The Signature Bridge Debacle Award

ECMCI am awarding the 2008 Signature Bridge Debacle Trophy to ECMC for its stunning refusal to even come to the table to discuss and plan out the Berger Commission’s mandate-now-law to merge the Kaleida and ECMC hospital systems.  ECMC has decided to take the matter to court, a tactic guaranteed to stall the merger for many years to come, and fatten the pockets of the current ECMC management team for many years to come as well.  Oh, the egos.

As Bob Gioia, chairman of the board of directors in charge of the merger, stated today:  “In my almost 30 years of public service, I have never experienced behavior like this, and I’m saddened for this community.”  ECMC, which has the same share of seats on the board as Kaleida, walked out of a recent board meeting and, to my knowledge, has not returned.

The Signature Bridge is the embodiment of long-delayed and overdue promises to improve (or at least the appearance to improve) quality of life in Western New York.  The closing of Main Street to vehicular traffic, the removal of the elevated portion of the I-190 and the Skyway, construction of Bass Pro and now the stalled hospital merger plan join it in infamy.

Excepting perhaps for the possible reopening of Main Street, the hospital merger has by far the most impact, addressing a problem that has cost taxpayer money and reduced the quality of health care for many years – too many beds, too much distribution and overlap of services, and too much overhead in the local health industry.  The cost of infrastructure just to support the roughly one-third of all beds that are routinely empty is money that either cannot be spent on health care for the occupants of those beds that are filled, or is a tax on our insurance premiums and our real estate.

ECMC is supposed to be a health care provider.  It is, instead, a JOBS provider, with health care taking the back seat.

3 Responses to The Signature Bridge Debacle Award

  1. Jay says:

    It is regrettable that a few weeks ago you were not the person interviewed on the “Hardline with Hardwick” show instead of Bob Gioia. Your passion is evident. In one paragraph you stated more reasons than Bob Gioia did during the entire hour. Equally disturbing was when Young of ECMC was interviewed the following week by Hardwick. He dismissed in broad language the national studies that demonstrate how to achieve efficiency, productivity, positive outcomes in the health care delivery system. In short he seemed to be saying that these studies do not apply in Buffalo. One can only assume that Young could not have been speaking like this unless he had the backing of many of our elected officials

    My only question is why hasn’t the Oishei Foundation used some of their money to educate the public?

  2. Becky says:

    If the laws and mandates had thrown most of the eggs in ECMC’s basket I imagine Kaleida wouldn’t be too happy either.

    I fail to understand how dissolving the public benefit corporation that is ECMC is a major problem. Of course the unions would be unhappy, same as Kaleida’s would be if they got dissolved. Do they have the power via the law to stop it? In other words, is it illegal?

    It’s not like the politicians that Gioia supports are worried about not getting union political donations. They don’t get any now. But then again, they DO get donations from Big Business, of which Kaleida is one.

    Just various thoughts that together end up jumbled, just like the merger. I don’t think it ever really is what it seems to be on the surface of things.

  3. Paul says:

    The differences between ECMC as a public benefit corporation and Kaleida are enormous, and I could just about write a book on this (as, it seems, others already have). Here are a few highlights from last year:

    Kaleida – $1.1B revenue
    ECMC – $325M revenue

    Kaleida – 32% of all patients
    ECMC – 7% of all patients

    Kaleida – 55% of UB medical students trained here
    ECMC – 25% of UB medical students trained here

    Kaleida – 8,600 employees
    ECMC – 2,650 employees

    ECMC demands to be treated like an equal partner. Okay, so the Western New York Healthcare System (renamed “NEWCO” because of a naming conflict), the board that is to oversee the merger, provided an equal number of board seats to both hospitals (6 seats, I believe) with the others being non-affiliated members, people like UB President John Simpson. Didn’t work. ECMC won’t sit with the rest of the board to hammer out any merger details. So much for unified management, one of the key missions of NEWCO.

    Another key mission is to utilize as much of the existing infrastructure as possible. To that end, Millard Fillmore (city) would close but ECMC would remain open and focused on its specialties, while Kaleida consolidates to the Downtown area. A new heart and vascular services center would be built there. Not to be outdone, ECMC proposed its own heart center. No city in the country, much less Buffalo, can afford two specialized care facilities of this type, and from a business, research, university and health care perspective, it makes absolutely no sense to do this. ECMC’s intention is to do anyway. What do they care, they are a PBC (sort of like the Thruway Authority) beholden to no taxpayers. Kaleida, at least, is private and does have a mandate to remain profitable.

    …Which brings up yet another issue, and that’s the $14M “profit” that CEO Mike Young announced last year. Betcha that “profit” was managed more through accounting tricks – like extending amortization/depreciation into future years, or holding off on key capital purchases until the beginning of the new fiscal year. In fact, since employee health benefits have skyrocketed the past few years (ECMC employees get full health benefits for LIFE), and the state actually cut back on its funding to ECMC last year, it seems like the ONLY way ECMC could have turned a profit is through chicanery. The best managers in the world couldn’t have done it any other way. However, I’m guessing here. ECMC has recently refused to release much of the financials, at least not in accordance with the legislative rules when they became a PBC.

    ECMC employees get 54 paid days off, Kaleida employees get something like 32 – still an enormous number (and in my opinion, completely out of whack with private industry, which averages around 18-26 depending on who you talk to). That’s a 4-day work week with every 5th day paid, essentially. The cost differential alone is enough to create consternation with the ECMC unions, and perhaps CEO Mike Young doesn’t want to deal with it. Funny though, it would become NEWCO’s responsibility, not his. I would think he’d want this.

    The costs to retire ECMC’s debt is $100M plus the dissolution of the public benefit corporation (thank you, Joel Giambra) while New York State indicates that hundreds of millions in infrastructure appropriations hinge on the merger. That state money (yes, it’s taxpayer money but at least it’s going to WNY) is in jeopardy if NEWCO can’t release the merger plan by June 30th.

    The entire WNY hospital system – built to handle a 600,000+ urban population – HAS to consolidate and shrink to success. This is the model being used across the country, even in cities that are growing in population. Eliminate duplicate services. Place emergency care where the action is, and consolidate everything else.

    Mike Young has been touted as a great CEO. He may very well be, but I don’t believe that his model of a fractured, duplicated health system in a mid-sized city benefits the population in any way.

    All this being said, it can be claimed that the quality of patient care does not improve with consolidation and, in fact, decreases because of the lack of competition (read The Synthesis Project on hospital consolidation from 2/1/06). But Buffalo has plenty of competition from the Catholic Health System. I strongly believe that – unless consolidation takes place to sustain profitability, health care will suffer greatly because of the eventual financial-driven compromises that must be made. Consolidation, therefore, is inevitable and will eventually be demanded by the public to improve quality of care. If we do it today, the State will actually help to pay for it. Do it tomorrow and we may find ourselves going it alone.


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