Opposition to a move to privatize three New York public hospitals grew on two fronts last week.
Opponents of an effort to lease Brooklyn's Coney Island Hospital to Primary Health Systems, a Wayne, Pa.-based for-profit operator, verbally pummeled members of the board of New York City Health and Hospitals Corp. at a public hearing.
Critics faulted HHC's board for moving in lock step with Mayor Rudolph Giuliani and failing to ask pertinent questions about his "privatization" initiative.
The outpouring came a day after three dissident board members joined community activists in suing the public hospital corporation, the mayor and other city officials for attempting to turn over Coney Island and two public hospitals in Queens-Elmhurst Hospital Center and Queens Hospital Center-to private operators.
Although widely viewed as a mere formality in a process of rubber-stamping Giuliani's plan, the public hearing drew an overflow crowd of 200 or more. In speech after speech, politicians, union leaders, public health advocates and community activists urged the board to defeat plans to relinquish Coney Island.
The suit, filed Oct. 7 in state Supreme Court, charges that officials failed to comply with city and HHC procurement rules. Those rules delineate a process for soliciting bids and awarding contracts. In the complaint, plaintiffs ask the court to block the city from completing lease agreements until they have complied with the procurement rules.
Steven Osborne, a spokesman for Maria Mitchell, the mayor's health policy adviser and chairwoman of HHC's board, said the suit has no merit because, as a public benefit corporation established under state law, HHC is not governed by city procurement or leasing rules.
The City Council also has a lawsuit pending against the city. That suit challenges the city's authority to lease the hospital without the council's authority.
Despite these hurdles and the criticisms raised at the hearing, PHS isn't reconsidering its deal with Coney Island, a spokeswoman confirmed.
At the hearing, critics of privatization faulted HHC and the city for failing to adequately explain how the proposed contract with PHS would improve care, preserve access for the poor and uninsured or save money. Opponents said a 10-page summary of the proposed contract released by the city just three working days before the hearing raises more questions than it answered.
"Why do we know so little about the plans?" asked Stanley Hill, president of District Council 37 of the American Federation of State, County and Municipal Employees. Hill said he fears the city is forfeiting public accountability without guarantees.
James Butler, president of Local 420 of the New York City Hospital Workers Union, said his members won't tolerate a reduction in benefits by PHS. He said the union stands prepared to strike.
Beyond risks to job security, placing Coney Island in the hands of a for-profit operator raises "citywide and statewide health policy implications," said state Assemblyman Jules Polonetsky, a Democrat who represents Coney Island. Only now are Albany lawmakers playing catch-up to remedy problems caused by letting for-profit HMOs operate in the state, he said. As an example, Polonetsky cited state legislation mandating at least 48 hours of hospital coverage for new mothers and infants.
At times the crowd grew unruly, antagonized by the board's three-minute limit on speeches, which was strictly enforced by sounding a high-pitched, intermittent whistle and turning off microphones.
New Yorkers have been far more vocal and vitriolic in their opposition to privatization than residents of Los Angeles. Following a multimillion-dollar bailout from the federal government, Los Angeles County's Department of Health Services agreed to downsize hospitals and focus on outpatient care. It is keeping county clinics open through partnerships with private operators (Sept. 9, p. 32).
By contrast, New York's privatization of Coney Island is "not a policy driven by any real need," said John Ronches, executive director of the Committee of Interns and Residents, which represents about 175 residents at Coney Island. The hospital is among the fiscally healthier of the 11 acute-care hospitals under HHC's control.
Before HHC's board makes any comment or takes action, its strategic planning and finance committees must meet and study testimony delivered at the hearing, said Osborne, Mitchell's spokesman. A vote is expected by the end of the month, he said.
Skeptics doubted that the hearing would alter the course of the city's contract negotiations. "This is a charade," charged City Comptroller Alan Hevesi. "This is to meet a legal obligation . . . . and railroad this through," he said.