Cuffed by Himself
De Blasio’s hospital hell
ONE problem with getting yourself arrested for a principle is that you wind up stuck with a record. So it was with Bill de Blasio, who accepted plastic wrist restraints on behalf of Long Island College Hospital last summer — and so acquired full moral responsibility for New York City’s bewilderingly opaque, quietly collapsing hospital system.
It’s far from clear whether the mayor is up to that challenge, but he’s certainly not bashful about burrowing further into the hole he’s already dug.
LICH is a 150plusyearold fullservice hospital in Brooklyn’s gentrified Cobble Hill neighborhood; it’s been on shaky financial footing for decades — a condition common to hospitals across the five boroughs.
The State University of New York bought LICH in 2009. Big mistake: “This has been very costly for us,” says H. Carl McCall, chairman of SUNY’s board of trustees and a master of understatement — for “costly” scarcely describes it.
LICH has burned through more than $100 million of SUNY funds since last summer alone. SUNY has been trying to peddle it almost from Day One — attracting realestate developers in profusion, but no body interested in running a traditional communitybased hospital.
Which isn’t surprising, since tradition doesn’t count for much when it comes to hospital finance. The system has too many empty beds, far too much staff for the patient load and not enough money — and this is not news.
Meanwhile, nothing attracts the usual suspects more quickly — or thickly — than a realestate developer. This explains how thenlongshot mayoral candidate de Blasio came to be arrested in front of LICH last July, “protesting” its impending closure.
The hospital was de Blasio’s red line. The handcuffs solidified hardleft union support, raised his profile substantially and arguably set him on a path to the mayoralty.
This did not, however, solve the hospital’s problems — nor SUNY’s, which was losing some $13 million a month when de Blasio took office. So what’s a new mayor to do? Declare victory and move on? Not The Blaz. Not last Friday, during one of his most contentious press briefings yet.
McCall, SUNY Chancellor Nancy Zimpher and Gov. Cuomo had colluded (in the best sense of the word) to give de Blasio the deal everybody could have had last summer: Sale of the LICH to a developer to be named later, some subsidized housing, an onsite healthcare facility of some sort — and, it seems, a little baksheesh for the boys and girls.
That is, while there’s no hospital hardwired into the agreement, Public Advocate Letitia James and some “community groups” stand to collect several million dollars from the sale of the LICH site to fund a “healthcarerelated” notforprofit.
Even that could vanish, if the deal falls through. It could evaporate in as little as three weeks (“It’s not a settlement that is going to guarantee anything,” said one lawyer working to keep the hospital open), but it still frees SUNY of LICH by the end of May.
So maybe de Blasio should’ve just said thank you and left it at that. Nope: He had to gild the lily.
The deal marked a “truly historic, transcendent moment,” he said Friday — touting it as a template for saving other moneypit acutecare facilities, including Interfaith Hospital in Brooklyn and St. John’s in Far Rockaway. As if. The harsh truth is that if the LICH deal has any staying power, it will be solely because of the realestate money — at least $250 million, and maybe as much as $300 million, for the site in tony Cobble Hill.
Good luck matching that, Interfaith.
Indeed, good luck matching that, City Hall.
For, even as Advocate James and others spent Monday celebrating the LICH deal as a template for In terfaith (again, it’s not), the head of the city’s Health & Hospitals Corp. was all but declaring bankruptcy before the City Council.
HHC President Alan Aviles, citing federal and state operatingaid cuts and “astronomical increases” in employee fringebenefit costs, predicted an HHC operating deficit of some $1.4 billion a year by 2018. That’s a big hole in Mayor de Blasio’s budget.
HHC owns and operates 11 hospitals; it treated 1.4 million patients last year, 500,000 of whom had no health insurance. The city’s privately owned facilities don’t face as large an uninsured problem, but enough of one to threaten many a bottom line.
And that’s not all that HHC and the privates have in common: Both have far too many empty beds — and thus far too much staff being paid to “serve” patients who aren’t there, and so aren’t bringing in dollars to cover those salaries.
Neither has any reasonable hope of state or federal bailouts. (That $8 billion Medicaid “waiver” bonus that both de Blasio and Cuomo are touting doesn’t amount to much in the context of New York’s $56 billionayear Medicaid budget.) And neither has much in the way of real estate to sell.
The sooner some hospitals close, the faster their paying customers will move to the others — leaving
them better able to survive. The longer the walking dead like LICH linger, the worse off everyone is.
But lacking is any evidence of the political will that is going to be necessary to move the mayor past a crisis he didn’t create, but which he continues to exacerbate — and the bill for which is going to land on his desk.
Yes, the handcuffs arguably got him to where he is today. Now he needs to get out of them, and that’s not going to be easy.