Good morning. Thank you for the opportunity to speak to you today.
While I applaud the stated goals of the Berger Commission, it missed the mark in Queens by not strengthening patient access to high level services. The establishment of the Berger Commission compelled me to develop a vision for a comprehensive and sustainable health care delivery system in Queens. Therefore, I hired the firm of Price Waterhouse Coopers to document every statistic on the current state of health care delivery in Queens. When that was completed, we interviewed all the health system leaders in the Borough, including representatives of the Queens County Medical Society.
On November 14th, I released my report. I would like to share with you some of the key findings:
1) Queens is under-bedded and underserved – the Borough of Queens has 2.3 million residents with a ratio of 1.4 beds per 1,000 people. By comparison, Manhattan has 1.5 million residents and 7.1 beds per 1,000 people. And, there is a growing demand for healthcare services in Queens. Our Borough is growing by leaps and bounds. And most of the growth is residential. New and growing families are placing further stress on an already overburdened healthcare delivery system. As a matter of fact, the study shows that there will be a dramatic increase in the number of individuals 45 years of age and older. This factors in aging baby boomers as well as the graying of the population. Currently, there are more than 374,000 residents in Queens who are 60 years of age or older. That is 1/3 of the entire city’s elderly population. Make no mistake; this increase in the elderly population will result in a heightened demand for inpatient, outpatient and emergency room services.
I am pleased that the Berger commission recommends 40 additional medical/surgical beds at Queens Hospital Center. However, the Berger Commission also recommends the closure of Parkway Hospital, resulting in the loss of more than 250 beds. It also recommends the elimination of 180 beds on the Rockaway Peninsula – with a rapidly expanding population fueled by an unprecedented growth in housing. The loss of those beds is totally unacceptable.
2) Perhaps the most dramatic finding in my study is that in 2004, more than 1/3 of the discharges of Queens residents occurred outside of Queens County. This translates into 97,000 discharges a year that are leaving the borough. That means that on any given day, 1,400 residents of Queens County are hospitalized in beds outside of the county. The main reason they leave is for complex cardiac care. There is limited access to high level services throughout the Borough. This is especially true in the western Queens communities of Astoria, Long Island City, Sunnyside and Woodside.
3) The last, but very crucial finding is that in its current state, our Borough’s health care delivery system is not financially sustainable. The average hospital in Queens has a negative operating margin and we loose $630 million of revenue per year due to outmigration. Based on the evidence in my report, I believe six steps are necessary to turn my vision into a reality:
A) The State Department of Health must establish Queens as its own health region. This would make it possible for health care providers within the Borough to expand services and successfully obtain certification for new services. And did you know that some Manhattan Hospitals use the more than 100,000 residents of western Queens to support their certificate of need applications for establishing new services or expanding existing ones? For example, Queens is home to two of the nation’s busiest airports, yet we do not have a burn center.
B) A new comprehensive hospital must be built in the Rockaways. I am pleased that the commission echoed my recommendation and also called for a collaborative effort between the two hospitals currently serving the Rockaways, St. John’s Episcopal Hospital and Peninsula Hospital Center.
C) A new comprehensive hospital and ambulatory care centers must be built in western Queens; an area that even the federal government acknowledges is medically underserved. A new, state-of-the-art hospital is needed in western Queens. Although Mt. Sinai of Queens currently has plans to expand and modernize, it is land-locked in Astoria and limited in what it can currently do with its physical plant.
We also need more ambulatory care in western Queens. Ambulatory care centers enable patients to seek care closer to home. Western Queens is experiencing a population boom that will eventually result in more than 10,000 housing units that did not exist a decade ago.
The New York City regional advisory committee recommended, in their report to the commission, that expanded capacity and increased access to services was needed in western Queens. Yet, the commission ignored its own regional advisory committee. Indeed, there is nothing in the commission’s report to effectively address in any way the growing demand for high level complex care for the residents of this major section of our Borough.
D) Specialty physicians must be imported to Queens rather than continuing to export Queens Patients out of the Borough. This can be accomplished through affiliations with specialty hospitals.
E) We must also establish a medical clinical campus in Queens. The Sophie Davis School of Biomedical education of the City University needs a clinical campus to become a four-year degree granting medical school. Currently, CUNY does not provide the last two years of hands on clinical training in a hospital setting. The commission acknowledges the financial advantage of academic medical centers. However, the commission makes no recommendation for Queens. I believe that Queens Hospital Center is the ideal location for this clinical campus.
F) To achieve these five goals, I will establish a health care task force comprised of the health care leaders of Queens to work with the new state administration and the legislature. Clearly, implementing and achieving the goals of the report will require a team effort that includes the City, the State and our health care providers.
In conclusion, we must provide better access to services and increase the allocation of all services, throughout the entire Borough. And, if we accomplish these two goals, our hospitals will be financially healthy as well because, we will keep our patients and their health care reimbursements in Queens!
The Berger Commission and I agree that the health care system is broken. But its prescription for Queens is not the cure.