Below is a letter that was sent by Governor Spitzer today to the more than one thousand trustees of New York hospitals. A similar letter was sent to the hospital CEOs on the Board of Governors of the Greater New York Hospital Association. The letters urge individuals who have tremendous influence over the state’s hospitals and who care deeply about improving the quality of care, to partner with the Governor in advocating for and implementing meaningful health care reform.

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March 6, 2007

Dear [Trustee Member]:

As a former trustee of a major New York hospital, I appreciate the commitment you have for your hospital, its staff and its patients. It is a commitment I shared as a hospital trustee and one I continue to have as New York’s Governor to all the hospitals of this State and to our entire health care system. That is why I am writing you directly to make clear the urgency for fundamental health care reform and to ask you to join me as a partner in this important endeavor.

My patient-centered vision for health care means that the status quo – what we spend, how we spend it and what we get in return – must change. The interest groups that represent your hospitals – Greater New York Hospital Association (GNYHA) and Local 1199/SEIU (1199) – have spent millions of dollars attempting to distort what we are trying to do. Allow me to set the record straight.

Consider these facts:

— NYS is #1 in the nation in Medicaid spending per capita, more than twice the national average;

— NYS is #1 in the nation in hospital spending per capita, also more than twice the national average; and,

— NYS is #1 in the nation in combined state and local taxes, which as studies have shown, has largely been driven by soaring Medicaid spending.

Now, consider what these record numbers of tax dollars are getting us:

— 2.6 million uninsured New Yorkers, including 400,000 children;

— #1 in the nation for percentage of deaths from chronic disease;
— #3 in the nation in per capita deaths from coronary disease; and,

— 1 in 4 New York children is obese; and 1 in 12 has asthma.

Anyway you look at it, New York’s health care system is broken. New Yorkers pay far too much and get far too little in return. And yet the same politically-driven spending decisions that created this crisis in the first place are what GNYHA and 1199 seek to protect.
<.p>Our budget implements a vision for health care that pivots away from the institution-centered system we have toward the patient-centered system we need. That means greater access to health insurance – a commitment to make insurance available to all 400,000 uninsured New York children, and cut in half the 2.6 million uninsured over the next four years. It means greater investment in preventive, primary, and home- and community-based care – sectors that have long been overshadowed by institutional care. And it means a greater commitment to public health initiatives aimed at obesity, diabetes, cancer, asthma, lead poisoning, HIV/AIDS and other chronic health problems.

In addition to these investments, our budget takes actions to realign the health care system and adapt it to health care demands that have changed dramatically over the past decade –the need for more innovative and less restrictive approaches to long-term care; more focused and managed approaches to chronic disease; the demand for safe, high quality, and efficient health care services; the promise of health information technology; and the need for qualified and trained caregivers, particularly in areas of our state that are traditionally underserved. My budget begins to address each of these areas by getting the growth of Medicaid under control, by ensuring that Medicaid dollars pay for services to Medicaid patients, by starting a long-needed update of our reimbursement system so Medicaid dollars reward the right kind of care, and by beginning needed reforms in Graduate Medical Education.

These efforts will be further bolstered by work through our Departments of Health and Insurance, which will focus on insurance coverage, health information technology, public health and many other critical areas of our health care system.

The statewide effect of our budget actions on hospitals ($302 million) is a reduction of just 0.2% of our hospitals’ operating revenue – the same hospitals that have enjoyed revenues of 6.9% on average every year for the past four years, and the same hospitals whose representative association, GNYHA, together with 1199, can afford to spend $22.5 million in campaign contributions since 1999, $12.7 million on lobbying since 2003 (more than the teacher’s unions, public employees and trial lawyers combined), and millions more on television advertisements – all in the effort to make sure the health care system that is failing New Yorkers stays exactly the way it is. We are confident that this minimal reduction in Medicaid revenue can be managed with greater efficiencies and smarter management.

You have a powerful voice in this debate. Yet, thus far, that voice has been drowned out by millions of dollars worth of television ads that attack our health care plan with cheap sound bites and misleading facts. It’s time for an honest, open debate on the future of health care in New York. I urge you to engage in this debate, to ask the questions that you as trustees and as members of the public must demand be answered.
Together, we can reform our health care system and improve health care quality at a price we can all afford.

Sincerely,

Eliot Spitzer

10 Questions for Hospital Trustee Members to Consider

As fiduciaries, trustees, taxpayers and some of New York’s most successful entrepreneurs and most important civic leaders, please consider the following questions:

How can it be that the same hospitals that claim poverty and demand billions of dollars in state subsidies can afford to sustain a $65 million “education” fund, contribute $22.5 million in to political campaigns since 1999, and spend $12.7 million on lobbying since 2003? Couldn’t all that money be better spent on care for our needy patients, professional education for our nurses, and public health education for our communities?

Furthermore, how can it be that those same hospitals that claim poverty and demand billions of dollars in state subsidies can afford to pay their executives multi-million dollar salaries?

How can it be that the State gets blamed for the financial condition of our hospitals when year after year some of our hospitals make millions or break even and others lose millions, and yet those hospitals have comparable patient populations? Is it the state or management that is to blame? If this budget were truly bad for patients, why are consumer organizations and primary care groups supporting it?

Don’t smart management principles dictate that hospitals will be able to absorb this minimal and short-term revenue loss – just 0.2% of New York hospitals’ total operating revenue?

How can it be that in a 52-page report by GNYHA entitled “Shared Responsibility: A Prescription for Comprehensive Health Care Reform in NYS,” the only mention about reforming the way in which hospitals operate to better adapt to the changing demands for health care is the Berger Commission?

Isn’t the Berger Commission only the first step in a broad effort to realign and rationalize our health care system?

How can a budget that reduces GME spending by $104 million out of graduate medical education payments that exceed $1.4 billion dollars – the highest in the nation destabilize New York’s teaching hospitals, especially when $24 million of that amount is being reinvested in Medicaid payments to hospitals serving the largest numbers of Medicaid payments?

The Berger Commission was supported by the hospital associations because it was recognized that closing underutilized beds would strengthen the health care delivery system. Shouldn’t that make all hospitals stronger going forward and better able to manage reform?

Insurance expansion will improve continuity of care, improve patient health and improve hospitals’ bottom lines. Doesn’t that have to be the State’s first priority? How can we make health insurance affordable for New York’s businesses and consumers, if the State props up inefficient hospitals?

Can you defend a 2002 election-year deal to use billions of Medicaid dollars to fund a labor agreement, sending hundreds of millions of precious Medicaid dollars to hospitals that serve few Medicaid patients?