by Alvin Blanco and Omar Py, NYC
At the moment, 60 hospitals in rural Texas are under the risk of being closed. This is a consequence of the costs-cutting measures on Medicare that will affect a lot of communities that depend on these facilities. Furthermore, a lot of jobs will be lost. Besides this, the U.S. Department of Health and Human Services has already recommended a nationwide re-evaluation of other “critical access” hospitals. This re-evaluation has the main purpose of cutting a great part of the reimbursements provided by Medicare for the function of several facilities of critical access, like the rural ones. With these cuts, the Federal government plans to save $450 million. According to Don McBeath, director of government relations for the Texas Organization of Rural and Community Hospitals (TORCH), “at the end of the day, if that becomes reality, we’re looking at the closing of 50 or 60 hospitals in the state” (Kaiser Health News, Sept. 11th, 2013).
This will be just another step in the hospital crisis that threatens public health, its workers and users in this country. In the first four months of 2013, nine hospitals were closed: Anaheim General Hospital, Bellflower Medical Center, Los Angeles Metropolitan Medical Center and Newport Specialty Hospital, in California; Lakeside Memorial Hospital, in New York; Earl K. Long Medical Center, in Louisiana; Stewart-Webster Hospital and Calhoun Memorial Hospital, in Georgia; and Renaissance Hospital Terrell, in Texas (Becker’s Hospital Review, April 24th, 2013).
The crisis is particularly strong in New York City, where the attacks include the closing of the Labor and Delivery Department of North Central Bronx Hospital and the decision to close the Interfaith Hospital and the Long Island College Hospital (LICH).
The first sector affected by this crisis is the health workers. In September, in one example, the Franciscan Alliance cut 125 job positions from the hospitals of Illinois. Only one month after, the same corporation announced plans to lay off 275 employees and eliminate 650 other positions in other facilities of Indiana and Illinois. Also in Indiana, St. Vincent Health laid off around 850 healthcare workers in July, and the IU Health let go 900 workers in September (Wishtv.com, Oct. 23, 2013). And in New York the administrators of the Long Island College Hospital pretended to layoff 500 workers.
Obamacare is a solution for capitalists, not for workers!
One of the consequences of the Affordable Care Act – so called Obamacare – is a strong reduction in the hospital’s re-imbursements. According to Brian Tabor from Indiana Hospital Association “The Affordable Care Act (is responsible for) reductions in payments to hospitals over 10 years (of) almost $4 billion for Indiana hospitals alone” (Wishtv.com, Oct. 23, 2013). To the National Association of Urban Hospitals (NAUH), Obamacare “includes $155 billion in payment cuts for hospitals. Much of that reduction consists in a cut of 75% in Medicare Disproportionate Share Hospital (DSH) payments”. DHS payments are supplemental payments made to selected hospitals that care for especially large numbers of low-income patients.
A 2011 study published by NAUH estimated that this cut in Medicare DSH payments could implicate in the lost of 73,898 direct jobs in 2014, the first year that the cut will take effect. One of the hospitals affected by these cuts, the Connecticut’s Lawrence + Memorial Hospital, announced last September that it was cutting 33 jobs. According to the hospital CEO Bruce D. Cummings, “L+M and other hospitals are contending with massive structural changes that are happening very rapidly (…). We are also experiencing unexpected — and previously unbudgeted — cuts in federal (Medicare) and state (Medicaid) funding. “
Cummings said that the Tax Payer Relief Act, a Congress’ continuation of Bush-era of tax cuts, had a $1.3 million impact per year for the last five years in L+M. Only the budget sequestration carried out in last April 1st, resulted in a $1 million loss this year and will result in a $1 million loss next year. And the 20% cut promoted by Governor Dannel P. Malloy (D) in Medicaid payments to hospitals has a cost of $550 million to Connecticut hospitals.
In the arm wrestling between federal government and hospital administrators, workers and communities are the most affected. “The sheer magnitude of the Medicare and Medicaid cuts impel us to look at all of our services and costs, including the largest component of our budget—personnel,” Cummings said. To local and federal bureaucrats and to hospital administrators, the health crisis is a math problem. Hospitals are businesses, and like other businesses, they need to be profitable. But thousands of people are losing their jobs and hundreds of thousands are losing affordable healthcare near their homes.
Health must not be a private business. People’s lives are not a math game. Obamacare is a great business for health insurance companies and to some hospitals, but it is not a solution for public health. Only a public and state-owned public health system under workers’ control can be a solution to the present hospital crisis.