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Berger Defends Hospital Closings: Commission Chairman Says Report’s Findings Were Made to Benefit Patients

October 25, 2007

By Lauren Stanforth, Albany Times Union, N.Y.

Oct. 25–ALBANY — To many hospital workers around the state, Berger is a bad word.

The reason is because last year’s Berger Commission report single-handedly laid the groundwork for nine hospital closures and the reconfiguration of 47 more statewide.

Stephen Berger, the chairman of the commission, formally known as the Commission on Health Care Facilities in the 21st Century, knows what his reputation is now with those in government and health care alike.

“I’m a walking toxic Superfund site,” Berger joked Wednesday during a small talk at the Nelson A. Rockefeller Institute of Government. “So no one in government wants to get anywhere near me.”

Despite how some might feel about the former state Social Services commissioner, Berger made no apologies about the recommendations the commission made, which were ultimately all approved by the state Legislature.

None of the closures or mergers were personal, he said. The commission was trying to restructure a broken health care system by lifting up the healthiest institutions to provide the best service to patients, he said. Berger, now chairman of a private New York investment firm, said no one disagreed with the concept. But when it came time to make hard decisions, everyone thought the theory did not apply to their institutions.

“We have a system that’s provider-driven, that’s institution-driven,” he told the group of about 50 people from state health care interests. “It is not consumer-driven, it is not customer-driven.”

The few who attended from locally affected hospitals included Bellevue Woman’s Hospital CEO Anne Saile and some of her staff. The commission recommended Bellevue close, but the 40-bed Niskayuna hospital is instead being taken over by Ellis Hospital next week. Meanwhile, Ellis and St. Clare’s hospitals in Schenectady are working out a future merger between them, thanks to the Berger Commission’s report.

Saile said she got to the Rockefeller building on State Street early so she could get a front seat. During a question-and-answer period, Saile asked if the commission thought its recommendations were infallible. Berger said the recommendations didn’t mean the commission thought Bellevue was bad, but that it was trying to make the best judgments for the system overall.

Saile said afterward she’s still not clear on how the closures and mergers will save money — particularly because the state has already given out $362 million to help implement the commission’s recommendations. Berger said during the talk that restructuring isn’t necessarily about money, but strengthening the hospitals that need it.

Berger said the hospital closures and mergers are only a first step. The larger problem is the insurance reimbursement system, which he said forces hospitals to offer highly specialized services, such as advanced cardiac care, because the higher reimbursement covers lower reimbursed services such as maternity.

James Sinkoff, CEO of the Whitney Young Health Center in Albany, attended the talk and said he agreed with many of Berger’s views, but said reimbursement must be changed to reflect how well providers prevent chronic illness. Sinkoff pointed to the problem of hospitals getting approval to expand their emergency rooms when many patients are simply using them for primary care.

“If I improve the health of 100 diabetic patients, then I should be rewarded for that,” Sinkoff said. Lauren Stanforth can be reached at 454-5697 or by e-mail at lstanforth@timesunion.com.

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Copyright (c) 2007, Albany Times Union, N.Y.

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