May 27, 2020

Dear Editor,

In these unprecedented times, we are all struggling with some form of loss: a loved one, a job, our former daily routines. This pandemic has also expanded the definition of loss exponentially. In healthcare, and in New York State alone, the loss has been unimaginable. Our state treated more COVID-19 positive patients than any other state in the country. In fact, nearly 45% of total confirmed U.S. cases have been identified here. While hospitals in upstate New York have not seen the influx of COVID patients as compared to their downstate counterparts, they have been equally affected by this pandemic, losing over $1 billion in revenue since the onset.

Since the pandemic began, upstate New York’s hospitals stood ready. They prepared for an influx of patients by creating surge capacity, expanding operations and infrastructure and acquiring needed supplies. When the surge didn’t happen, upstate hospitals offered to take patients from downstate, to share staff and donate equipment and supplies at a time when costs for masks, isolation gowns, face shields and gloves increased between 300 and 2000 percent.

In March, all hospitals stopped normal operations in compliance with the state’s mandate that hospitals halt all elective procedures and other routine care. Needed but non-urgent treatment was delayed for some patients and others hesitated to seek care for even urgent problems, such as heart attack or stroke.

The halt of services also meant that hospitals stopped receiving revenue and financial losses ensued forcing hospitals from Buffalo to Albany to layoff or furlough over 6000 healthcare workers.

Since the start of the pandemic, upstate hospitals have lost over $1 billion in revenue. There is little hope these numbers will improve this year, forcing hospitals to remain in financial peril indefinitely. The much-publicized COVID-19 federal funding for New York State was woefully inadequate for upstate New York’s hospitals and health systems. Of the nearly $8 billion New York State received, upstate hospitals received less than 10%. How is it possible that upstate hospitals, which represent half of all hospitals in the state and serve as the largest employers in most counties, were so disproportionately left out of the funding distribution? How was loss of revenue not a determining factor for federal aid?

There is no question that COVID-19 has had a devastating impact on New York State’s already precarious fiscal health. The State now projects a $13.3 billion budget deficit. Governor Cuomo has stated that unless federal aid is distributed to state and local governments, New York will need to make drastic cuts in state Medicaid spending of up to 20 – 30 percent. These cuts are in addition to the $2.5 billion Medicaid reductions adopted in this year’s State budget. Cuts of any kind to healthcare providers during a public health pandemic is incomprehensible and unacceptable.

Without a commitment from our local, state and federal leaders to funding equality for our upstate hospitals and health systems, the losses will be insurmountable. The loss of an upstate hospital will lead to the collapse of entire communities.


Gary J. Fitzgerald
President & CEO
Iroquois Healthcare Association

Travis Heider
President & CEO
Pandion Optimization Alliance

(The Upstate New York Healthcare Coalition is a partnership between Iroquois Healthcare Association and Pandion Optimization Alliance. The Coalition represents over 60 hospitals and healthcare systems in approximately 45 counties of upstate New York, spanning 40,000 square miles.)