Though it's been brewing for more than a year,the announcement this week of New York state's planned hospital closures has hit with gale force. Not surprisingly, at least one health system has already gone to court to fight the closure of one of its facilities.
And who can blame them? While from a state-wide perspective, there may be good public policy reasons for the closures, staff at local hospitals believe in what they're doing and feel connected to their communities. State-level abstractions seem very far away when you're stitching up a kid's cuts, taking out gallbladders and leading diabetes education classes in a upstate town like Cheektowaga, N.Y., the site of one of the targeted hospitals.
With all of the attention being paid to the New York effort, though, people seem to be missing a much larger question: Will we see other states, or even the federal government, begin forced restructurings if New York state achieves its goals? After all, New York is far from being the only state with a financially-compromised healthcare industry.
Take Connecticut, for example. A few weeks ago, the state's Legislative Program Review and Investigations Committee released a report suggesting that the state's hospitals are far less healthy than those in many other parts of the country. For its part, the Connecticut Hospital Association has said that more than half of the state's non-profits are running a deficit, and that those with a surplus have too little to run effectively. Will Connecticut legislators take a cue from New York and begin planning a wave of closures, mergers and repurposing of facilities?
The scariest prospect, of course, would be if the federal government took the bit in its teeth and contemplated a national healthcare industry cutback. In my politically un-savvy opinion, this would create the political controversy of, say, the century. It would rank up there in historical significance with the AT&T breakup, but the fallout would activate the wrath of Ma and Pa Kettle in ways that a dull old telecom divestiture never could.
Still, don't think the feds aren't thinking about it, and rather seriously. After all, bear in mind that when they committed $1.5 billion as partial funding for the New York effort, closing hospitals was a requirement of the deal. All in all, not stuff to help a healthcare administrator sleep well at night. - Anne