This article is adapted from a healthcare roundtable I moderated on May 6 as part of "Promoting an Informed Public", a public television series I anchor.
Among the panelists were Assemblyman Herb Conaway (D—Delanco), who is also a medical doctor; Dr. John A. Brennan, executive director, Newark Beth Israel Medical Center; Joseph Della Fave, executive director, Ironbound Community Corporation: and Renee Steinhagen, executive director, New Jersey Appleseed Public Interest Law Center.
How many hospitals in New Jersey have closed in the last 10 years?
Conaway: About 20 have closed, largely in urban areas that serve a population that is largely uninsured or have government insurance that unfortunately does not pay the full cost of their [hospital] care.
As several hospitals have closed in Newark, what has been the effect on Newark Beth Israel Medical Center?
Brennan: Last year we saw 210,000 patients in the primary-care setting, and we will probably be at 240,000 patients this year. The main hospital has gone from 2,200 to almost 3,300 births and will probably hit 4,000 births by the end of this year. The Children’s Hospital used to see 35 patients per day; now it is 65 per day. As a result, we are adding $2.5 million worth of personnel to run an antepartum unit. For our [neonatal intensive care unit], we’ve added 40-plus new nurses.
Some will say, “But you are still managing to provide basic health care, so what’s the problem?”
Steinhagen: Some people are telling us that these closings will actually help hospitals like [Newark Beth Israel] become more sustainable. If occupancy rates are high, the economics of the hospital are improved. But any situation has to be looked at individually, as to the population that is being served, and their particular needs
Della Fave: It is a devastating situation for the neighborhood. You have overcrowded schools, you have no parks for kids to play in, and you get a hospital closing. All that contributes to a demoralized neighborhood.
The state reimburses 60 cents on the dollar in terms of health care provided to people who have no insurance. What are the implications?
Conaway: The state and federal governments have not lived up to their responsibility. Poor people do not have people that go to bat for them. Too many are immigrants. Too many don’t vote. There is not enough value placed on the needs of those who are poor and working.
Should more hospitals cut out acute care but still offer other vital health services?
Conaway: This was done in Camden. It closed the hospital but left the E.R. in place. A dental clinic, [afterschool programs, and senior services] moved in. So the building remained vital. If you close down an E.R., those patients don’t go away. They have acute needs that … need to be met.
The governor’s proposed budget would reimburse hospitals about $740 million a year—only half of what you are mandated to provide. How can you survive?
Brennan: We can only cut back so many nurses on the floors, only so many doctors. There comes a point where there is a quality-of-care issue.
What impact would universal healthcare have on New Jersey hospitals?
Conaway: We need to reduce the number of uninsured among us. If we do that, there will be less dependency on Charity Care dollars, and the revenue picture for hospitals should improve.
Note to Reader: This article is adapted from a healthcare roundtable I moderated on May 6 as part of Promoting an Informed Public, a public television series I anchor.The program, underwritten by the Healthcare Foundation of New Jersey, will air on Thirteen/WNET, NJN, and the Comcast Network. For more information, visit caucusnj.org.
Steve Adubato, PhD., is an Emmy Award-winning anchor for Thirteen/WNET and a media analyst and columnist for MSNBC.com. He provides commentary on talk radio station 770-WABC. He is the author of the book "Make the Connection", as well as the soon-to-be published book "What Were They Thinking?", which examines highly publicized and often controversial public relations and media mishaps. For more information, log on to www.stand-deliver.com