Muhlenberg - Courier - Editorial: Plan the losses

Published in the Courier News, Monday, April 21, 2008

Editorial
If hospitals must close, plan the losses

Plainfield residents care deeply about Muhlenberg Regional Medical Center and its impending closure.

State health officials do not.

It's not that they want Muhlenberg to close, exactly. But they're OK with it. Heather Howard, commissioner of the Department of Health and Senior Services, explained recently that aid shortages and a glut of beds mean that the state's health care system could be strengthened by more closures that better maximize health resources.

Many health-care experts would challenge that analysis, among then Kenneth Bateman, president and chief executive officer of Somerset Medical Center in Somerville, and Robert Wise, president and CEO of the Hunterdon Healthcare System. The two hospital leaders met with Courier News editors last week, arguing that no hospital closure should be viewed as desirable, and that the supposed "overbedding" doesn't take into account the wide variety of health-care services provided by every hospital.

But even if we do accept Howard's assertion, the state is going about this the wrong way. Gov. Jon Corzine's budget includes significant cuts in charity-care aid, increasing pressures on hospitals already dealing with aid shortfalls and likely resulting in more closures. Howard said additional closings are virtually inevitable.

But are the "right" hospitals shutting down? The state's approach -- intentional or not -- is to cut off the aid supply and see who dies first. But unless the state can find the money to more adequately compensate charity care costs, it needs something more akin to what we see when the federal government considers closing military bases. New Jersey needs an independent commission to examine health-care delivery across the state and develop recommendations on potential hospital closures. And that commission needs the power to carry out those recommendations once there has been opportunity for rebuttal, public input and re-examination.

The independent commission already exists, and has done much of the groundwork in determining the state's health-care needs. But it's report issued earlier this year didn't name names of "non-essential" hospitals, and the group is strictly advisory.

As we've seen with Muhlenberg, the loss of a hospital is an emotional public event, and politicians from targeted communities will invariably attempt to block any closure -- as we also see in prolonged battles over military bases. The development of a statewide closure plan must be insulated from political pressures as much as possible. And in the end, the Legislature should be limited to an all-or-nothing acceptance of a plan, rather than plucking individual facilities from the list thanks to a particularly powerful legislator or two.

We're not entirely sure that some hospital closures are good for New Jersey. We do know, however, that simply waiting for a handful of facilities to close up shop after they've withered on the vine long enough isn't the way to manage the process.

Online story here. Archived here.

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