The Bronx Ink

by Selamawit Gebrekidan

At the Montefiore Medical Center in the Bronx there is concern that the new bill will cut in half the annual funds the hospital had received from the government for low-income patient care. The medical center expects to receive only $50 million in what is known as the Disproportionate Share Hospital fund. With 32 million more people coming into the system, a hospital spokesman said, resources will be definitely be strained.

by K. S. Nikhil Kumar

A Brooklyn doctor of 25 years believes that the health care reform legislation is not the right direction to be moving in because it puts more pressure on professionals like him, instead of on the insurance industry.

The number of patients will increase as a result of the reform he explained, but there will not enough doctors to treat them. “I’m just afraid that’s going to be less time for each patient.”

“We’re already seeing a lot of patients for free due to Medicare and government sponsored insurance,” said the gastroenterologist, who declined to named because of “the battles” medical professionals are having with the insurance industry. He also said that referring physicians might take issue with him speaking out.

“I’m predicting that there will be job cuts,” he said. He fears professionals like him will have to take on more patients as a result of the reform.

According to the anonymous doctor, the government was moving more in the direction of family practice and away from specialization with this bill. He predicted a future with centers being operated by nursing agencies and less by specialists.

by Sarah Butrymowicz

It’s too soon to say how nursing homes in the Bronx – and all over the country – will feel the impact of the health care bill, but there are some causes for concern, experts say.

Patrick Cucinelli, senior director of public policy solutions at New York Association of Homes and Services for the Aging, is particularly apprehensive about expansion of Medicaid coverage. He worries that mandates for additional coverage, in a state that is already struggling to fund its Medicaid program, will bring an added pressure to make cuts at institutional levels, like nursing homes, in order to free up funds to cover individuals.

Nursing homes in the New York have lost over $1 billion in revenue from cuts to Medicaid in the last three years and are chronically underpaid by the program, ranging anywhere from $15 to $25 dollars a day per resident.

At Morningside House Nursing Home, about 70 percent of revenue comes from Medicaid. Managed care and Medicare round out nearly all of the rest, with a small amount of private care.

But Medicare provisions in the bill could be problematic in the future as well. For instance, the bill includes productivity cuts to Medicare reimbursements, operating on the assumption that nursing homes earn more each year. But this sort of cut may make sense at hospitals, though not at nursing homes where many of the residents are receiving palliative care or are terminally ill, said Dr. William T. Smith, president and CEO of Morningside House. “It’s a different picture in long term care,” he said. “We don’t have the same care rates or discharge rates.”

The health care bill also creates a new advisory panel that will be charged with making Medicare more efficient, ideally offsetting any cuts. But Smith doesn’t think there is enough wasteful spending in nursing homes to make a difference. “I can’t anticipate this bill being funded out of efficiencies and productivity measures,” he said.

Also, the bill might help keep elderly people out of nursing homes by allowing them to stay home longer. The bill includes a new initiative, which establishes a trust fund, called CLASS. After five years, individuals who chose to pay in to the trust would have another small source of revenue to pay for home and community based services to keep relatives at home. Elderly people “need as much help as they can to stay in the community,” Smith said.

by Danielle Bengsch

The reaction among a sampling of Brooklyn pharmacists to the bill’s passage ranges skepticism to confusion about what its impact will be.

“We just don’t know yet what is going to happen,” said Derek Durham of Prospect Garden Pharmacy in Park Slope. He hopes to get some information from the pharmaceutical board.

Similarly, a pharmacist at the Myrtle Avenue Pharmacy in Fort Greene said, “I don’t know what it means for my business. When it’s decided, I’ll do a Google search to find out more about it.”

Meanwhile, Michael Goldman of the Ocean Pharmacy in Midwood thinks that the health care reform will bring nothing good for small independent pharmacies like his. “We don’t support it,” he said. “It is not good for out business because reimbursements are going to go down.”

To Goldman it does not matter that millions more will be insured now. “If we make less money for the medicine we sell, what good is it if more people are insured? It’s going to be more work for less money.”

by Matthew Huisman

Longtime community activist Charles Barron, who has represented the 42nd district of Brownsville and Canarsie as well as parts of East New York and Flatbush for nine years, said the new health care bill creates more questions than it answers due to the size and scale of the legislation.

“Before the bill people were always complaining about health care,” Barron said. “We don’t really know what it all covers. I am concerned that people will be fooled into thinking this is comprehensive change.”

Barron said it was in fact only a baby step toward health care reform because people are going to still be paying out of pocket instead of the government footing the entire bill. He also questioned some of the last minute changes to the bill and slammed fiscally conservative Democrats, whom he refers to as “blue dogs,” for demanding compromises to the bill in exchange for their votes.

“We want to stop these corporate run parties, Democrats and Republicans, from prioritizing profits for insurance companies over health care for the people,” said Barron, who feels the benefits of the revised bill favor insurers. “That’s the problem when you have a two party system and both are dependent on the money from corporate business.”

As of Monday, Barron’s office had not been directed any calls concerning the health care legislation.

by Mary Plummer

Late in the afternoon Monday, New York State Assemblyman Joseph Lentol, Democrat – 50th District, hadn’t heard a word from his constituents on the passage of yesterday’s healthcare legislation.

Speaking from Albany, he said he was pleased with the passage of the healthcare bill. But he wasn’t sure exactly what the bill will mean. He regularly gets calls from people complaining about their limited coverage. He said patients in Brooklyn often are denied treatment at their preferred hospitals because they lack health insurance.

“It isn’t the best deal that I would have liked to have seen struck but you have to begin somewhere,” he said, adding that there’s no turning back now. Lentol supported a public option. His district includes Greenpoint, Williamsburg and Fort Greene.

Lentol praised the bill and what it will do for entrepreneurs, artists and young people in Brooklyn. Adding that the bill will help provide insurance to young people who want to pursue careers in more creative areas that don’t currently provide coverage.

“From now on healthcare will be an entitlement, not something you have to worry about having in order to survive,” he said.

by Danielle Bengsch

Republicans willing to speak about the bill’s passage were either unhappy or outraged.

Leon Nadrowski is a surgeon, internist and speaker for the Republicans in Brooklyn.

He is also local leader of the Republican Party in the 50th Assembly District that includes Williamsburg and Greenpoint. “I find socialized medicine is on the horizon,” he said. “All the Democrats are pushing towards socialized medicine like they have in Canada and in Great Britain.

There the people are fleeing their countries to get medical treatment. It’s a disaster.”

The bill’s passage is the “first step towards socialism,” said Belindra Lindros, Republican State Committee member from the 40th Assembly District, which includes East New York, Canarsie and Brownsville.

Many of the Republicans in her district, she says, are senior citizens who are facing cuts in their medical insurance. She also says that insurers have raised the fees before the passage of the bill. “What they’re telling you and what you are seeing is the total opposite,” she said.

by Matthew Huisman

Carl Hum, president of the Brooklyn Chamber of Commerce, said the health care bill will help expand the coverage offered to the workforce and emphasized that a healthy workforce is essential for any successful business.

“From a business perspective it only makes sense that health care is provided for employees,” Hum said, referring to the low-cost health insurance that the chamber offers its members. “We have over 500 businesses and we know the results. They are getting a more dedicated work force that doesn’t have to worry about paying for health insurance. Our economy is built on having a stable and reliable workforce.”

The bill will require companies with more than 50 employees to provide health insurance to their employees, which is of some concern to small business owners. But since 90 percent of businesses in Brooklyn have less than 50 employees many companies won’t face the steep cost of providing health insurance.

Hum is optimistic that the bill will help small businesses and hopes the price tag associated will be a reasonable one. “Overall the bill is unlike anything else. You are not going to get anything that’s perfect but it comes a long way to cover people. The question is will it be affordable or not?”