SARANAC LAKE - A report published this week by a statewide health care advocacy organization declares that hospitals are some of the most powerful economic engines for communities in the North Country.
The study shows that statewide, hospitals employ nearly 687,000 New Yorkers and generate $108 billion in economic activity, accounting for 9.4 percent of the "gross state product."
Area leaders and hospital officials said this week they plan to cite the report as they seek to influence the policies of Governor-elect Andrew Cuomo when he takes office in January.
William Van Slyke of the Healthcare Association of New York State said a breakdown of the numbers in his group's report indicates that North Country hospitals account for more than 12,000 jobs and generate $1.4 billion in economic activity.
"Hospitals, in the whole of the North Country and across the state, are incredibly powerful economic anchors that are at risk."
Van Slyke said the public understands the value of hospitals when it comes to delivering critical services - but often taxpayers and lawmakers overlook the formidable economic impact of health care facilities in rural communities.
"Especially in communities up in the North Country where, aside from some of the state Department of Correctional Services facilities, hospitals are probably the biggest employers in the entire region," he said.
In the Tri-Lakes region alone, the Adirondack Medical Center employs roughly 920 people and has an economic impact estimated at $120 million annually.
While hospitals enjoy lead-dog status in the North Country's economic hierarchy, they're also one of the state's biggest expenses.
In just three years, health care providers in New York have suffered upwards of $5.3 billion in Medicaid cuts and an additional loss of $13 billion in federal Medicare funding.
Van Slyke says hospitals and health care providers are starved for capital and becoming increasingly fragile.
"If the legislature and the incoming governor decide they're just going to keep cutting across the board, it's going to imperil these facilities and it's going to result in lost health care services for sure," he said. "But it also results in lost jobs. That means more people leaving the area and less opportunity. That's something we need to be aware of."
State Assemblywoman Janet Duprey said this week she doesn't need to be told how important hospitals are to the communities she represents. The Republican's district spans across northern New York and is home to three major health care facilities - the Adirondack Medical Center in Saranac Lake, the Alice Hyde Medical Center in Malone, and the Champlain Valley Physicians Hospital in Plattsburgh.
Duprey bristles at the mention of Gov. David Paterson, who orchestrated major health care cuts in his 2010 executive budget.
"For whatever reason, the Paterson administration did not understand the issues surrounding health care in the North Country," she said.
She adds that lawmakers downstate don't fully appreciate the complexities of providing health care in the rural north.
"We continue to fight that battle of having people from the city - particularly New York City, but other metropolitan areas as well - understand that we have 50 to 60 miles between our hospitals," Duprey said. "It's not as easy as if somebody has an issue with one hospital, they can walk across the street or a few blocks down the road to another and get service."
But despite a rough stretch for the health care industry, officials are expressing a cautious optimism that Governor-elect Andrew Cuomo will take a different approach to health care funding as he begins drafting his first executive budget early next year.
Duprey says Cuomo appears to be giving the North Country a louder voice in the conversation.
"I'm pleased that he's included some North Country people on his transition team," she said. "I think the message will come across that at least he's listening to us, so much as he'll consider the people that get appointed to positions and what their input is and where they stand on issues."
Van Slyke said that Cuomo has called for a fundamental redesign of the state's Medicaid system. The Healthcare Association of New York State thinks Cuomo is right - and a task force of the group's membership has sent the incoming governor a body of specific recommendations aimed at reforming the system.
Assemblywoman Duprey notes that the battle over health care funding in the North Country fits into a larger conversation regarding the region's reliance on the state for fiscal solvency - a conversation that includes parks, visitors centers, prisons, and schools.
That's why Duprey hopes that Cuomo isn't just paying lip service to the North Country - she says he needs to "walk the walk" come January.