New York Post Opinion Pieces Say New York’s Hospitals, Health Care System Fail to Provide ‘Premier’ Care; Call for Reforms

In a New York Post opinion special adapted from the Manhattan Institute's City Journal, Steven Malanga, a senior editor at the institute, writes that many New Yorkers consider the state's health care system, with its "famous" teaching hospitals, the "best" -- and "therefore the most expensive" -- in the nation. However, he adds, "Expensive, yes -- but the best? Oh, no -- not anymore." Malanga points out that for 35 years, "political rather than practical considerations" have "ruled" the state's decisions on health care issues, prompting "disastrous results." According to Malanga, state lawmakers have "piled on mountains" of regulations, "starved successful" hospitals for capital, "kept inefficient but politically connected institutions alive" with large subsidies and levied "special assessments and surcharges" on businesses and residents "already burdened by high costs." As a result, he concludes, national "pressures," including "cutbacks" in federal spending and the rise of managed care, have "sparked a succession of crises" that "can only be solved if the state's political leaders stop treating health care like a patronage fiefdom to be financed and protected for their own political gain" (Malanga, New York Post, 7/16).

Hospitals in Decline
In a separate Post opinion piece, Malanga writes that New York City's hospitals, although "more costly than ever, can "no longer claim to offer premier health care." He points out that the city's large academic medical centers still "boast a galaxy of star doctors" and provide "world-class care to those rich enough to pay for it," but adds that the "big subsidies haven't stopped a broader decline." According to Malanga, while New York hospitals have "long argued" that they required subsidies to "maintain their national preeminence," the facilities "rarely rate well" in studies of quality of care. He maintains that New York hospitals, plagued by "long" patient stays, "high" bills and "only average" mortality rates, "simply don't measure up to today's profile of a top hospital." Pointing out that Solucient, a "well-respected" health care consulting firm, ranked no New York facilities in the company's current list of the "Top 100 Hospitals in America," Malanga writes, "Such results might shock most New Yorkers, but they are no longer so surprising to health care experts, who view the state's hospitals as out of step with the industry's most progressive trends" (Malanga, New York Post, 7/16).

Suggested Reforms
In a third Post opinion piece, Malanga urges "strong-willed, reform-minded" state lawmakers to pass health care reforms that "truly make a difference." He suggests:

• Eliminating "costly subsidies that serve no useful purpose," such as the $544 million paid annually for graduate medical education and retraining of hospital employees.
• Reducing the "charity/bad-debt fund," a $738 million annual fund financed by an 8.18% surcharge on health care services, designed to cover the cost of health care for uninsured, low-income residents who do not qualify for Medicaid.
• Allowing some state hospitals to "fail and close," given the state's bed surplus.

New York Post Editorial
Meanwhile, in an accompanying editorial, the Post warns that Malanga's analysis of New York's health care system "will be hazardous to your piece of mind," adding that the billions of dollars that the state has spent on health care have "failed to ensure top quality at New York facilities." According to the Post, the spending only served to "provide jobs for unionized hospital workers" and "buy votes for lucky politicians." The editorial also points out that "misguided liberal zeal" in the 1960s and a "lack of political will to stand up to critics of reform" today have prompted the state's health care "disease," which the Post blames on the "powerful combination" of doctors, hospital employees and "well-connected" industry leaders. While state lawmakers may "want to restrain spending," they "don't dare," according the editorial. The Post warns that "unnecessarily high health-care costs have been crippling the state economy for decades," concluding, "Someone has to stand up for reform" (New York Post, 7/16).