For the third year in a row, the New York City Health and Hospitals Corporation (HHC) – the nation’s largest municipal healthcare system that includes Queens Hospital Center and Elmhurst Hospital Center – cared for a rising number of uninsured New Yorkers in our 11 hospitals, four nursing homes and more than 80 health centers.
Across our public system, the number of our patients with no health insurance grew in 2009 to nearly 453,000 – a 14 percent increase from 2006.
In Queens, more than 80,000 uninsured patients were served by our two public hospitals this past year, even as they struggled to fill the critical health care access gap created by voluntary hospital closings in the borough.
As the economic downturn continues to drive up the number of uninsured patients seeking our services, our commitment to provide the best care possible to individuals and families without reliable access to health care remains as strong as ever.
However, rising costs and repeated Medicaid cuts now seriously threaten our capacity to fulfill our mission.
As a result of three successive years of state budget cuts, the city’s safety net system now receives $240 million less in annual Medicaid revenue than it did in 2006. And, we face another cut of $70 million in the Governor’s proposed budget for the fiscal year that begins April 1.
As generations of residents from this borough know, HHC has long cared for all New Yorkers regardless of ability to pay or immigration status and is the most significant healthcare safety net in the state.
During 2009, our healthcare facilities provided more than 40 percent of all outpatient services to uninsured residents in the entire state. We estimate that our annual cost of caring for our 450,000 patients without health insurance is about $850 million each year.
We could not care for so many uninsured patients without access to what is known as Disproportionate Share Hospital (DSH) funding, a source of federal funding created specifically to help support hospitals that serve a disproportionate number of low income and uninsured patients.
Although DSH funding is provided by the federal government and is matched by the city – at no cost to the state – the state must grant us access to the DSH funding.
Alarmingly, the 2010-2011 Executive State Budget provides no assurance that we will continue to be granted access to our current level of DSH funding, and it now appears that our DSH funding may be reduced by as much as $300 million, on top of the estimated Medicaid cut of $70 million.
DSH funding is the lifeblood of our public system – it would be virtually impossible to sustain our mission – and all of our public hospitals, nursing homes and health centers – without it. As the recent efforts to enact expanded insurance coverage nationally make clear, providing health care services to the uninsured cannot be done with magical thinking. It comes at a significant cost. It is no different here in New York City, where HHC is the next best thing to universal coverage.
We are keenly aware that the magnitude of the state’s own budget deficit is daunting and that our State leaders are facing very difficult choices. Nevertheless, we know that any further cuts to our system’s Medicaid funding will seriously weaken our Queens hospitals and our public healthcare system as a whole.
Moreover, any reduction to current DSH funding levels will dangerously destabilize our system. That is why we are advocating for a reversal of the proposed Medicaid cuts and for a fair share of the DSH dollars to support our uncompensated care.
Now more than ever, a strong, viable healthcare safety net here in Queens and across our city is critically important. If our public system is to survive the next few turbulent years, we will need our community residents, our labor partners and our elected officials – at all three levels of government – to do everything possible to keep our public healthcare facilities here in Queens and across the city fiscally sound.
We fervently hope that our State elected officials will agree.
For more information about New York City’s public hospital system, visit www.nyc.gov/hhc.
Alan D. Aviles is the president of the New York City Health and Hospitals Corporation.
