Wednesday, October 4, 2017

the Italian solution is

not andrew cuomo the harley riding thief but g ristori pubmed.org ristori + bcg


bring in a real italian ristori because lswerys are as useless as the finest minds to prevent stsmpedes in the nyc city subway system


andrew cuomo to rome and ristori to ny to help save lives and improve health care


cuomo kills ristori saves





Photo

In a statement, Gov. Andrew M. Cuomo suggested that New York City use its surplus budget funds to help NYC Health + Hospitals, the largest provider of “safety-net” care in New York.CreditSam Hodgson for The New York Times 

ALBANY — After weeks of warning about its possible consequences, a federal cut to New York’s hospitals took effect on Sunday, adding stress to the state’s already overworked public health care system.
The cut came as a result of a lack of action by Congress on so-called Disproportionate Share Hospital payments, known as D.S.H., which are federal funds that help hospitals cover the cost of serving poor and uninsured patients. Under the Affordable Care Act, those funds were supposed to be reduced as more patients received insurance coverage.
On Sunday, the cuts — which had been forestalled by Congress on several occasions — took effect with the beginning of a new federal fiscal year.
Budget officials said the cuts would result in a loss of $1.1 billion to hospitals around the state over the next 18 months, a shortfall that the state says it cannot make up because of its own looming budget deficit, estimated at about $4 billion.
“The irony and meanspirited nature of the cuts is breathtaking,” Gov. Andrew M. Cuomo, a Democrat, said in a statement on Friday. “These cuts are specifically targeted to our most stressed hospitals and neediest populations.”
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At the same time, however, the state was being accused of withholding money owed to NYC Health + Hospitals, the largest municipal public hospital system in the nation and the largest provider of “safety-net” care in New York.
On Friday, the group’s interim president, Stanley Brezenoff, wrote a strongly worded letter to Howard A. Zucker, the state health commissioner, voicing his bewilderment about a seeming delay in a large D.S.H. payment. Mr. Brezenoff said the state owed H + H about $380 million for services it provided to some 1.2 million patients. About a third of those patients were uninsured, Mr. Brezenoff said.
The letter was reported by Politico on Friday, the day Mr. Brezenoff sent it to Mr. Zucker.
“I look forward to your expedient intervention to resolve this unfortunate and unnecessary delay,” Mr. Brezenoff wrote.
The governor’s initial response, however, was less than encouraging. In his statement on Friday, Mr. Cuomo suggested that the city — run by his frequent sparring partner, Mayor Bill de Blasio — should help make Health + Hospitals whole.
“New York City with a $4 billion surplus needs to help H + H,” Mr. Cuomo said, noting that Nassau County and the State University of New York also needed to provide financial help for its hospitals. “The situation is clear,” the governor added, “the first source of financial assistance for these hospitals must be their associated local governments and SUNY.”
That sentiment drew a rebuke from the mayor’s office, which said the city was already contributing $1.8 billion this fiscal year. “We have always said our reserves are for a rainy day,” said Freddi Goldstein, a spokeswoman for Mr. de Blasio, “not for when Governor Cuomo refuses to give our public hospitals what they’re owed for caring for New Yorkers.”
In an interview on Monday, Mr. Cuomo’s budget director, Rob Mujica, disputed the assertion that the Disproportionate Share Hospital payments were being withheld from the city hospital group, saying that there was no set payment schedule, and that the state was merely trying to get Mr. Brezenoff’s organization to plan judiciously for possible future cuts.
“What we’re saying is, let’s figure out what we’re going to do to deal with this,” said Mr. Mujica, adding, “If they just spend as if they are going to get this money continuously, they’re going to fall off a cliff.”
Mr. Mujica said that the New York City hospitals were not being singled out, noting that other safety-net hospitals were also awaiting funds, and “it’s not possible for one hospital to take the position that they should be immune.”
Mr. Mujica’s remarks follow a letter — also sent Friday — from the state’s Medicaid director, Jason Helgerson, which informed Mr. Brezenoff that the state’s health department had hired an outside firm to come up with “a detailed financial analysis” of each safety-net hospital and “their overall condition.”
“We obviously need a long-term financial strategy to deal with these cuts now so hospitals know what to expect,” Mr. Helgerson wrote.
Mr. Cuomo has tried to get Mr. de Blasio to contribute more for services before, including in July when he insisted that the city pay for repairs for the deteriorating subway system. The system is run by the Metropolitan Transportation Authority, which the governor controls.
Still, the drama over the D.S.H. payments may eventually be moot: On Monday afternoon, Senator Chuck Schumer, the Democratic leader, said he was “cautiously optimistic that we can forge a common-sense, bipartisan agreement to preserve D.S.H.”
Regardless, the state is also facing other possible cuts, including the deduction for state and local taxes, which Mr. Cuomo’s office estimates would cost New York residents $17.5 billion.
In an interview on Monday, Mr. Brezenoff said his organization was still awaiting its funds, which he said typically are disbursed well before the Oct. 1 start of the federal fiscal year. As for Mr. Mujica’s assertion that plans for future cuts should be developed now, Mr. Brezenoff seemed mystified by that logic.
“They seem to be saying, ‘There’s a lot of pain coming down the road, why don’t you take some pain now?’” he said.

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