 
“Anyone here take Metro North to breakfast this morning?” Allan Atzrott asked nearly 200 business and community leaders who attended St. Luke”™s-Cornwall Hospital”™s 8th annual President”™s Breakfast at the Powelton Club in Newburgh May 8. Â
No one had.
Atzrott is president and CEO of St. Luke”™s-Cornwall, whose merger was praised by the Berger Commission as a model for other hospitals to follow ”“ “but we couldn”™t continue offering programs like in-patient psychiatric because of the cost,” Atzrott told the audience. “The economy has forced us to make some difficult decisions ”“ cutting our inpatient psychiatric unit was one of them.” SLCH is also partnering with a for-profit dialysis provider because of the increasing deficit that program was facing.
“In 2008, we provided more than $21 million in charity care but lost $3 million in operations as a result,” Atzrott told the group, reimbursement rates that leave the hospital with a climbing deficit and more uninsured people coming to the hospitals”™ emergency rooms as the recession deepens. Â
What seemed to amaze the Virginia-bred Atzrott was what he described as New York”™s fuzzy math. “There are 700 school districts, 11,000 forms of government and 6,000 taxing districts in New York State,” continued Atzrott. “I”™m from Virginia, where there is one school district in each county. How many are there in this county alone? I am still trying to figure how New York manages.”
Apparently, noted Atzrott, not very well, based on the growing deficit in Albany and the constant cuts having to be made in services, while taxes continue to climb.
New York”™s “fuzzy math,” combined with Medicaid”™s and Medicare”™s reimbursement rates, are causing more hospitals to cut programs and trim staff. Although the cost of an emergency room visit is $410 on average, Medicaid reimbursement covers only 55 percent of the cost, said Atzrott.
While President Barack Obama has promised to bring reform to the health care system, Atzrott wondered where to begin and how it can be done while hospitals are struggling to serve the ever-increasing uninsured community right now and still provide the best care possible to their patients.
“Reform can”™t be done overnight, and it has to be done on a national level,” he said. “The dire shape our economy is in is adding the growing ranks of uninsured.”
The cost of commercial insurance has added to New York”™s inhospitable health care atmosphere, said Atzrott, making other states more attractive to new doctors. “In Orange County, a doctor pays nearly $200,000 in malpractice insurance a year; in Dutchess, it is 30 percent less, only because of the insurance companies”™ line of demarcation. Someone needs to take a look at how these decisions are being made and how they justify premiums that are just outrageous.”
Atzrott added that, in addition to the cost of commercial insurance, there are more than 200 for-profit insurance companies in the state that hospitals and private physicians must navigate, noting the number of staff needed to deal with such a number of companies and their associated claims. “It”™s more than time to do what (Attorney General Andrew) Cuomo says is needed: consolidate, merge and modernize the way the state handles reimbursements, decides on premiums and compensates hospitals.
Can any business in this room survive making 60 cents on each dollar? Because that is what is what we are being asked to do.”
Now, the most recent cost-of-business variable, whether big or small, profit or non-profit, is the MTA”™s new mobility tax. It will be a juggling act for St. Luke’s-Cornwall, which has 1,800 employees. “Westchester Medical Center has laid off 500 people because they can”™t make their payroll,” said Atzrott. “This tax means an additional $250,000 a year the hospital must come up with in order to fund the MTA ”“ but where is the oversight of the MTA? And who in this room is using it?”
Atzrott is not alone in his disgust with the recent bailout of the Metropolitan Transportation Authority. Chambers of commerce from the three counties that receive the least service ”“ Orange, Rockland and Putnam ”“ learned they, too, will be paying 34 cents for every $100 of payroll. “It”™s a business killer,” say local chamber presidents. So much so that Orange, like neighboring Rockland, has called for a way to get out of the MTA and negotiate directly with NJ Transit, with whom the MTA currently contracts its service on the west side of the Hudson.Â
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Atzrott had one thing to give thanks for, besides the “wonderful and caring employees” of St. Luke”™s-Cornwall and its emergency angioplasty service: the hospital”™s new 20,000-square-foot cancer care facility currently under construction on the Cornwall campus, which will offer the only radiation oncology center in Orange County to utilize TomoTherapy radiation technology. The new center is scheduled to open by September.
From a hospital or the corner deli, Atzrott asked the audience to remember to “think local when it comes to seeking services. For us personally, our affiliation with Mt. Sinai has brought even more quality service to the region. Our hospitals rank right up there with hospitals in the city. Please remember that when you need a good hospital, you don”™t have to go out of the region to find one. Let”™s keep our dollars here and keep our facilities growing to offer the best anyone can find anywhere.”
As for the mobility tax, Atzrott wonders how Albany can justify exempting school districts while ignoring other must-have services “or anyone else, for that matter.”
