Public Policies, Market Trends Destabilize Role of NYC's Teaching Hospitals in Caring for the Poor

Academic Health Centers and health care for New York City's poor

From 1997 to 1999, researchers at Columbia University's Eisenhower Center for the Conservation of Human Resources, studied the effects of changing health marketplace dynamics on New York City's academic health centers, i.e., teaching hospitals affiliated with medical schools.

Key Findings

  • Per capita and total health care expenditures in New York City have become substantially higher than elsewhere in the country.
  • The city's academic health centers have not realized the expenditure controls and reductions they had hoped to achieve through mergers and system building.
  • Academic health centers are on the cutting edge of medicine, with costly new technologies.
  • Congress is unlikely to continue to support indefinitely the training of more than 12,000 residents in New York City, thereby threatening an important source of future income for academic health centers.
  • Because 28 percent of New York City's population under age 65 is uninsured (compared with a national average of 20 percent), cutbacks in funding to hospitals, resulting from the federal Balanced Budget Act of 1997, placed a disproportionate burden on the academic health centers.
  • City hospitals are heavily indebted, collectively owing as much as $9 billion, primarily for capital expenditures, expansion and equipment.

Funding

The Robert Wood Johnson Foundation (RWJF) supported this project through a grant of $286,237.