The Record
Thursday, August 21, 2008
BY GARY CARTER, former president of the New Jersey Hospital Association

We need a rational, not an emotional or political, way of looking at healthcare needs in New Jersey.

More than 10 years ago, during my fourth year as president of the New
Jersey Hospital Association, I wrote the following in a newspaper
article:

“Hospitals are important community resources, a source of security
whether we use their services or simply take comfort in the fact that
they’re there. It’s never easy to watch as one closes or changes to
another health care mission. But the reality today is that some
hospitals must close to keep in stride with a changing healthcare
landscape.

“So while the heart pleads, ‘Please don’t change my local hospital,’ the
mind knows that our state has too many empty hospital beds, and that the
surplus is driving many hospitals into deep financial losses. Those
losses could threaten quality and ultimately drag down the entire
state’s health care system.”

Since then, almost 20 hospitals have closed. But I still think there are
too many hospitals, and I am not alone in that thinking. The final
report of Governor Corzine’s New Jersey Commission on Rationalizing
Healthcare Resources (also known as the Reinhardt Commission) stated,
for example, that the Hackensack-Ridgewood-Paterson area – which
includes the former Pascack Valley Hospital in Westwood – had a
larger-than-necessary supply of hospital beds for its population.

Closing a hospital is a gut-wrenching, emotional decision, but in the
end, those communities that do so are the ones best positioned for the
future of health care. I believe that is exactly what has happened in
Bergen County: that the people of Bergen County have stronger, more
viable health care services available to them today – and will for years
to come – as a direct result of having one less hospital.

Less is better

Another interesting aspect of the closing of almost 20 hospitals is that
during this time, according to the findings of the state Department of
Health and Senior Services, the quality of care in New Jersey hospitals
has improved.

In November 2007, the Pascack Valley community of Bergen County took the
tough but necessary step of closing Pascack Valley Hospital. Prior to
its closing, the hospital’s occupancy rate was less than 40 percent, and
since its closing there has been no report that access to care has been
adversely affected. I live in a community without a hospital, and the
closest one is, on a good day, 20 minutes away, and I don’t believe I
have an access issue.

Now, according to “Healthy interest in Pascack” (Page L-1, Aug. 17),
Hackensack University Medical Center has proposed the development of a
new acute-care hospital at the Pascack Valley site. For all of the
reasons I have outlined above, and many more, this is not a good plan.
It flies in the face of the findings of the governor’s commission, and
will only serve to weaken the hospitals that have so ably served the
patients of the Pascack Valley Hospital service area.

It is tempting to say the investment of $80 million by a for-profit,
outside firm is a good idea. But in reality excess capacity, regardless
of whose money it is, only increases the cost of health care, and it is
already too expensive. While we have taken many steps in the past decade
to correct the fact that there are too many hospitals and beds in New
Jersey, this would be an enormous step back. I wonder how the state
could ever accept an application to essentially reopen Pascack Valley
Hospital when its own commission indicated that the area had too many
hospitals. The right thing to do – and, in my view, the only thing to do
- is to ensure the newly established strength of existing Bergen County
acute-care hospitals by not allowing another one to open.

I urge Governor Corzine, the health commissioner and the state’s Health
Planning Board to heed the conclusions of their own report and develop a
statewide health plan, so that we will in fact have a rational – not
emotional or political – way of looking at the health care needs of
New Jersey.

As I wrote more than 10 years ago, letting our hearts win out over our
minds when it comes to health care is a grave mistake. That’s something
none of us wants. My mind knows that, and my heart does, too.

Gary Carter is former president of the New Jersey Hospital Association,
a Princeton-based trade organization that represents 114 hospitals
throughout the state.