By Penny Mintz
These days the security of our health care should be a top priority. In light of the present economy it is also clear that our health-insurance system cannot be married to employment. Millions of people lost their jobs and their insurance as a result of the pandemic, and that puts all of us in danger.
There are many reasons why we lack the kind of universal single-payer health care that most other industrialized countries enjoy. Part of the problem is years of tax cuts to the highest earners. Another big part is that politicians rely on the billions of dollars that private insurance, big hospitals, and big pharma donate to their campaigns. The influence of such donations prevents needed reform. Controlling those donations is virtually impossible because, in accordance with the Citizens United decision of 2010, the Supreme Court ruled that corporations are people, money is speech, and people (read: corporations) have freedom of speech (read: donations).
Meanwhile, we have a health crisis, unlimited health costs, unaffordable private health insurance, and 18 hospitals that have been shuttered in NYC since 2003. Our local St. Vincent’s was one of those; and Mount Sinai has been planning to replace Beth Israel’s 850-bed full-service hospital with a 70-bed facility.
On August 12, 2020, the New York State Legislature conducted a joint hearing on how hospitals have performed during the pandemic. Department of Health Commissioner Howard Zucker, SUNY Empire State President Jim Malatras, and New York City Council Member Carlina Rivera testified during the first session of the virtual hearing.
Assembly Member Dick Gottfried asked whether the reductions in hospital capacity over the years had gone too far. He suggested that perhaps we needed a “course correction.” The answer was: apparently not. Despite Governor Cuomo’s reports back in late March that New York State had 53,000 beds and needed 140,000 to deal with the pandemic, Dr. Malatras asserted that the system had the flexibility to ramp up in a pandemic. That would require a flexibility miracle.
Dr. Zucker testified that on March 1, 2020 all public and private hospitals had been directed to double their capacity. At that point Mount Sinai, fortunately, had not yet sold the Beth Israel building on East 16th Street. So it was quickly able to return 400 beds to use at Beth Israel, up from 200. Mount Sinai also increased its capacity uptown by 68 beds by enabling Samaritan’s Purse to open a field hospital in Central Park. This move was widely criticized when it was found that Samaritan’s Purse required volunteer workers to sign a “statement of faith” that disqualified gays and Jews, among others, from working for them. In any event, 68 beds is far from the requisite doubling of its capacity of 1,141.
No one addressed how capacity could be substantially increased within the other remaining hospitals. Dr. Zucker did speak about the USNS Comfort and the hospital that was opened in the Javits Center. These facilities, however, proved to be ineffective during the pandemic. Before the two facilities closed, only 1,095 were treated at Javits and 182 at the Comfort.
City Council Member Carlina Rivera took a different position. She called for an outright halt of the closure of “every hospital that had been slated to occur through the certificate-of-need (CON) process.” A CON must be granted before a hospital can close, and the Department of Health relies on the Public Health and Health Planning Council (PHHPC) for its CON determinations.
Rivera wants to see a change made to the process. She said there should be “more patient representation and public input” than that provided by PHHPC—its members overwhelmingly represent corporate interests. Rivera reminded the legislature that a community-based planning process had existed in the 1980s. That process, she said, should be restored and integrated into the CON proceedings.