In late November 2006, the Berger Commission finally issued its long-awaited report on health care reform in New York state. There’s no doubt New York’s health care system needs reform; that’s a given. But do we really want the kind of reform recommended by this ideologically driven group that is accountable to practically no one?

	“LEGISLATORS KNOW THE IMPORTANT ROLE THESE FINE INSTITUTIONS PLAY … THAT’S WHY WE ARE OPTIMISTIC THEY WILL FIX THIS MESS. … I ALSO KNOW THAT UUP WILL NOT REST UNTIL THIS MESS IS CLEANED UP. OF THAT I’M CONFIDENT.”
By William E. Scheuerman UUP President bscheuer@uupmail.org

Absolutely not. But that’s not the real issue. The real issue is whether we can undo the bad parts of the report.

As absurd as this sounds, the report was part of a process well outside the boundaries of what we usually call democracy and public oversight. Worse, a report containing major policy changes impacting health care in New York for the next generation would take effect automatically unless both houses of the Legislature said no. Worse still, the Legislature met for one day in mid-December and never got around to voting on this important issue. Even though both the Senate and Assembly held hearings on the report’s recommendations, the much-needed depth of discussion and public oversight was grossly lacking.

So much for full discussion and careful analysis of the legal and fiscal implications of the commission’s policy recommendations, not to mention a full understanding of their impact on community health care throughout the state.

SUNY hospitals threatened

Clearly, the process was flawed. But what about the substance of the report?

Let’s start with the report’s recommendation to privatize the SUNY teaching hospital in Syracuse and to conduct a study to determine the feasibility of privatizing the hospitals at Stony Brook and Brooklyn. For six or seven years running, both houses of the Legislature have rejected proposals to privatize or otherwise remove the hospitals from SUNY. One may think the commission report offered new evidence to change legislators’ minds. But it didn’t. The report didn’t present a single shred of new evidence to make legislators change their minds. Given the secret nature of the commission’s deliberations, we shouldn’t be surprised. It’s clear that the pirates of privatization were trying to sneak through the back door what they’ve been unable to achieve through an open, democratic process.

First-rate institutions

Now let’s get it straight. SUNY’s teaching hospitals are first-rate institutions that are well managed and efficiently run. But don’t take my word for this, just look at the findings of PricewaterhouseCoopers, an independent auditor. They say the SUNY hospitals “… have done an exceptional job competing in relatively unpredictable markets given state operating constraints.”

So, what problem was the commission addressing? Are we again dealing with a solution in search of a problem? It sure seems that way. A change in hospital governance in itself will not alleviate the hospitals’ fiscal pressures. Governance changes do not create money, but they will change the mission of the hospitals without public discussion.

Services, accountability at risk

Removing the hospitals from SUNY would allow them to terminate the expensive tertiary services needed by the community, services such as the burn and trauma units at Upstate Medical Center in Syracuse. These services are costly, but essential. Where will a burned firefighter go for treatment in central New York should the hospital close its burn unit?

And what about the uninsured in a 15-county area served by Upstate? Where will they go for treatment? Are we prepared to let these people die without care?

A change in governance would also remove the hospitals from public accountability. Currently, the hospitals are accountable to the SUNY Board of Trustees, the governor, the Legislature and the people of New York state. If the hospitals are privatized, policymakers would surrender their much-needed oversight.

The Legislature didn’t vote on the commission’s recommendations in December, so the report became law Jan. 1. But don’t despair. The hospitals can’t be privatized without further legislative action. And key legislative leaders have publicly stated that they would not allow the state Health Department to privatize SUNY hospitals. Legislators know the important role SUNY plays in training future doctors and nurses; they know the important role these fine institutions play in the community, too. That’s why we’re optimistic that they will fix this mess and do it under the bright sunshine of the democratic process. I also know that we at UUP will not rest until this mess is cleaned up. Of that I’m confident.