I am surprised that the Star Ledger published Rev. Colvin's response to their June 24th editorial. I had felt for months that this usually stalwart crusading paper was deliberately ignoring the Muhlenberg situation.
Perhaps my opinion was the result of being a frustrated writer, On May 14th I had submitted a rather long essay requesting it to be considered for the op/ed page. I was not surprised when it never appeared inasmuch as I have no status as an agency executive or professor to merit inclusion among the papers stable of paid columnists.
for those who have the time, I am reproducing the letter here.
IMPACT OF HOSPITAL CLOSINGS
Affordable accessible health care is a paramount political issue today. New Jersey’s present policy in reducing hospital beds in medically under-funded population locations is not an appropriate answer to this problem.
Closing Muhlenberg Hospital in Plainfield is the wrong answer for New Jersey’s Health Care System. The fact that the excessive hospital beds are in the north and central portions of the state does not justify indiscriminate closing hospitals that operate at a loss. No attention has been directed at the economic demographics of the affected areas.
Among the recent 22 Hospitals closed since 1992are; Columbus and St James in Newark, Alexian Brothers and Elizabeth General (merged into St Elizabeth Hospital) in Elizabeth, Barnert in Patterson, and Union Memorial in Union. All had a commonality, an urban hospital serving a population with a high percentage of uninsured or Medicaid dependent individuals.
Nonprofit hospitals in NJ are mandated to care for all regardless of ability to pay. The State has repeatedly reduced funds allocated for reimbursement of such hospitals care. Medicaid reimbursement is probably well below true operating costs.
Prior to issuing a closure CN in depth auditing of the books determined the actual loss necessitating closure must be performed. The book losses must be due to actual operation costs, not number manipulations or coast/income shifting in a multiple unit hospital system.
How much of Solaris’s increasing operating loss can be attributed to Muhlenberg Regional Medical Center patient mix or due to a JFK reported 116 unoccupied beds in an affluent community and a desire to eliminate competitive beds from another portion of its system. Or was it due to the sale or transfer of profitable services away from MRC? These too are questions that deserve clarification.
However one fact remains, Accepting society’s and government’s responsibility to provide care to the less fortunate, why is the State permitting the loss of the only beds that service that population? Logically, the bed reduction should come from the overabundance of affluent area hospitals. Hospitals providing care to a poor urban population must receive in-creased economic support.
The humanitarian and prognostics outcome of the changes in care patterns have not been addressed. Minutes can be the difference between life and death. Yet, no concern has been directed to the increase time re-quired to reach treatment as a result of these closures.
Perhaps that is due to the proximity of the remaining hospitals. The road network could also be a mitigating factor.
The Pascack Valley demise demonstrates the opposite. A recent newspaper article stated “While the average ambulance run to Pascack Valley and back was an hour, according to EMTs, “it now takes at least 90 minutes for round trips to the next closest hospitals - The Valley Hospital in Ridgewood or Englewood Hospital and Medical Center” said a veteran Park Ridge EMT”.
The time for rescue squads to transport Plainfield’s residents to JFK’s ER will increase from 10 minutes to 25 or more depending on traffic conditions. Since according to local EMTs JFK’s ER has been on "divert" for two hours almost daily, without an increased load from the MRC area. How long will it take to reach a more distant functioning receptive ER over the poor existing road networks?
I have deliberately used the term functioning since an ER as proposed for MRC without the readily availability of acute in-hospital facilities is nothing more than a walk-in –clinic. No EMT would consider transporting a critical patient to such a facility. For patient inadvertently initially treated in such an ER there would be further time delay for an ambulance to arrive load and transport to the acute care hospital where triage would occur before treatment.
Finally there is the issue of the ability for car less members of a family to visit patients in the surviving hospitals.
There is no problem relating to good public transportation and road net-work access for the Elizabeth, Newark, Patterson, and even Union hospitals are in areas where there is public access.
However, consider what will happen in the Muhlenberg core area. From Plainfield to JFK by public transport would involve a train or bus to Penn Station Newark, a train to Menlo Park, and then a bus to the hospital. The bus from Plainfield could also be used to take the Menlo Park train from Elizabeth NJ Transit RR Station. Please figure out the time and cost for such an adventure. On the other hand a taxi from Plainfield to JFK costs $30.00 one way.
The State cannot permit or condone the fait accompli closure of Muhlenberg Hospital? For the community welfare of the core Muhlenberg population, Commissioner Howard must take positive corrective action to restore, not close, Muhlenberg to full service capabilities.
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