A Crisis Long Coming

New York City’s public-hospital system is headed over a fiscal cliff while Gov. Cuomo and Mayor de Blasio squabble about whose responsibility it is.

The interim head of NYC Health+Hospitals, Stanley Brezenoff, last week wrote state Health Commissioner Dr. Howard Zucker that H+H “barely has 18 days cash on hand.” Brezenoff demanded the state pass along $380 million in federal funds.

But the governor points out that the feds slashed these “disproportionate share” monies as part of the ObamaCare law. The state faces long-programmed cuts of $1.1 billion over the next year and a half.

ObamaCare, you see, was supposed to reduce the ranks of the uninsured so massively that hospitals that serve lots of people without insurance (who often can’t pay their bills) wouldn’t need as much federal help.

Well, they got that wrong: Even though more New Yorkers now have insurance, H+H’s costs for covering some 400,000 uninsured patients a year have risen. Meanwhile, it’s losing patients who are covered (mostly by Medicaid) to other hospitals.

The gov rightly notes that the city has had seven years to plan for the aid cut. But the H+H “plan” was more like a prayer, resting on hopes of $60 mil- lion a year in more federal aid, along with vague “savings initiatives” (most of which require concessions from hospital unions) and supposed new revenue sources.

All this, when the overall US hospital sector has long been shrinking, thanks to alternatives like urgent-care clinics and medical advances that have slashed the average hospital stay.

Experts have warned for decades that the city needs to close more of its public hospitals — even though now down to 11, it still has far more per-capita than other US cities, in a town packed with private hospitals.

Last July, the city Independent Budget Office warned that H+H faces a cash shortfall of $6.1 billion over the 2016-20 period, thanks to the factors already noted plus the system’s rising costs.

Long term, H+H will have to close more hospitals, or gain a far larger subsidy from the city — or both. Even if Cuomo is unfairly holding up this payment, the system’s simply not viable as is.

Yet in the face of this crisis, de Blasio has failed even to find a permanent H+H chief in the 10 months since Dr. Ramanathan Raju jumped ship last November.

Count it as one more case where the mayor just can’t be bothered with the hard work of keeping city government functional.