By George Capsis
On a dark, chilly, rainy Thursday October 27th evening in the large shabby 1927 Mason Hall, now part of Baruch College on 23rd and Lexington, a sparse group of perhaps 100 mostly seniors took their seats in dispersed clumps to represent the “community” in the “Community Forum to Learn More About the Mount Sinai Beth Israel Transformation.” In the front two aisles sat absolutely all of our local politicians and a few not-so-local (one looked like he came up from Washington). We even had a nice young man from the New York State Department of Health but he, unfortunately, forgot to bring his business cards. He said, “I’ll email you” but he never did.
Introduced on the stage were two Mount Sinai Beth Israel “spokespersons,” Susan Somerville, RN (President of Mount Sinai Beth Israel) and Dr. Jeremy Boal (Executive Vice President of the Mount Sinai Health System) who will be, I think, the “President” of the proposed 70-bed hospital at 14th and 2nd Avenue, the Phillips Ambulatory Care Center at 14th and 4th Avenue, the Cancer Center on 15th between 8th and 9th Avenues, and one remaining Beth Israel building on 16th Street and 1st Avenue. After a slick PowerPoint presentation, the theme of which was that they are not closing a hospital but investing $500 million to build a state of the science medical complex to better respond to the community’s needs, the politicians were invited to speak.
Matthew Washington, who used to work for developer Douglas Durst and is now the Manhattan Deputy Borough President, did not want to see the Beth Israel site become a towering mass of luxury condos and asked that it be 100% affordable apartments (not likely).
The State must approve the building or closing of any hospital and any changes that might change or reduce the medical services provided. One political questioner was concerned that Mount Sinai was trying sneak through the closing of a hospital that once had over 800 beds to one with only 70 by making small innocuous proposals over time. That ruffled feathers; our young man from the New York State Department of Health hesitantly fended off the accusation by stating, “We are looking at it.”
After the St. Vincent’s debacle and the accusations that our politicians utterly failed to save it, or even really found out why it went under, the large political attendance was understandable but no local politician came out to say: Wait a minute. Mount Sinai had over 800 beds, 600 of which were being used, and now you want to replace it with a hospital containing only 70. Dr. David Kaufman, the former head of physicians at St. Vincent’s, believes that you need 300 beds to amortize the high cost of diagnostic equipment and basic infrastructure.
The ancient audience was then invited to form a line; each trotted to take the mike. They spoke about how the old are the ones who get sick and need good doctors and hospitals but, unfortunately, are less able to fight to get them. The cost of medicine surges, fed by profit-making insurance companies and a conflicting mass of government programs costly to administrate and easy to exploit.
New York has lost 20 hospitals in the last 16 years. More will be lost unless we develop a way of, say, adding medical treatment to our social security payments so that we start paying for our lung cancer operation at 70 with our first check from McDonald’s at 18.
Susan Somerville waited for the end of a stumbling question like a cat ready to pounce and gleefully dispatched the victim with well oiled phrases like: “We want to start with the real needs of our patients and gather in one place the medical talents and diagnostic equipment they need.” She also delighted in repeating an arpeggio on the theme that no jobs would be lost: “We will reassign, we will transfer, we will fire no one…”
But wait. They began the presentation by announcing that Beth Israel is losing $80 million a year and saying: “We will lose a half billion over the next four years.” And there you have it. Since Mount Sinai took over Beth Israel in 2014, they have not been able to stem the green flow via management interventions. In fact, their attempts to encourage early retirement or move doctors and nurses to other locations have only alienated them. One nurse smiled when she said, “There is so much animosity towards Mount Sinai even the patients pick it up.” A doctor in the Eye and Ear Infirmary of Mount Sinai talked about senior doctors being forced out because their compensation was too high. There is no question that Mount Sinai failed to manage down the multi-million dollar monthly losses, so the only solution was to sell Beth Israel to a developer like Bill Rudin for $500 million.
So, this is a desperate dollar solution. If they don’t sell Beth Israel, it will financially destroy Mount Sinai. And the way to sell it is to say that they are improving medical services, that many operations today don’t need a bed, and that it is better to stay home to avoid hospital infections (hospitals are bad places).
And then, as an aside, Dr. Boal, offered that the new 70-bed hospital would not have a Trauma I emergency room and that, “You need to go to Bellevue which has an excellent Trauma I facility.” Oh wow! Just 48 months ago, when Beth Israel doubled the size of their emergency room to accommodate the closing of St. Vincent’s, I assumed that the proposed token 70-bed facility would be Trauma I for cardiac surgery and the most serious medical emergencies. Here, Dr. Boal quickly offered that, when I get a heart attack at 69 Charles Street, I should tell the 911 ambulance driver to take me to Bellevue in heavy traffic to help out Mount Sinai which couldn’t afford to maintain a Trauma I facility on 14th Street and 2nd Avenue.
St. Vincent’s had 22 operating rooms, 880 nurses, and over 1000 physicians.
OK, you can’t demand that Mount Sinai management keep the facility open and continuously lose over six million dollars a month. It is not a Mount Sinai problem but a problem with how this country controls and pays for the cost of health care. I believe that the problem is not serious enough for Hillary to address after she is elected, as she will not have sufficient control of the House to do anything about it.
But we, the citizens and taxpayers of New York City, instead of Bill Rudin, should buy Beth Israel.