8th
In 2006, the system was losing approximately $10 million per month. I don’t know how much bloat they have cut since but I would doubt it would do much to combat their ever expanding finance costs on what the NYT reports is now $700 million in debt. Because of inefficiencies in the design of the hospital both from a layout and operational perspective, about 40% of people who entered their emergency room waiting room left untreated. An enormous share of their revenue came from turning emergency room walk-ins into in-patients. Not only were they seeing a large share of those potential patients walk away but their bed count (total potential in-patients) dropped by almost half in the last couple of decades because they didn’t have the money to support the beds. It was a vicious cycle. Also, because it was a Catholic institution, they could not provide family planning treatments. One of the fastest growing revenue generators at hospitals across the country is in vitro fertilization. The area that surrounds that hospital is just about the perfect demographic for IVF but because of their charter, those rich, older families were sent across town. (I doubt abortions are a big money maker but those were off limits also.)This is the problem with almost all of our healthcare infrastructure in America. Hospitals were designed not around efficiency, but around having a space to treat tuberculosis, diarrhea from dirty water, and a business model that hasn’t progressed out of the fee-for-service structure of the 19th Century.
Our country now has drastically different healthcare needs— 75% of our healthcare costs are from chronic, behavioral-based diseases but our infrastructure is built for acute issues with a glut of hospital beds and white coats that treat behavioral based disease with pills and scalpels.
I did my residency at St. Vincents. It’s now almost closed. And I’m happy.
I truly believe that something better will be created that will eventually meet our vastly different needs. Sometimes society needs to purge. Sometimes we need to move on with total faith that our generation can produce something better, something more meaningful to our current population, and something we, as progressive, modern, ridiculously intelligent Americans can be proud of.
And I’m late to my meeting with the group Bloomberg hired to figure out a way to run NYC healthcare as efficiently as he runs his own company. The future is bright…
