble

Good Samaritan Hospital, West Islip, NY- With Long Island hospitals projected to lose $64 million in Medicaid cuts in Governor David Paterson’s proposed 2009-’10 budget, a variety of briefings, sponsored by the Nassau-Suffolk Hospital Council, Inc. (NSHC), were held last week to address the issues.

The last of the three briefings held on Long Island regarding the effects of the state’s fiscal crisis on healthcare was held at Good Samaritan Hospital Medical Center on Friday, Feb. 20, at 10 a.m.

NSHC President and Chief Executive Officer, Kevin Dahill, provided an overview of budget concerns and related issues and what these cuts may mean for hospitals.

Dahill noted the idea of the briefing was to give those present, who were hospital staff and officials, a good understanding of what the state budget process is all about. “This year it takes on a much more profound dimension given the significant downturn in our economy,” he said.

With a $13.5 billion deficit in New York State, Dahill noted they are concerned about the impact this deficit will have on hospitals. If cuts and taxes go through, a tax of .7 percent on hospital gross income is proposed, it will mean program closures, such as dialysis and mental health programs and layoffs, noted Dahill, who emphasized healthcare is a good investment, “When you have money coming in why would you cut from an industry with the potential to be stable” he asked.

The latest series of numbers, from 2006, seem to show the hospitals are doing fine, but Dahill noted, this is not the case now, as Long Island was barely breaking even then, which did not allow our hospitals the opportunity to reinvest money into their institutions.

Michael Fraser, director of communications for the Healthcare Association of New York State (HANYS), noted HANYS surveyed members in the fall of 2008 to see what they were doing in order to deal with the economic climate. Fraser noted they found that the overwhelming majority had to implement some sort of measure that included layoffs, cutting back on services, freezing hiring and shutting down or scaling back on improvement projects at their facility; in many cases, a combination of some of those measures was required.

The main message of the day, Good Sam President and CEO, William Allison, noted, was that everyone is working hard to get additional Medicaid stimulus money to this state. Fraser noted the stimulus Medicaid money is critical for New York at this point.

FMAP, the Federal Medical Assistance Percentage, is the federal share of Medicaid dollars spent in New York. “Right now it is a 50/50 match if spent in New York, meaning the federal government matches our dollar with a dollar,” Fraser said.

However, just because the federal government has $12 billion allocated for New York, does not mean that is how the Governor and legislature are going to a spend that money, noted Fraser.

The Medicaid dollars in Washington, DC need to offset the Medicaid cuts the governor proposed. “They have more than enough money to do it (offset the cuts), actually they have four times the amount coming in they need to offset, but it’s up to the state’s discretion,” Fraser said.

Allison spoke to the issue at the briefing, he noted the hospital has seen an incredible surge in occupancy and that Good Sam is a safety net for the community. “There is a notion that we are not getting what we need, Allison said, “We’re not asking for a bailout, but don’t ask Good Sam to bail out the banks,” he said.

Likely Page BreakState Senator Brian Foley (D- Blue Point), noted the state should use federal funds to hold hospitals harmless over the next two years, “We don’t want to use federal funds to delay decisions, but to give us some breathing room until it’s time to make some budgetary reform decisions,” he said.

“Elected officials need to hear from you, hospitals do not vote, you do,” Dahill said.


Problems with HMO Medicaid

When I learned that I was pregnant with my first son, I was shocked. I was never to become pregnant because of my heart murmurs and other preexisting health problems.

The pregnancy was a difficult one and required many prescriptions and doctor appointments. Each doctor wanted a certain type of medical, only. Some people are not eligible for a certain type of Medicaid once they are over the age of 21, or do not have children, or their health changes. Their doctors can no longer see them and then they must do what we all hate to do switch doctors, which usually switch medication and so then we still do not feel any better then we did in the first place.

The OB wanted me to hold HMO, while my cardiologist didn’t want to accept the HMO. My prescriptions had to be changed to generic, where I had reactions and even more problems with my heart as I could not have the name brand.

Iowa Medicaid has a lot of problems in itself, but discussing with other people from other states it is now obvious that the HMO problem goes farther then just Iowa, it is nationwide.

Not only does Medicaid limit the care that people receive from their doctors, but HMO limits it even more.

If someone is having a heart attack, the last thing that they are going to do is call to see if it is okay to go to the emergency room. Yet, they must or Medicaid will not cover the charges. They will send you a letter and seek alternative payments such as out of your own pocket, another parties insurance coverage just in case your heart attack was spurred by your neighbor’s dog, anything so they do not have to pay for your emergency room visit.

The other problem with title 19 in a majority is that people who can not afford medical are getting assistance, yet, they are not as a majority of doctors are not accepting Medicaid.

Since living in Davenport, Iowa, I learned that you must be given a book and then call the doctors in that book to see if they will accept you as a new patient. If your conditions are more then they are willing to deal with then you are denied.

Yes, denied healthcare service. So where do you go when you don’t have a doctor, the famous emergency room that Medicaid is throwing a fit about in the first place. Where else is one to go when having a heart attack.

So you change Medicaid plans, this is a problem as well as many times they do not pay the bill right away. So then you are stuck with a $400 that Medicaid will not pay as you’re on either on title 19 or HMO so that you can go to your cardiologist, but then must switch it next month so that you can find a family doctor for a new company.

The problem with HMO is not getting fixed either and the doctors are getting tired of never getting paid and so are now denying health services to Medicaid patients, and they are the ones that need the health provider the most.

Imagine the cancer patients that have to go through these nightmares of switching, adjusting and going to a different doctor each month.

Imagine the children who will not get their immunization shots as there is no doctor that will see them as they have parents that have Medicaid to seek the assistance they need for their child.

I once saw a sign that said, “If I didn’t need the help, I wouldn’t have asked.”

I agree, if Medicaid patients didn’t need the help they wouldn’t have asked.

Now, I am asking, next president, will you fix our HMO? Will you make it or bribe the doctors into seeing us that can not afford our medical bills without taking food from our children? WIll you help the cancer patients, the heart patients?