Saturday, March 28, 2009

Who said health care reform?

Last week a local brewery stopped plant operations briefly to show concern about the proposed increase in New York State's excise tax on beer.

It’s hard to know what taxpayers might think about increasing the beer tax. Most people don’t know about it, and that is probably the point. Hidden taxes are below the radar of taxpayers who otherwise focus on income tax, sales tax, or property tax.

Who knows about hidden taxes on health care? The state has proposed an invisible tax on hospital revenues, something like a sales tax on every dollar a hospital collects. Significantly, this is not a tax on a hospital's "bottom line." Many New York hospitals don't even have a positive bottom line.

The impact of the state's proposed hospital tax, along with the proposed cuts on hospital payments, now appears much worse than it did a few months ago. According to Healthcare Association of New York State (HANYS), new figures from the Department of Health show Community General Hospital will lose some $2.2 million (far more than the $636,000 loss estimated last December). [1]

The accompanying chart shows the result of hidden taxes and state cuts on all four Syracuse hospitals. Together these hospitals will lose nearly $9 million under the proposed state budget. To see the impact of the budget on any hospital in New York, go to this site.

There are also hidden taxes on health insurance. I was surprised to learn this week just how much they are. The health insurance tax represents the fourth largest source of income for New York State. The following information comes from Excellus, updated as of March 10.

Major sources of NYS taxes, last year
1. Personal income taxes, $36.27 billion
2. Sales and use taxes, $11.301 billion
3. Corporation franchise taxes, $ 4.265 billion
4. Private health coverage taxes, $3.177 billion
5. Petroleum business taxes, $ 1.184 billion

After the proposed increases, health insurance taxes will move to the third largest source of state revenue, at $3.75 billion annually. [2]

Taxes on hospital revenues...increased taxes on health insurance. Did someone say, “health care reform?”

[1] The state’s proposed cuts and taxes will cost Community General about $200 for each patient admitted to the hospital.

[2] Excellus estimated the state’s hidden taxes would add some $400 to the cost of treatment for a woman diagnosed with breast cancer who has a lumpectomy and follow-up cancer care.

Saturday, March 21, 2009

Her Whole Life Was Nursing

Last month I read in The Post-Standard the obituary of Margaret Eklund, who died at age 91. She was the first Director of Nursing at Community General Hospital, having joined the organization in April 1962. One of the original administrative team, Ms. Eklund was employee #0006.

Community opened on January 1, 1963 and Ms. Eklund built its policies, hired its nursing staff, and established a culture of of excellence and caring.

I did not know her, but in the weeks since Ms. Eklund's passing, I have asked some who knew her for their memories. Ms. Eklund set high standards for herself and for all with whom she worked. She was meticulous and demanding, and her starched whites, including cuff links, were legendary.

When Syracuse General Hospital merged with Community in 1964, Ms. Eklund brought the nurses from General into Community's new organization. The transition was "very skillful, very amiable," remembers Charles Calligaris, Community's Associate Administrator (employee #0002).

“Ms. Eklund was a very effective Director of Nursing," Mr. Calligaris recalls. "She supported her staff. The nurses were professional, and they felt good about themselves.”

With General Hospital came its nursing school, and Ms. Eklund also served as Director of Nursing Education until the nursing school transferred to Onondaga Community College in 1968. A student from that era recalls some hijinks -- students going to the hospital roof to let off steam. As she recalls, a bit ruefully, “Ms. Eklund didn’t appreciate any fooling around.”

Ms. Elund’s obituary reads: “She fought lifelong to set the highest standards in healthcare for all and for the elevation of as well as respect for the nursing community.”

Remembers Charles Calligaris: “Her whole life was devoted to nursing.”

Thursday, March 19, 2009

Adequate sleep and safe driving

Yesterday News10Now interviewed Dr. Culebras about sleep disorders and daytime vigilance -- especially driver safety. You can see the story here. Also, see the posting, below.

Wednesday, March 11, 2009

World Sleep Day

Dr. Antonio Culebras, a consultant at the Sleep Center at Community General Hospital, is the co-chair of World Sleep Day, March 20. This is the second year Dr. Culabras has co-chaired the event.

A professor of neurology at Upstate Medical University, State University of New York, Dr Culebras is a specialist in stroke and sleep disorders. He is active in the World Neurology Foundation, the American Academy of Neurology, the World Federation of Neurology, and the International Stroke Society.

World Sleep Day is organized as an international event by the World Association of Sleep Medicine (WASM) to educate the public about the importance of sleep disorders. Click here to see a video of Dr. Culebras.

With specialists in neurology and pulmonology, Community General's fully-accredited Sleep Center is in its 21st year and diagnoses and treats sleep disorders and daytime alertness. The six-bed center is directed by Dr. Robert E. Westlake, Jr., a board-certified pulmonologist and specialist in sleep medicine.