Liberal

February 9, 2014

When the Walrus was a young pup, he was introduced to a number of new words and concepts.

One of those new words was “Liberal”.

The Walrus learned that people who were categorized as Liberal were those who:

–          Are not opposed to new ideas or ways of behaving that are not traditional or customary;

–          Believe that government should be active in supporting social and political change;

–          Are broad-minded and tolerant of different views and standards of behavior in others;

–          Are politically and/or socially progressive, supportive of gradual reform, particularly political reforms which extend democracy, distribute wealth more evenly, and protect the personal freedom of the individual.

Today, it seems as though some people have bastardized the meaning of Liberal.  These folks seem to want to demonize those who identify as Liberal!

I’ve enjoyed the past 6 decades of my life thinking that: While change is always difficult for us humans, looking at situations in new and different ways is productive, healthy and sometimes truly beneficial.

I’m very sad that some of my fellow Americans are unable or unwilling to embrace this philosophy, but I guess in a free society, that is their prerogative.

We have some 700 public school districts across New York State, and as Governor Cuomo pointed out recently in an interview, “It’s not about more money gets us more results.  Because if that was the case, our students would be doing better than any students in the country, because we are spending more than anyone else.”

No one could successfully argue that the K-12 public education system in New York State is either (a) effective, or (b) efficient.

Designed and governed under assumptions which were likely correct in the 19th century, we continue to operate our schools as though we live in a world where the horse is the primary means of transportation; where oil lamps and candles are used for illumination after dusk; and where young people are needed early and late each day to do chores on the farm.

An article published on February 7, 2014 in The Journal News (http://www.lohud.com/article/20140207/NEWS/302070065/City-rural-schools-say-they-re-underfunded) helps to illustrate some of the complexities in state funding formulas which seem to have disparate negative impact on small city and rural school districts which are more likely to be both ‘high need’ and ‘low resource’.

Digging further into the mystery of school funding in New York State led me to the NYS Association of Small City School Districts, and the December 2013 newsletter, http://scsd.neric.org/newsletters/2013/2013%20SCSD%20Newsletter%20december%202013%20FINAL.pdf.

One of the outcomes of ‘The Campaign for Fiscal Equity’ was a promise made in 2007 by our elected officials in Albany that state funding would be adjusted to take into account both the availability of local resources and the relative “need” of students in each district.

As Governor Cuomo pointed out, we are already spending the most of any state on education, and our overall results are mediocre.

Indeed, it is not how much we are spending, but how the money gets spent.  If our elected officials want to constrain education spending, they need to pass legislation which removes costs from the system.  One way to accomplish that would be through school district consolidation to remove redundancies and spread fixed costs over a broader base.

Another way to accomplish holding the line on spending would be to divert aid from wealthy, high-performing districts and re-direct that aid to low-resource, under-performing districts.

When it comes to educating our young people, there really doesn’t seem to be any “starve the beast” solution on the horizon.

Let’s pay attention to this issue now, because if we don’t fix it now, it will only continue to fester and act as a drag on the economic and fiscal viability of New York State.

More on Dysfunction in NYS

February 5, 2014

An article about health insurance policies purchased through the New York State health exchange (an outcome of the Affordable Care Act) appeared on the front page of our regional newspaper (The Journal News) on Sunday, 2/2 – http://www.lohud.com/article/20140201/NEWS/302010057/Westchester-Medical-Center-won-t-accept-ACA-patients

The reporter had canvassed all of the acute-care hospitals in the Lower Hudson Valley and found that all would accept coverage offered through the exchange except one: Westchester Medical Center.

The reporter explained that the CEO of Westchester Medical Center had said the insurance exchange reimbursements were too low to cover the costs of the services it offers as a teaching hospital.

“We want to participate,” CEO Michael Israel said. “We have not been offered rates that we can live with.”

Westchester Medical Center (WMC) was originally a subsidiary of Westchester County Government, and it was reorganized in 1997 as a “Public Benefit Corporation”, one of about 1,000 of these ‘shadow government’ entities which exist across the state. (See a report issued by the NYS Comptroller in December 2013 — http://www.osc.state.ny.us/reports/pubauth/PA_employees_by_the_numbers_12_2013.pdf

Since this conversion, Westchester Medical Center (WMC) has been no stranger to controversy.

WMC is very similar to Erie County Medical Center (ECMC):  Both are teaching hospitals; ECMC has 569 certified beds; WMC has 652 certified beds; both were formerly subsidiaries of County Government; and each has converted to a Public Benefit Corporation.

One marked difference between ECMC and WMC shows up in the category of personnel and payroll.

In the year ending 12/31/2012, ECMC reported 3,436 employees and a gross payroll of $154 Million.  WMC reported 3,928 employees and a gross payroll of $280 Million.

ECMC paid a bonus to 61 employees, totaling $245,381. The highest individual bonus reported was $15,000.  That seems reasonable and fair, assuming there was some criteria employed to gauge the performance above and beyond the salary paid.  The CEO at ECMC total compensation was reported at $698,000.

WMC paid a bonus to just 13 employees, totaling $940,338.  The CEO at WMC total compensation was reported at $1,375,000 including a bonus of $339,000. Even the next in command at WMC was paid more than the CEO of ECMC:  total compensation $800,000, including a bonus of $150,000.

As CEO Michael Israel points out in a subsequent article published in The Journal News (2/4/2014) http://www.lohud.com/article/20140204/NEWS02/302040083/Rejecting-ACA-health-policies-Westchester-Medical-Center-under-state-scrutiny?odyssey=mod|newswell|text|News|s

““I don’t think it’s wrong or objectionable to want to be reimbursed an amount of money to cover the costs of treating our patients.”

Well said, Mr. Israel.

The remaining question is:  What sort of accounting shenanigans took place to allocate all (or a portion of) Israel’s compensation – and the other 12 who received extraordinary  bonuses – to the cost of treating patients?

The Ultimate in Irony?

February 3, 2014

A stated primary purpose of the Affordable Care Act is to ensure that all Americans have access to affordable health insurance.

Over the past 2 years, we’ve watched and heard elected officials at various levels of government fabricate stories to try and convince us that having a government-legislated mandate which gives us access to affordable health insurance is bad.

The Westchester Medical Center in Valhalla, NY is a “NYS Public Benefit Corporation.” As such, it serves as a regional healthcare referral center, mandated to provide high-quality advanced health services to the residents of the Hudson Valley and the surrounding area, regardless of their ability to pay. WMC also serves as an academic medical center involved in research and education that enables advanced care and prepares future generations of physicians.

According to a report published in April 2012 in The Journal News, the medical center spent $11.8 million in 2010 to compensate 44 executives, with Michael Israel, the CEO, at the top of the list at some $1.4 Million.

Now, in a Kafkaesque twist, this over-compensated CEO of a public benefit health care provider has proclaimed they will not accept any coverage plans offered through the NYS health care exchange! (The Journal News, February 2, 2014).

The Journal News has done an admirable job following and reporting on the perpetual shenanigans which seem to plague Westchester Medical Center. Yet, leadership at WMC seems to continue to ignore the reason they enjoy the benefits of public subsidies from the local, county, state and federal governments.

Here it is: the ultimate Catch-22:

1. You have insurance.

2. The Public Benefit Corporation which was created (and continues to exist) to, “manage a health care system which will provide health care services and health facilities for the benefit of the residents of the State and the County, including to persons in need of health care services who lack the ability to pay..” won’t accept your insurance.

Folks, you just can’t make this stuff up!