OP-ED: The hidden costs of healthcare at New York-Presbyterian
As a labor union lawyer and general counsel to the Center for the Independence of the Disabled, NY, representing thousands of hardworking New Yorkers, abled and disabled, I stand alongside many others who are deeply concerned about the state of healthcare in our city.
The rising cost of living squeezes families, yet one of the biggest drivers of this crisis is not often talked about: sky-high healthcare costs, particularly at institutions like New York-Presbyterian Hospital. This hospital, which operates under a “not-for-profit” status, has become the most expensive health system in New York while maintaining double-digit profit margins but deteriorating service. This situation is not just unsustainable; it’s unconscionable.
Americans already spend more on healthcare than people in other developed countries, but New Yorkers pay even more. According to the nonprofit Health Care Cost Institute, per-person spending on healthcare services in New York was 20% above the national median in 2020. This is a staggering figure, and it’s no coincidence that New York-Presbyterian is at the center of it. A 2022 report by the 32BJ Health Fund found that hospital charges were the leading driver of soaring health costs for its members, with New York-Presbyterian charging, on average, 358% more than Medicare rates for equivalent services.
All of us—political leaders, unions, and civil rights organizations—have a responsibility to advocate for better pricing transparency, lower patient-to-professional ratios, fair healthcare charges, less crowded emergency rooms, shorter waits for admission in those emergency rooms, and more equitable redistribution of profits to benefit the community, perhaps even aid to failing institutions like Beth Israel and St. Luke’s Hospitals. If we fail to act, we risk undermining our core mission of what is supposed to be the goal of our regulated healthcare system: the highest-quality healthcare at an affordable price.
Let’s be clear: New York-Presbyterian’s profit margins are not just healthy—they’re astronomical. In 2021, the hospital reported the largest profit windfall ever for a New York hospital, totaling roughly $1.5 billion with an operating profit margin of 17.4%, which is 65% higher than the national average. This trend has continued into 2024, with the hospital reporting an operating income of $112.5 million in the first quarter alone, a significant increase from the previous year.
It is even more troubling that New York-Presbyterian reaps huge tax benefits due to its nonprofit status. It received more than $415 million in tax breaks in 2021, yet allocated a mere 1.7% of its revenues to charity care and spent only $142 million on community benefits—a roughly $247 million gap. This raises serious questions about the hospital’s commitment to the community it serves rather than to its executives and their seven-figure salaries.
Moreover, the exorbitant charges at New York-Presbyterian cannot be justified by quality. While the hospital claims to be a premium provider, publicly available data paints a different picture. Their flagship hospital on the Upper East Side earned a “C” grade for quality, with patients at higher-than-average risk of having dangerous objects left in their bodies after surgery, experiencing serious breathing problems during surgery, or even just developing bed sores from lack of basic attention. (My own 102-year-old mother experienced this poor treatment, topped off by having an ambulance drop her off in her unattended apartment rather than the rehab nursing home they were supposed to take her to.) This, coupled with concerns about staffing levels and working conditions flagged by unions led by the New York State Nurses Association (NYSNA), should alarm everyone.
As healthcare costs continue to rise, the burden falls squarely on the shoulders of New York’s workers and consumers, exacerbating the cost-of-living crisis in our city. Half of working-age households in New York City do not make enough money to cover basic needs, yet they are being asked to shoulder the financial burden of a hospital system that prioritizes profits and high executive salaries over people.
It’s time for our elected leaders to demand accountability from New York-Presbyterian and respond to the rising demands of unions and the affected communities. We need transparency, fair pricing, and a commitment to reinvest profits into the community, not corporate coffers and executive pockets. Only then can we ensure that healthcare in New York is accessible, affordable, and of the highest quality for all.
Arthur Schwartz is the general counsel of the Center for the Independence of the Disabled, NY, and counsel to numerous unions, including Transport Workers Union Local 100 and the Amazon Labor Union.
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