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| DATE | 2020-08-22 |
| FROM | Ruben Safir
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| SUBJECT | Subject: [Hangout - NYLXS] Who needs hostials - STILL ... Today not last
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nytimes.com
N.Y. Hospitals Face $400 Million in Cuts Even as Virus Battle Rages
By Luis Ferré-Sadurní and Jesse McKinley
11-13 minutes
State lawmakers said that slashing hospital budgets to rein in Medicaid
costs while the coronavirus is spreading is “cruel, inhumane and
unacceptable.”
St. Barnabas Hospital in the Bronx faces a possible Medicaid cut that
its leader called “a shot in the gut.”
Credit...Gabriela Bhaskar for The New York Times
For the last few weeks, Dr. David Perlstein has been scrambling to find
more beds and ventilators, knowing that the coronavirus outbreak, which
has filled his Bronx hospital with more than 100 patients, will
undoubtedly get much worse.
Then a week ago, Dr. Perlstein, the chief executive officer of St.
Barnabas Hospital, was given some disturbing news by a state senator:
His hospital could soon lose millions of dollars in government funding.
The funding cut was proposed by a panel that Gov. Andrew M. Cuomo
convened earlier this year, before the virus had reached the United
States, to rein in the state’s growing Medicaid program by identifying
$2.5 billion in savings.
But the timing of the proposals, which were released in mid-March and
include about $400 million in cuts to hospitals, was a blow to the
morale of many hospitals and medical workers on the front lines of the
fight against a ruthless virus that has infected tens of thousands in
New York.
“It’s a shot in the gut,” Dr. Perlstein said. “During a time I need to
commit all the energy I have to really save lives and expand access and
not skimp on resources, now I have to worry about how we’re going to
continue to pay our bills.”
Asked about the proposed cuts, the governor said on Saturday that
hospitals would receive a windfall from the $2 trillion federal stimulus
package, which provides over $150 billion in grants to hospitals
fighting the virus across the country.
“The places that are getting the most funding now because of what the
federal government did are the hospitals,” Mr. Cuomo, a third-term
Democrat, said. “They are doing better than anyone else.”
He then said, as he has before, “The state has no money.”
Government spending cuts are inherently contentious, but the optics of
reducing money to hospitals at the epicenter of the nation’s pandemic
quickly sparked a backlash from elected officials across New York City.
Six lawmakers from Brooklyn wrote a letter to Mr. Cuomo calling the
millions of dollars in cuts to four hospitals in their districts “cruel,
inhumane and unacceptable” and “catastrophic during a pandemic.”
Brad Hoylman, a state senator from Lower Manhattan, said the proposals
seemed wildly out of step with the current images of doctors, nurses and
others fighting the disease in hospitals across the city.
Image
Doctors test hospital staff with flu-like symptoms for coronavirus
infection in tents outside the main emergency department area at St.
Barnabas.
Credit...Misha Friedman/Getty Images
“It seems tethered to a different time and place,” Mr. Hoylman said, of
the proposal, noting that the formation of the panel, the Medicaid
Redesign Team, was announced the same day — Jan. 21 — as the nation’s
first confirmed case. “Now New York is the epicenter of the pandemic.
And the members of the M.R.T. frankly didn’t have that information.”
The Democratic-controlled Legislature will be asked to approve the
proposals this week, as it hustles to pass a state budget by the April 1
deadline, a usually arduous task made all the more difficult by the
outbreak: Four members of the State Assembly have been diagnosed with
the disease, and neither chamber has convened since mid-March.
Lawmakers are also considering the proposals against a bleak financial
backdrop: The state was projected to have a $6 billion budget gap,
mostly a result of increased Medicaid spending, but the coronavirus
crisis could lead to an additional $10 billion to $15 billion shortfall.
State Senator Gustavo Rivera, the Bronx Democrat who serves as chairman
of the Senate Health Committee, said Mr. Cuomo’s plans were a “debacle,”
and particularly jarring considering the governor’s much-applauded
handling of the coronavirus crisis.
“It still boggles my mind that this is the same guy who goes, and sits
down in front of that TV, and in front of you all in Albany, lays it all
out, smartly and ably,” Mr. Rivera said, praising the governor’s
coronavirus performance. “And then he breathes in, and the next thing
that comes out of his mouth, ‘And you got to let me cut the Medicaid
system.’”
As part of the budget negotiations, the executive branch provided the
State Senate with data showing how hospitals could be affected by the
proposed cuts; each senator then received an email detailing the impact
on hospitals in their districts, Mr. Rivera said.
Many of the hospitals that would be hurt by the cuts are so-called
safety-net hospitals, which largely serve uninsured or undocumented
residents, some of whom are considered susceptible to infection because
of cramped living or work conditions.
The Coronavirus Outbreak ›
Frequently Asked Questions
Updated August 17, 2020
Why does standing six feet away from others help?
The coronavirus spreads primarily through droplets from your
mouth and nose, especially when you cough or sneeze. The C.D.C., one of
the organizations using that measure, bases its recommendation of six
feet on the idea that most large droplets that people expel when they
cough or sneeze will fall to the ground within six feet. But six feet
has never been a magic number that guarantees complete protection.
Sneezes, for instance, can launch droplets a lot farther than six feet,
according to a recent study. It's a rule of thumb: You should be safest
standing six feet apart outside, especially when it's windy. But keep a
mask on at all times, even when you think you’re far enough apart.
I have antibodies. Am I now immune?
As of right now, that seems likely, for at least several months.
There have been frightening accounts of people suffering what seems to
be a second bout of Covid-19. But experts say these patients may have a
drawn-out course of infection, with the virus taking a slow toll weeks
to months after initial exposure. People infected with the coronavirus
typically produce immune molecules called antibodies, which are
protective proteins made in response to an infection. These antibodies
may last in the body only two to three months, which may seem worrisome,
but that’s perfectly normal after an acute infection subsides, said Dr.
Michael Mina, an immunologist at Harvard University. It may be possible
to get the coronavirus again, but it’s highly unlikely that it would be
possible in a short window of time from initial infection or make people
sicker the second time.
I’m a small-business owner. Can I get relief?
The stimulus bills enacted in March offer help for the millions
of American small businesses. Those eligible for aid are businesses and
nonprofit organizations with fewer than 500 workers, including sole
proprietorships, independent contractors and freelancers. Some larger
companies in some industries are also eligible. The help being offered,
which is being managed by the Small Business Administration, includes
the Paycheck Protection Program and the Economic Injury Disaster Loan
program. But lots of folks have not yet seen payouts. Even those who
have received help are confused: The rules are draconian, and some are
stuck sitting on money they don’t know how to use. Many small-business
owners are getting less than they expected or not hearing anything at all.
What are my rights if I am worried about going back to work?
Employers have to provide a safe workplace with policies that
protect everyone equally. And if one of your co-workers tests positive
for the coronavirus, the C.D.C. has said that employers should tell
their employees -- without giving you the sick employee’s name -- that
they may have been exposed to the virus.
What is school going to look like in September?
It is unlikely that many schools will return to a normal
schedule this fall, requiring the grind of online learning, makeshift
child care and stunted workdays to continue. California’s two largest
public school districts — Los Angeles and San Diego — said on July 13,
that instruction will be remote-only in the fall, citing concerns that
surging coronavirus infections in their areas pose too dire a risk for
students and teachers. Together, the two districts enroll some 825,000
students. They are the largest in the country so far to abandon plans
for even a partial physical return to classrooms when they reopen in
August. For other districts, the solution won’t be an all-or-nothing
approach. Many systems, including the nation’s largest, New York City,
are devising hybrid plans that involve spending some days in classrooms
and other days online. There’s no national policy on this yet, so check
with your municipal school system regularly to see what is happening in
your community.
Indeed, the brunt of the proposed cuts at St. Barnabas, where almost 90
percent of patients are partly covered by Medicaid, could come from
reducing $7.7 million in Indigent Care Pool funds, grant money meant to
reimburse hospitals for treating poor and uninsured patients for free.
Dr. Perlstein, who complimented Mr. Cuomo’s response to the coronavirus,
said it was unconscionable to grapple with the prospect of a funding cut
“when we’re 14 days from Armageddon.”
“Especially at a time I’m asking my staff to give it all,” said Dr.
Perlstein, who has worked at the hospital for over 20 years. “If these
cuts remain, I have no way to survive as a hospital. I’m already walking
a very fine line when it comes to revenue.”
Robert Mujica, the state budget director, said that it was
“disingenuous” to scrutinize any individual hospital cuts without taking
into account “the full picture” of other savings and efficiencies from
the proposals, which he stressed are still being negotiated with the
Legislature.
Asked about the proposals last week, Andrea Stewart-Cousins, the Senate
majority leader, said the state should be looking for ways to
“strengthen our system and not in any ways of undercutting it.”
Image
Credit...Cindy Schultz for The New York Times
Mr. Hoylman said he was hoping that the Medical Redesign Team might
reconsider its recommendations, or at least delay their implementation,
saying he was concerned about the “public messaging” of Albany looking
to save money in the middle of crisis.
Officials from New York City’s Health and Hospitals Corporation said
that it was too early to judge the effect of the proposals on its 11
public hospitals, but that any consideration of cuts should be delayed
until after the coronavirus crisis has subsided.
New York funds more than $1 billion a year in hospital charity care,
designated for uninsured or underinsured patients. But the complicated
formula used to distribute that aid to hospitals has come under fire
because it often gives hospitals more money than they actually spend in
charity care, while undercompensating others.
The changes proposed by the Medical Redesign Team are meant to more
fairly allocate those grants.
The proposals would effectively result in lower charity care grants for
about 60 percent of all New York hospitals, but they would increase
grants for 20 percent of hospitals, according to Bill Hammond, the
director of health policy at the Empire Center, a conservative think tank.
“This is classic health care financing,” Mr. Hammond said. “No matter
what you do, you create winners and losers. In this case, there are more
losers. People who were expecting more money, they’re not going to get it.”
--
So many immigrant groups have swept through our town
that Brooklyn, like Atlantis, reaches mythological
proportions in the mind of the world - RI Safir 1998
http://www.mrbrklyn.com
DRM is THEFT - We are the STAKEHOLDERS - RI Safir 2002
http://www.nylxs.com - Leadership Development in Free Software
http://www.brooklyn-living.com
Being so tracked is for FARM ANIMALS and extermination camps,
but incompatible with living as a free human being. -RI Safir 2013
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