EDITORIAL: Hospitals in the ICU: Running out of patients and cash

March 26--If the city's financially sick public hospital system were a human patient, the caregivers who've stalled while the disease eating away at it has advanced, year after year, would be guilty of malpractice.

The 11 full-service hospitals and many more health clinics that make up Health + Hospitals, designed in and for a different era, are losing patients and bleeding cash. Deficits are projected to exceed $1.2 billion this year and top $2 billion each year to come.

It's been a year since budget officials have revealed exactly how much money the system is losing.

Mayor de Blasio claims to be on the case. His response thus far has been close to laughable.

After two years of inattention, in 2016 he unveiled an H+H "transformation plan" that promised to "not close any hospitals or layoff any workers," and banked on favorable treatment from state and federal government.

Layoffs soon became inevitable. Congress has delayed but not derailed billions of dollars in coming Obamacare cuts to federal aid used to care for uninsured patients. Only de Blasio's vow not to close a single hospital endures, without examination -- but must be on the table, along with all possibilities for restructuring.

What Health + Hospitals needs, stat, is an aggressive strategy to transform a system that remains more or less the network created in 1969, centered on inpatient beds, in an industry where overnight stays have become rarer and outpatient services are a booming business.

The city hospitals grapple toward course correction, while shouldering high costs of maintaining the legacy -- and losing patients. They need to go all in on the future.

The city Independent Budget office last week put a price tag on forestalling intervention: $2.1 billion this year. That's how much taxpayers inject into the system beyond what patients and insurers pay for services, up from $1.3 billion in 2014.

The financial picture would be worse were it not for yeoman's work done by just-retired interim president and private-sector hospital pro Stanley Brezenoff, who realized important savings and efficiencies. But he was still boxed in by de Blasio, who refuses to allow anything close to the visionary rethink needed for survival.

Dr. Mitchell Katz, who took over the hospitals in January, is ditching costly consultants and plans to invest in care -- beginning by hiring 55 primary care doctors so his facilities can book patients presently turned away, and expanding patients' access to money-making procedures like angioplasty.

It's a cautious start when extraordinary measures are in order.

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