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ECMC plan premature New heart center could boost care, but hospital issues need to be settled

Plans to build a $92 million heart center at Erie County Medical Center could be bad medicine for the county and for health care in Western New York. Even if detailed examination of the proposal -- the responsibility now of the State Health Department -- deems it sensible, it is still poorly timed. Any such project needs to be pursued in conjunction with the Berger Commission's program for hospital closures and mergers, not in defiance of it.

ECMC unveiled the surprise plan this week along with its annual report, which showed a remarkable turnaround from previous years. ECMC, historically a giant economic sponge that siphons money from Erie County taxpayers, turned a $7.5 million profit in 2006. The hospital still got a $20 million subsidy from the county (it returned $3 million in a gesture of good faith), but the $7.5 million is over and above that aid, and to post this kind of a gain marks a startling turnaround for the hospital.

Credit goes to the ECMC management team, including its president, Michael Young, and those who insisted on a change in the hospital's governing structure, principally Erie County Executive Joel A. Giambra, who pushed for transition to a public benefit corporation. Together they have engineered a remarkable feat in a relatively short time.

It's a shame to see that achievement overshadowed by a questionable program for premature expansion. ECMC, to be sure, understandably is playing to survive in what remains a highly competitive environment. But the entire state is in the midst of a process of rationally downsizing hospital care in New York; this is not the time to propose a radical expansion.

Health care in Western New York, particularly, is weighed down by the problem of too many hospitals serving too few patients. It is true that hospitals have fewer licenced beds than they used to, but they still have buildings to pay for and maintain, expensive equipment to operate and staffs to pay.

The consequences of clinging to these buildings include diverting money to brick and mortar instead of patients, and diminishing the quality of care. By dividing and subdividing the region's patient base, hospitals find it increasingly difficult to perform the minimum number of procedures required to achieve excellence.

It's hard not to wonder if this proposal has something to do with bolstering the hospital's negotiating position, as it pursues the Berger Commission's order to discuss a merger with Kaleida Health. Indeed, the commission called for creation of a new center for heart and vascular procedures in Buffalo, but ECMC has put the heart before the course.

Young and his team rightly insist that health care decisions here should be driven by patient outcomes, not just corporate needs. Centers of excellence in health care specialties may make great sense for the people of this region, much as Roswell Park Cancer Institute makes sense for cancer patients. But first, ECMC and Kaleida must come to some conclusion about a merger -- then the community and the state can consider a new heart center, and what otherwise looks like a good ECMC plan.

To reverse that order stiff-arms the commission and tells residents that ECMC would rather go it alone than help the region deal with an overall problem that is an ongoing threat to the quality of hospital care in Western New York.

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