New York City's Health and Hospitals Corporation (HHC) is facing a $1 billion deficit.
The shortfall comes as the nation’s largest public hospital system confronts shrinking funding from Albany and Washington while the number of uninsured people is increasing.
Alan Aviles, the head of HHC, says many payments from Medicaid don’t cover the costs of medical treatment.
"We continue to serve more and more patients with less and less dollars. But you cannot serve 450,000 uninsured patients through magical thinking. Ultimately it does require hard dollars," Aviles says.
A spokesperson for the state health department says that it is doing the best it can to help the city’s hospitals. She says much of the drop in state funding is actually due to federal stimulus running out.