As Chris Morris reports, this report is the latest salvo in a debate over how to fund hospitals and the state's healthcare system.
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Local leaders and hospital officials say they plan to use the report to lobby Governor-elect Andrew Cuomo when he takes office in January.
“Hospitals, in the whole of the North Country and across the state, are incredibly powerful economic anchors that are at risk,” said William Van Slyke, spokesman for the Healthcare Association of New York State. He says a breakdown of the numbers within his groups report finds that North Country hospitals account for more than 12,000 jobs and generate some $1.4 billion in economic activity.
Van Slyke says the public understands the value of hospitals when it comes to delivering critical services – but often, taxpayers and lawmakers overlook the economic impact of health care facilities in rural communities, “especially in communities up in the North Country where, aside from some of the state Department of Correctional Services facilities, hospitals are probably the biggest employers in the entire region,” he said.
In the Tri-Lakes region alone, the Adirondack Medical Center employs roughly 920 people. Spokesman Joe Riccio says the hospital’s total economic impact nears $120 million, including payroll, supply purchases, capital spending, income taxes, and more. Riccio stresses that the bulk of AMC’s employees live in Saranac Lake, Tupper Lake or Lake Placid.
“Clearly, those payroll dollars – all of that money – is going right back into the community,” he said. “That’s an obvious and direct economic benefit and if it weren’t there, you’d notice.”
While hospitals enjoy lead-dog status in the North Country’s economic hierarchy, they’re also one of the state’s biggest expenses. In just three years, health care providers in New York have suffered upwards of $5.3 billion in Medicaid cuts and an additional loss of $13 billion in federal Medicare funding.
The healthcare association’s Bill Van Slyke says hospitals and health care providers are starved for capital and becoming increasingly fragile. “If the legislature and the incoming governor decide they’re just going to keep cutting across the board,” he said, “it’s going to imperil these facilities and it’s going to result in lost health care services for sure. But it also results in lost jobs. That means more people leaving the area and less opportunity. That’s something we need to be aware of.”
Janet Duprey doesn’t need to be told how important hospitals are to the communities she represents in the state Assembly. The Republican’s district spans across northern New York and is home to three major health care facilities – the Adirondack Medical Center in Saranac Lake, the Alice Hyde Medical Center in Malone, and the Champlain Valley Physicians Hospital in Plattsburgh.
Duprey bristles at the mention of Gov. David Paterson, who orchestrated major health care cuts in his 2010 executive budget. “For whatever reason, the Paterson administration did not understand the issues surrounding health care in the North Country,” she said.
Duprey thinks downstate lawmakers don’t fully appreciate the complexities of providing health care in the rural north. “We continue to fight that battle of having people from the city – particularly New York City, but other metropolitan areas as well – understand that we have 50 to 60 miles between our hospitals,” she said. “It’s not as easy as if somebody has an issue with one hospital, they can walk across the street or a few blocks down the road to another and get service.”
Adirondack Medical Center’s Joe Riccio echoed Duprey, noting that residents of the North Country don’t have a multitude of choices when it comes to health care.
“The very nature and geography of the North Country and the Tri-Lakes is spread out,” he said. “Obviously, if it weren’t for the programs and services that AMC provides, people would have some difficult choices to make.”
But despite a rough stretch for the health care industry, there’s cautious optimism that Governor-elect Andrew Cuomo will take a different approach to health care funding as he begins drafting his first executive budget early next year.
Duprey says Cuomo appears to be giving the North Country a louder voice in the conversation. “I’m pleased that he’s included some North Country people on his transition team,” she said. “I think the message will come across that at least he’s listening to us, so much as he’ll consider the people that get appointed to positions and what their input is and where they stand on issues.”
Van Slyke notes that Cuomo has called for a fundamental redesign of the state’s Medicaid system. The Healthcare Association of New York State thinks Cuomo is right – and a taskforce of the group’s membership has sent the incoming governor a body of specific recommendations aimed at reforming the system.
Assemblywoman Duprey notes that the battle over health care funding in the North Country fits into a larger conversation regarding the region’s reliance on the state for fiscal solvency – a conversation in Albany and here at home that includes parks, visitors centers, prisons, and schools.