In Defense of Public Health Care

By HENRY GARRIDO
Executive Director, District Council 37, AFSCME, AFL-CIO

Mayor Bill de Blasio has proposed a sensible rescue plan for our city’s public hospital system.

His plan addresses the system’s financial crisis without hospital closings and layoffs. The $2 billion plan charts a course for NYC Health + Hospitals to meet the challenges posed by major changes to the health-care sector throughout the country.

DC 37 Executive Director  Henry Garrido

DC 37 Executive Director
Henry Garrido

But critics are calling for cuts that would hinder services and slash jobs.

Charles Brecher, the research director for the Citizens Budget Commission said, “Transforming this system can’t be done without making painful choices.”

Daily News columnist Errol Louis wrote: “De Blasio has promised that no hospitals will be closed and no personnel will be laid off…. One wonders when and how any real savings will ever happen if the administration refuses to bite the bullet.”

Believing the plan siphons off $2 billion that could be better allocated for senior services and education, Lewis says the city should “talk about doing radical surgery on our hospital system.” His argument pits the elderly and students against poor, undocumented immigrants and uninsured patients.

As public employees, we believe that government should not pick and choose who benefits from its services. Government has a moral obligation to assist the poor and downtrodden rather than cast them away as undesirables.

The mission of NYC H+H is to prevent the indigent and uninsured from falling through the cracks. Of course public health care should provide services efficiently. But the raison d’être of NYC H+H is to help patients — not to make a profit.

Ours is the biggest municipal public health care system in the country – serving more than 1.2 million patients every year. It handles nearly one-third of the emergency visits in the city, and it plays a leading role in the city’s responses to crises like the Ebola outbreak and the 911 terrorist attacks.

We cannot allow NYC Health + Hospitals’ role as the primary provider of our safety net to be compromised by insufficient funding, drastic cutbacks in personnel and services, hospital closings or the contracting out of services.

Our union has made clear its desire to work in partnership with the hospital administration to help with the restructuring.

Mirroring a national trend, NYC H+H aims to strengthen community-based care. It already operates more than 70 community-based health-care facilities and plans to open more. One of our concerns is to ensure that members asked to work at community sites are appropriately trained.

Declining safety-net funding

A major cause of the health-care system’s financial crisis is the decline of safety-net funding. State and federal funding is projected to decline from $2.2 billion in fiscal year 2016 to $1.4 billion in fiscal year 2020.

We are working with our national union, the American Federation of State, County and Municipal Employees, to secure more federal support.

Here in New York, we back legislation to change the state’s unfair charity care funding formula to make sure NYC H+H is better funded. NYC H+H cares for 60 percent of the indigent and uninsured patients in the state, but it receives only 3 percent of the $3.5 billion Albany allocates for those patients. Legislation we seek would change the charity care formula to match patient care.

For years, NYC H+H has adapted to changes in health-care delivery and proper funding. The de Blasio plan represents its latest effort — and it’s a good one.

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