TEACHING HOSPITALS: Financial Crisis Threatens Mission
Writing in today's New York Times, columnist Bob Herbert writes that a "deep financial crisis" is spreading through the nation's teaching hospitals, which in turn threatens the nation's entire health care system. "It's a total crisis, a complete crisis," said Neil Rudenstine, president of Harvard Medical School, who said the cumulative debt of Harvard's five affiliated hospitals is "well over $100 million so far" this year. The situation is much the same for teaching hospitals across the nation. In California, UCSF Stanford Health Care will most likely lay off 2,000 staff members over the next 18 months to prevent losses of $135 million. Herbert blames teaching hospitals' woes on the 1997 Balanced Budget Act's Medicare cuts, managed care and rising medical costs. "The only payers who help balance the books have been those who pay through private insurance, and the payments for that are declining as well," said Dr. Joseph Martin, dean of the Harvard Medical School. "Toying with the future of such a system is as dangerous as Russian roulette," Herbert contends, pointing out that teaching hospitals provide 40% of the nation's charity care and are "the places where cures are found, treatments developed [and] miracles realized." And in the words of Rudenstine, teaching hospitals are "where physicians get educated" -- where they receive their first exposure to "the connection between scientific study and the real world of clinical treatment." With additional cutbacks in Medicare soon to come, the situation is not likely to get better for teaching hospitals, Herbert says. And if that happens, many will be forced to "go out of business or become for-profit institutions, which means they will drop the research and teaching components because those things don't make any money," Rudenstine predicts. "They'll become perfectly good hospitals up to a certain level, but not up to the level at which we now treat disease, and not up to the level where you can actually train the best physicians," Rudenstine said (4/15).This is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.