WESTCHESTER COUNTY, NY — February 10, 2020 — Let us now praise the Albany truth tellers. First among them is Gary Fitzgerald, who heads the organization of upstate health care providers. Health care upstate is in big trouble. Consider:
- 85 percent of upstate hospitals operate at a loss.
- Thousands of jobs for doctors and nurses are unfilled.
- Upstate patients are older and sicker.
- The state and federal governments pay only about 70 percent of upstate health care costs.
- Health care budget cuts mean closure of upstate hospitals and nursing homes.
Such closures mean enormous job cuts, directly and when other employers decide to leave communities with inadequate health care.
It’s another phase of the economic decline of upstate, especially rural New York, and it’s a vicious cycle. Shrinking local economies mean less money, and less money makes economic growth impossible, which shrinks the economy. Beware the impact of state budget cuts on upstate.
The problem is that Fitzgerald is a lonely figure upstate. Almost every Republican and their business allies want to cut health care spending.
Bill Hammond, of the rightish Empire Center for Public Policy, says, “The only real solution is to control costs.” The pithy Assembly Minority Leader Will Barclay, R-Pulaski, sums it up: “Spend. Less.”
There’s a fundamental disconnect here. If Fitzgerald is right, then what these upstaters advocate will deeply undermine the upstate communities they represent.
It’s not that we should ignore the cut-health-care crowd. Their prescription should be taken seriously and examined. And in the end, if the elected representatives of upstate rural New York really insist on their cut-health-care-spending position, they are likely to prevail, no matter how persuasive Fitzgerald may be.
Fitzgerald, by the way, offers more than a grim prognosis. He’s got a plan. Health care should be viewed as an economic development enterprise. Today in New York the phrase “economic development” is code for huge giveaways to big corporations, selected by the governor, some in upstate cities, almost all unneeded and unsuccessful.
Fitzgerald has a different vision. “Without health care systems in upstate New York, you will not get economic development. What business in their right mind would ever want to come to a community that just closed its hospital, and where it’s very difficult to get a doctor’s appointment?” He adds: “We cannot break through the economic development funding sources” to help solve the problem.
Aha — a common-sense solution. Use the giveaway dollars to fill the thousands of vacant job slots in rural health care facilities. Employ doctors and nurses and let them in turn spend their salaries locally and create economic activity across upstate.
Fitzgerald is right, and his plan should at least be on the table for discussion. New York should support adequate health care as a moral necessity. It helps if we find a way to view it as an economic opportunity. It should be debated and tested in the legislative budget process.
Unfortunately, the debate seems to be returning to a fruitless division between reflexive resistance to spending cuts and reflexive anti-government, anti-spending rhetoric. Pro-health care progressives like me need to protect upstate no matter what their local electeds say. The governor needs to use his economic development funds differently. And upstaters need more than standard resistance to providing good health care.
Whatever side you take in these fights, leave room for Mr. Fitzgerald.
# # #
Richard Brodsky is a former state Assembly member.
# # # # #
Original publication by Times-Union on February 9, 2020. https://www.timesunion.com/opinion/article/Richard-Brodsky-The-hard-truths-about-health-15042866.php