Democratic primary debate: round five
We talk about what the candidates said and the policies discussed at last night's Democratic primary debate.
5 years ago
Updated: 7:25 p.m.
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Democratic presidential candidate Bernie Sanders is using the impending closure of Hahnemann University Hospital as a case in point for his plan for Medicare for All, urging state and local lawmakers to keep the 495-bed facility open.
At a rally Monday afternoon outside the hospital at Broad and Vine streets, the Vermont senator, who calls himself a democratic socialist, thanked all the workers and the trade union movement.
“This is not a complicated issue, it’s a matter of getting our priorities right,” Sanders said, adding that patient care is more important than profit for major corporations.
Sanders said his message is simple: “Keep this hospital open.”
“As all of you know, the possible closing of Hahnemann has nothing to do with health care, it has everything to do with greed,” Sanders said.
“Enough is enough,” he said in a short speech before an enthusiastic, sign-waving crowd unofficially estimated in the hundreds. Ardent Bernie 2020 supporters mingled with medical workers in lab coats and scrubs. Some watched from the upper windows of the venerable hospital building.
Sanders also weighed in earlier this month on the hospital’s planned closure, blaming it on corporate greed in an op-ed in The Philadelphia Inquirer with City Councilwoman-at-large Helen Gym. In the Inquirer piece, they wrote of Joel Freedman, CEO and president of the parent company of Hahnemann’s owner, “By separating the health-care business from the real estate, Freedman has positioned himself to sell off the land for a fortune while allowing the hospital itself to wither away.”
Leadership at Hahnemann announced the hospital’s closure in late June, calling it the result of a $300 million operating deficit.
As proposed by Sanders and embraced by others in the 2020 Democratic presidential field, Medicare for All would be a single national health-insurance program. As Medicare currently covers people over 65, Medicare for All would replace private health insurance, with the federal government setting rates for services, medications, and medical equipment, among other things.
Sanders connected Hahnemann’s closure and Medicare for All by saying that a single-payer plan would change the culture of profiting from health care. He said the current national system in America is designed to incentivize profit for insurance companies, drug companies, and in this case, real estate speculators.
“That is wrong, that is immoral, that is not what this country is about,” Sanders said. “We believe that health care is a human right, and we’re gonna fight for a system that is based on human needs, not corporate profits.”
Sanders said he will introduce legislation in the Senate calling for a $20 billion emergency trust fund to help states and local governments purchase hospitals in financial distress.
“In my view, any time a hospital is put up for sale in America, the local community or the state must have the right to buy it first with emergency financial assistance,” he said.
Local leaders already are asking for help from Congress to ensure that Hahnemann patients’ medical needs will continue to be met.
Earlier Monday, Philadelphia Mayor Jim Kenney and Pennsylvania Gov. Tom Wolf pledged $15 million to help fill coverage gaps for any new medical operator that planned to open at the Hahnemann site. In a statement, Kenney and Wolf acknowledged that the hospital is not in a financial position to stay open, but they said it would be wrong to put taxpayer money toward bailing out Hahnemann’s owner and Freedman, who heads its parent company, American Academic Health System, for what they called “irresponsible ownership.”
Kenney and Wolf said they were “working with potential investors to find support for maintaining a level of medical services in the community served by Hahnemann,” and they called on Congress and the federal government to match their investment. They also said they hoped the funding commitment would “incentivize a long-term solution to emerge to serve the community at this site.”
When asked if there was a plan for a new operator in place, Kenney spokeswoman Deanna Gamble said not necessarily, but that the funding served as a “commitment from the city and state to put public funds to continuing operations if there was a viable option on the table.”
In a statement, Freedman responded to Kenney and Wolf’s funding commitment by saying he has always been open to any scenario that might have saved Hahnemann, including shifting the real estate and operations to a nonprofit entity.
“We made such an offer to a not-for-profit entity three months ago, whereby such not-for-profit could have acquired the Hospital, real estate, and certain HPP interests held by Hahnemann for nominal consideration, plus the assumption of ordinary course liabilities,” Freedman said in the statement. He went on to say that the city and the state knew about the offer, but the deal fell through, leaving American Academic Health System with no option but to close the hospital.
Shanna Hobson was one of hundreds gathering on a blockaded Broad Street before the Sanders rally. She said she has been an ER nurse at Hahnemann for six years. The last few weeks have been surreal, Hobson said, as the emergency room went from a fully functioning department to nearly empty.
Hobson said that the emergency staff is unable to perform certain procedures due to supply issues, and that patients in urgent need of care are being transferred to other facilities. She and the other staff members have not heard word of when Hahnemann’s ER will stop accepting patients, Hobson said, though the state Health Department confirmed it will be Wednesday. She hoped Sanders’ shining a light on the issue would push local officials to save the hospital. In any case, she said, she’d be in it until the very end.
Family medicine physician Janet Cruz said she’s not for Medicare for All per se, but that she hoped Sanders’ attention to Hahnemann will get people talking about health-care costs overall.
Maureen May, president of the 8,500-member Pennsylvania Association of Staff Nurses and Allied Professionals, kicked off Monday’s rally, thanking Wolf and Kenney for their $15 million commitment. In a statement issued before she spoke, May urged Wolf to use the funds to bring a buyer to the table who would keep the 170-year-old hospital open.
Calling Freedman a coward, Susan Bowes, president of the hospital’s nurses association, said: “In a city with one of the highest poverty rates … rising gun violence and the opioid epidemic, Hahnemann’s closure will cost lives.”
Councilwoman Gym got the crowd riled up with cheers of: “Whose city? Our city! Whose hospital? Our hospital!” Gym said the closing of Hahnemann should not be treated as inevitable, and that Hahnemann needs to stay open as a model for other hospitals in financial distress across the country, a message echoed by Sanders. Gym said that would send a message to elected officials that they can’t just let corporations and Wall Street come in and take over.
“This is our line in the sand,” Gym said.
Ohio State Sen. Nina Turner, a Democrat who served as a Sanders surrogate during his 2016 presidential campaign and represented him at a protest rally last week at Hahnemann, also made a point of using Philadelphia and Hahnemann as an example.
Hahnemann is the canary in the coal mine for the rest of the nation, Turner said. If Hahnemann closes, she said, hospital workers may lose their pensions. “The other side may have more money, but baby, we got the people.”
Cancer patient and St. Christopher’s Hospital for Children pediatric physician assistant Maria Garcia gets her chemo care at Hahnemann.
“It has been a complete package of focused patient care. Unfortunately, this package is now in danger of being dismantled, and that is a disgrace,” Garcia said. She praised her team of nurses, and said she hopes to continue her treatment with them at Hahnemann in August.
While Sanders and other political leaders are demanding that the hospital stay open, its lawyers are moving it slowly through bankruptcy proceedings, with the goal of shutting it down.
In Wilmington on Friday, U.S. Bankruptcy Judge Kevin Gross approved hospital attorneys’ request for interim financing during Philadelphia Academic Health’s Chapter 11 process, essentially giving Hahnemann’s owner permission to borrow money from investors MidCap Financial so Hahnemann can pay its bills and keep operations going during the shutdown process.
The real estate on which Hahnemann sits — in a desirable area north of City Hall — is not owned by Philadelphia Academic Health and is not part of the Chapter 11 bankruptcy petition.
In addition to Hahnemann, Philadelphia Academic Health owns St. Christopher’s Hospital for Children, which is part of the bankruptcy filing and which the health system plans to sell.
Last week, attorney Mark Minuti told the judge that the hospital would like to shut down its emergency department by Wednesday, July 17. He asked Gross to expedite a decision on that request, pending agreement from the Pennsylvania Department of Health, the city and other relevant parties, which Minuti assured Gross he could get. The state Health Department, which has a cease-and-desist order in place and a temporary monitor at the hospital, confirmed Monday that the emergency department will stop accepting new patients on Wednesday, though emergency services will still be available to patients already in the hospital.
Gross still must approve the overall closure plan for the hospital, to which the City of Philadelphia, the state Health Department, Pennsylvania Attorney General Josh Shapiro, and Drexel University have objected. Hahnemann is the primary teaching hospital for Drexel’s College of Medicine.
The judge encouraged Hahnemann’s leadership to meet with creditors to come to an agreement before he reviewed the plan, which Gross is expected to do this Friday.
The judge also is expected to make a decision this week on the proposal put forward by Hahnemann, Drexel, and Tower Health to transfer Hahnemann’s roughly 570 medical residency slots to Tower’s six hospitals around Pennsylvania. Tower currently has just 118 Medicare-funded residency slots.
That transfer will also need approval from the Centers for Medicaid and Medicare, as well as from the Accrediting Council for Graduate Medical Education, the body responsible for approving teaching hospital programs. Within that plan, residents would still be able to find their own placements elsewhere.