A raw deal for East End

The health-care system in our country is a shambles. More than 45 million people nationwide, almost 16% of the population, have no health insurance. Untold millions are paying through the nose to have coverage. Businesses are struggling to pay the double-digit annual increase in premiums for employee health insurance. People have to rely on an underground market to purchase prescription medications made in the U.S. from suppliers overseas because the cost of the medication in the U.S. is prohibitive.

“The United States spends nearly $100 billion per year to provide uninsured residents with health services, often for preventable diseases or diseases that physicians could treat more efficiently with earlier diagnosis,” according to the National Coalition for Health Care. Hospitals in the U.S. provide about $34 billion worth of uncompensated care a year, the coalition says, and over 30% of emergency department visits by the uninsured are considered nonurgent.

Central Suffolk Hospital in Riverhead, a private nonprofit community hospital, shoulders a burden, all by itself, of more than $5 million in uncompensated care every year. Eastern Long Island Hospital in Greenport shells out more than $1.5 million a year in uncompensated care, too. That’s care that a hospital is obligated to provide -— it can’t turn a patient away — for which it’s never paid. The uncompensated-care burden borne by local hospitals has been growing, just as the number of uninsured has been growing. Also contributing to the burden in our region is the growing number of undocumented immigrants on the East End.

Whose responsibility is it to pay for health-care services rendered to the uninsured who can’t pay the cost themselves? Is it really the responsibility of a private nonprofit hospital? What is government’s proper role in this? Isn’t it the role of government, not the private sector, to provide for the “health, safety and welfare” of the population?

Where is Suffolk County government in this picture? It’s far away and unresponsive, as usual.

Not only must the local community hospitals shoulder the entire burden of uncompensated care in this county — which lacks a county hospital -— the county won’t even cooperate in the financing of an expansion desperately needed in order to be able to provide advanced medical services on the East End.

It would cost the county nothing to guarantee the replenishment of Central Suffolk’s debt service reserve fund on its capital project bonds, issued to finance its expansion. The hospital has several years’ worth of a reserve fund to pay the debt service if it can’t make the payments out of its annual operating revenues, so the county would not likely ever be called upon to ante up. But the county’s guarantee would save Central Suffolk millions of dollars in interest payments, because it would mean a much lower interest rate on the hospital’s bonds.

The county executive prides himself on his “fiscal conservatism.” That’s swell, but why must the residents of the East End always be unfairly burdened? The fair distribution of the county’s quarter-percent sales tax is an example long in the public eye. But recent revelations on how we’re being short-changed in the delivery of health-care services are astounding.

An article in Sunday’s New York Times revealed that the East End office of the public health clinic has only four public health nurses to serve the entire East End. As a result, patients who need care, who can’t get care anywhere else, aren’t being served by the county health department at all.

Legislator Ed Romaine charges that the county executive is illegally refusing to fill more than 200 vacant positions in the county health department — positions, in other words, that the County Legislature put in the budget and funded. What’s the money being used for, then? How many of those vacant positions are also partly funded by the state or federal governments, I wonder? How can the executive branch of government legally rewrite the budget adopted by the legislative branch in this way?

Then there’s the matter of the digital mammography unit that the County Legislature funded for the East End. Guess what? That, too, is still not in place, according to our county legislator.

Meanwhile, in the Riverside-Flanders area, an area with the lowest per-capita income in Suffolk County, where 80% of the land is off the tax rolls — in public ownership — a quarter of the calls handled by the volunteer ambulance corps come from county facilities within the district (which don’t pay ambulance district taxes). Nearly a hundred times each year the small Flanders volunteer department must respond to emergency calls at the County Jail. Why doesn’t the jail have its own ambulance? Suffolk County thinks it would be “a waste of money,” according to our sheriff. Sure, why buy the cow when you can have the milk for free? With the taxpayers of the poorest area in the county footing the bill, while tax revenues from the East End migrate westward, why should the county see it any other way?

Legislator Romaine is right. The East End is getting the shaft, again. Suffolk County government abandoned its county seat decades ago. It up and moved to Hauppauge. It neglects the citizens of the East End until it’s time for a photo op against the backdrop of a scenic farm field, to buttress a politician’s claim to the label “environmentalist.” Then the folks in Hauppauge wonder why we wanted Peconic County.