I was late—very late—in cabbing over to the Brooklyn Bridge Marriott on January 11 to catch some of the Crain’s breakfast conference on the financial Gotterdammerung of Brooklyn’s hospitals.
As I approached the conference’s doors the Crain’s young lady chastised me on my tardiness and—bang—the room was filled to capacity, packed with 600 coat-and-tie members of the business end of the hospital business, and hospitals are indeed a very big business. New York State spends $52 billion a year on Medicaid payments to hospitals and other health services, and it was this growing and seemingly uncontrollable cost that got the State Department of Health to do a study starting in 2005 to find out what was going wrong and how, if possible, to correct it.
Heading the group that did that study—and hence its name, “The Berger Commission”—was and still is the 72-year-old, Lower East Side born Stephen Berger, graduate of Brandeis and former holder of a series of state jobs including Commissioner of Social Services in 1975 and executive director of the New York State Emergency Financial Control Board in 1976-1977, when he supervised the city’s budget during the financial crisis of 75-77 (and must have met Bill Rudin’s poppa, Lew, who got his fellow real estate billionaires to prepay their taxes to save the city). He even was the executive director of the Port Authority from 1985 to 1990.
Right now, if you want to talk to his very nice secretary (he does not come to the phone, at least not for WestView News), you call Odyssey Investment Partners, which he co-started, and which specializes in, among other things, “leveraged acquisitions.”
The aim of the Berger report was to make health care less expensive to the state by closing what it perceived as marginal hospitals and eliminating “excess beds and redundant services.”
To help hospitals make the hard calls the report mandated, the state dipped into $1 billion in special state funds and $1.5 billion in Federal funds. (The state money was made available through the Health Efficiency & Affordability Law, which abbreviates into the most salubrious acronym in human history—HEAL.) You wonder why some of this money couldn’t have saved St. Vincent’s. Instead the Berger report killed St. V’s ideas for keeping its downtown and midtown hospitals alive, ruling that the midtown hospital (formerly St. Clare’s) be closed: “The State should not sustain an unneeded hospital campus in order to shore up another hospital in a system.”
Some months back Cuomo called Berger back into service to take a look at the quickly failing Brooklyn hospitals—hence the Crain’s meeting. (Crain’s talked about nurses and hospital workers picketing the meeting at the sure prospect of losing jobs.)
Squinting at the dais a hundred feet away I thought I saw the slight and balding Mr. Berger, and then he spoke with commanding conviction and I knew it was he—in fact, all the questions were directed to him. One hospital administrator began his question by alluding to Berger’s several recommendations and then adding a “but” that was quickly flattened by Berger—no, this was a Stephen Berger show and he was loving it.
The hospitals that go bankrupt and cost the state and feds the most are those serving the poor and uninsured, and that spells Brooklyn.
Berger contends that health services are “provider driven”—a doctor has no hesitation to request another test since the hospital charges the insurance company, Medicare or Medicaid for it.
Berger wants to make the hospital business attractive to private investors, but according to panelist Pamela Brier of Maimonides, rich hospitals “refuse to take poor and uninsured patients,” so how do you compete with them for investor dollars?
The hospital closures that have happened may save the state some money, but they have increased emergency room waiting time to an average of five hours.
“O.K.,” I said to myself. “You were late, so now you have to go up to the dais and confront and interview Berger.”
I waited while Channel 1 interviewed him. (Channel 1 is our only really local TV station—and it does a good job.) An admirer asked a question to which I only heard Berger’s response: “I have a job and my partners want me to do some work once and a while.”
And then it was my turn.
“Mr. Berger, my name is George Capsis, and this is my newspaper, and for three months I have been trying to get you on the phone.”
“I have a job and my partners want me to do some work once in a while.”
And then it was my turn again.
“For a year and a half we have been campaigning for a hospital to replace St. Vincent’s.”
He looked at me fiercely and blurted out quickly:
“You don’t need a hospital, you don’t need a hospital.”
And then something like:
“If you didn’t give Rudin such a hard time you would have a hospital.”
And I thought back to before the first bankruptcy proceeding, when permission had to be and was obtained from the Landmarks Preservation Commission to demolish the O’Toole building and build a new hospital designed by the I.M. Pei firm, and I heard myself saying:
“You don’t know what you are talking about” and repeating it as he walked away.
“You don’t know what you are talking about.”
As I lingered, recovering, at the exit door, a man spoke to me, and I realized he had been standing next to me during my encounter with Berger.
He had worked for Mt. Sinai but now worked with a hospital construction firm, so I asked him about Rudin’s claim that Coleman could not be a hospital today because the ceilings are too low. He smiled. “There are lots of hospitals out there with much lower ceilings.”
And, finally, as I emerged from the hotel I watched Berger get into a limousine as a passenger who was getting in the front seat stood and looked at me with an “I know you” smile.
I could have sworn it was one of the NSLIJ suits.
By George Capsis