Ep. 15: Big Money vs. the City of Brotherly Love

Briahna Joy Gray: That is the sound of everyday Americans protesting the closure of Philadelphia’s Hahnemann Hospital, a city fixture for the better part of two centuries. As the primary teaching hospital affiliated with Drexel University College of Medicine, the closure will displace 571 medical residents, but more than that, it will eliminate a vital resource for the hospital’s largely black and Latino patients. Located just off the Vine Street expressway, the hospital is ideally situated to accept patients with acute trauma, for a difference of a few seconds is literally life or death.

Protester:  This has been like working in a MASH unit for the last 15 years. The only reason really that we’re here is for the patient population because we believe in taking care of those that are in need. In a matter of life and death minutes saves lives or causes lives to be lost, so stabilizing and transporting out, that’s minutes lost.

Briahna Joy Gray:  That was a nurse who has worked at Hahnemann for 20 years. I spoke to her this past week when the Bernie campaign headed to Philly to lend support to protests against the hospital closure. It probably won’t surprise you to learn that the story of Hahnemann’s bankruptcy is a little more complicated than just profits versus losses. Less than two years ago, a California-based private equity tycoon named Joel Freedman purchased Hahnemann from its previous owner, Tenet Healthcare. What Freedman is doing now looks suspiciously like stripping Hahnemann for parts, regardless of the cost to the community. More than perhaps any other industry, healthcare brings into relief the tension between the needs of the vast majority of people and the profits of a tiny minority, a minority that nonetheless gets to make decisions for all of us. 

 This week I took the podcast on the road to talk to people on the front lines of, in the words of one protest sign, “The fight for people over profits.” 

This is Hear the Bern, a podcast about the people, ideas, and politics that are driving the Bernie Sanders 2020 campaign and the movement to secure a dignified life for everyone living in this country. My name is Briahna Joy Gray, and I’m coming to you this time from The Keystone State. 

 Hahnemann isn’t just any hospital. It’s what’s described as a safety net hospital, meaning that it provides care to underserved communities. Nearly half the patients admitted to Hahnemann are on Medicaid, and nearly two thirds are black or Latino. The hospital wasn’t hurting for patients. It was a busy level one trauma center whose location right off the highway made it a crucial access point for emergency care in the area. But Joel Freedman, the man who bought the hospital about 18 months ago, has different priorities. You see, the fact that the hospital is so well located in downtown Philly, just down the street from the city’s iconic city hall building, is the reason it’s such an important location for a hospital, but it’s also what makes it an attractive real estate prospect for Freedman.

Protester:  According to the people who own this hospital, there’s too much healthcare. They even had it on the front page of the Philadelphia Inquirer that, having a hospital in this location is obsolete.

Briahna Joy Gray:  Why in this location? We’re right here in downtown Philadelphia. It seems like a pretty prime location.

Protester:  You got the convention center over there, you got parking over there. You put a hotel over here. They think they can make more money, hotel, office building, condominium. Right now, under construction, right by The Kimmel Center down the street, they’re building a condominium. You can get one. All you need is between $2 and $4 million. You see, they’re building that and they’re closing this down.

Briahna Joy Gray:  I had the pleasure of speaking to at least a dozen folks in the crowd that day. One of them was nurse practitioner, Tarik Khan.

Tarik Khan:  Basically, there’s a big corporation that wants to shut this place down and take a community hospital away from the city. This hospital’s been here for over 171 years, before the Civil War. This hospital is in the heart of the city, and what they want to do is they want to turn it into condos. This hospital serves low income people. This hospital serves the poorest of the poor. It serves people of color predominantly, and we can’t lose this hospital.

Briahna Joy Gray:  What will Hahnemann’s closure, if it closes, mean for the people of Philadelphia?

Protester:  Most of our patients have an insurance that is not covered by other hospitals, that’s part of the problem. The other part of the problem is, the other hospitals won’t take patients without the insurance. 

Briahna Joy Gray:  What do you mean when you say they won’t take? What does that look like in practice?

Protester:  In practice, it means that we take care of those… We are the catch-all hospital for those people that can’t get healthcare anywhere else. 

Briahna Joy Gray:  Folks are showing up to the emergency rooms at other hospitals and they’re told, “Go to Hahnemann, go somewhere else?” 

Protester:  They’re stabilized and sent out.

Briahna Joy Gray:  That was the 20-year nurse from the introduction again, but I heard similar views from everyone I spoke to.

Protester:  I work in pharmacy, I’m a pharmacy tech there since 2001. Right now, we’re just trying to fight to get back our hospital. 

Briahna Joy Gray:  From your perspective, what does this hospital mean to the community?

Protester:  To me it means everything. Right now, they closed one hospital that was on Girard Avenue. Right now, they don’t have… especially the ones that don’t have insurance, they don’t have anywhere to go. We have Jefferson, we have Temple, but right here you’ll still get seen without, if you have insurance or anything like that too as well. We take on a lot of caseload. This hospital closing, the Jefferson and definitely I feel as though Temple and Einstein, they’re going to get a big influx. We were a Level One trauma center. That’s one. Just all the cases from that, the cases from maternity ward.

Briahna Joy Gray:  What does it mean to be a Level One trauma center?

Protester:  Oh, Level One trauma center? We take all the people that got shot or killed or anything, that come over here and we’ll take care of them best of our ability. But now they would have to get rushed… Unfortunately, if somebody got shot over here, they have to get rushed all the way over to Temple which, they might pass away on the trolley, even though we have EMTs and stuff, that can probably do certain work to keep them alive to that point, but you got to get them to that point.

Briahna Joy Gray:  The location of this hospital, which is now being valued for its real estate value, is actually really important to save lives.

Protester:  Yes, definitely, definitely. Of course, we know they want to have a luxury condo or apartment. Beautiful, I get it, but this is a perfect location for everybody, right off the highway.

Briahna Joy Gray:  The nurse I spoke to earlier explained that, even though they haven’t given up the fight, the hospital is basically being sabotaged. It’s increasingly difficult for it to fully function even while it’s technically still open.

Protester:  He removed some of the equipment that allowed us to function at a certain level, which then forced the physicians to say that, “We can’t deliver care safely.” He backhandedly wanted this hospital closed in two weeks, but because of PASNAP, 1199, our city council, our senators, we’ve been working to diligently try and keep this open for the safe delivery of care until we can get these patients placed in other hospitals, other physician groups.

Briahna Joy Gray:  The tragedy is that, the closure of Hahnemann is hardly unique. It’s part of a wave of hospital closures across the country. In almost every case, the root cause is the same, the endless search for profits in the healthcare industry. This is Summer Lee, a representative from Pennsylvania’s 34th district, whom I encountered at the protest.

Summer Lee:  We got hospitals closing in our area, so it’s natural to stand in solidarity. I had a hospital close in my community that was a lifeline, for-profit, but ours is a charity. It’s not just the for-profit bosses, we have people who are masquerading as charities. Hospitals are closing all over the place, and it’s usually impacting the already most vulnerable. It’s not just a Philly thing, it’s not just a Pittsburgh thing. This has happened all over the nation because of capitalism.

Briahna Joy Gray:  If you listen way back to episode two of this podcast, you might remember that US hospitals in rural areas are also closing at an alarming rate. One study counted 72 closures between 2010 and 2016, turning large swathes of this country into virtual medical deserts. It’s part of why it’s so crucial that Bernie Sanders, along with representative Jim Clyburn, fought for and secured $11 billion of additional funding under the ACA to expand access to community health centers for those who don’t have access to a primary care physician. The Community Health Centers Act will allow 5.4 million Americans to receive the primary care they need. 

 A study from earlier this year found that nearly a quarter of all rural hospitals, 430 of them across 43 states, altogether employing 150,000 people, are at risk of insolvency. In Mississippi alone, 31 rural hospitals are at risk of closing, representing nearly half of the state’s total. The reason? The owners of those hospitals find them insufficiently profitable. Now, Hahnemann is part of a somewhat newer trend, the expansion of private equity firms into the healthcare industry. Many of these firms are “notorious for buying companies with borrowed money and selling off their assets to make quick bucks,” as a recent article in the American Prospect put it. Hospitals, particularly those located in gentrifying areas, may be their newest speculative target.

 Joel Freedman’s company, Paladin Healthcare, appears to be following a familiar private equity script with regard to Hahnemann. After declaring the hospital unprofitable, Paladin filed for bankruptcy but did not include the hospital’s real estate in that filing. This will allow Paladin to sell the land to the highest bidder, and already several developers appear interested in turning the hospital into Philly’s next wave of tony, well-placed, condos. 

Is it true what they say that this is really just a big real estate ploy? 

Summer Lee:  Yes, go a little bit into his financials. You’ll see that, in the bankruptcy court, only the hospitals themselves were placed, not the land that they exist on.

Briahna Joy Gray:  Imagine a world where investment in healthcare didn’t depend on whether it earned some shareholder a few bucks. Where a new MRI machine might go where there is the greatest need rather than where there’s the most money. Where a banker based in California doesn’t shut down a 171-year old hospital in Philly because he couldn’t, ‘turn it around’ in the fewer than two years it was on his books. That’s the world Bernie is trying to build.

 I asked three state representatives who attended the rally what, if anything, could be done politically to stop this closure and others like it.

Sara Innamorato:  We could have not had an investment banker buy a hospital that has 70% of its patients relying on Medicare and Medicaid, and have him expect to turn a huge profit. It didn’t make sense from the beginning and the way that he has conducted himself is really outrageous and it’s terrible for workers and patients. We could have had that. I would say that for Philly elected officials, we’ve been talking about this for quite a while and working with the unions, but when you have the owner of a hospital who doesn’t have the best interest of workers and patients in mind, then you keep putting pressure on and then you also take to the streets like this.

Briahna Joy Gray:  That was Sara Innamorato, a state representative from Pennsylvania’s 21st district, which includes the City of Pittsburgh in Allegheny County.

Summer Lee:  I can’t speak for the Philly rep because we’re out in Pittsburgh, but, I mean, just from even you saying that. We have this rich affluent person who owns this hospital that’s now shutting down, who owns another one in DC, which puts in perspective that this isn’t about one hospital. If we only focus on this one hospital, then we’ll be losing track of the fact that this is a culture, that this is something that was allowed to happen, that we really have to address at its roots. Now, I think that there are political ways that we can address that, and I think that that starts with getting progressive politicians in it. 

 That starts with getting people who are unafraid to say that, “We’re going to tackle corporate greed, we’re going to close corporate loopholes, we’re going to tax the rich, we’re going to do these type of things,” and when you do that, then that’s supposed to trickle to other folks. But also, we’re still relying on folks. We’re still going to have to march. We’re still going to have to focus when the things come up because we work with the resources we have and they do have more resources than us, but we have each other. 

Briahna Joy Gray:  That was Summer Lee again, who also represents Pittsburgh, Allegheny county.

Elizabeth Fielder:  These hospital closures are a symptom of a profit-driven healthcare system. Until we change the way that we administer healthcare and health insurance and everything, until we do a complete overhaul of the system, this is going to keep happening. It’s going to happen in urban areas like Philadelphia and Pittsburgh, it’s going to happen in rural areas. It’s going to happen all across America until we intervene legislatively and say, “No more.” That no more are hospitals allowed to be in healthcare, allowed to be driven by profit motives, because people are always going to be sick, babies are always going to need to be born. You have a customer base that’s always in need and you can’t apply business principles to that, you need to apply human principles. We need to humanize these policies and humanize these decisions that we’re making when we’re elected to these governing bodies because it is about people’s lives.

Briahna Joy Gray:  Rounding out the crew was Elizabeth Fielder, who represents South Philadelphia. Again and again, everyone I asked to help me understand how and why this was happening pointed to a single structural problem, our for-profit healthcare system.

Protester:  Everybody knows what the problem is. People who are addicted to drugs they need a right to healthcare, a right to a job, a right to a place to live, food to eat, clothes to wear, and none of that is guaranteed by the system. But they say, “You need to take responsibility for yourself,” and now they’re saying this to the people of Philadelphia, “You’re going to have less health care and you need to take care of it for yourself.” No, it’s a social question.

Briahna Joy Gray:  I spoke to that protester at the start of the rally, and he was clear about where to place the onus.

Protester:  I believe that what they’re saying today, I’ve been saying for 40 years, human needs are more important than profits. I think what’s happening that’s important that you’re a part of is that, young people are starting to see that there’s a systematic problem here. You support Bernie Sanders, I don’t, but I respect the fact that you’re starting to get involved, to think about these issues because I see that this is new. You go back 10 years ago, somebody who had your ideas, you would talk to your friends and they would say, “What are you doing?”

Briahna Joy Gray:  Well, a lot of them still are like that, unfortunately. 

Protester:  “What are you doing? Go on, get a good job, get a nice place to live, and call it a day. But now, that’s what I see that’s beginning to change. The young people are starting to get involved.

 And 

Briahna Joy Gray: involved we are. When Dr. Heather Gautney, a senior policy advisor to Bernie Sanders and a Philly native, learned about the hospital closure, she immediately thought of ways the campaign could support efforts to keep the hospital open. That’s why on Thursday, she, Senator Nina Turner and myself went down to Philly. But more than that, the campaign used its call list to text supporters to join the protest if they could.

 May I ask how you came to know about this protest?

Protester:  I had a text from Bernie Sanders, so I’m really happy to be part of what he’s doing, and I’m thrilled that he’s able to organize to get us all out here just to really support the hospital. It was wonderful to hear Nina Turner, she’s awesome-

Briahna Joy Gray:  Yeah, she’s the best.

Protester:  She’s the best, and Bernie’s the best, and I’m proud to support them both. 

Briahna Joy Gray:  Are you from Philly? 

Protester:  I’m from the Philadelphia area. I’m a community college teacher in the area, and we need to get Bernie in there. We need to support education, college, healthcare, all the things that he stands for. 

Briahna Joy Gray:  Well, thank you. I didn’t come to get a pro-Bernie speech but I obviously love to hear it. 

Senator Nina Turner not only attended the protest, she closed out the day’s remarks from keynote speakers. I had to ask myself if I even needed to write a script for this podcast because as always, Senator Turner gives voice to calls for justice better than almost anyone.

Nina Turner:  It is a sin and a shame that the American healthcare for-profit-over-people system will allow a situation like this to happen in this great city, to the great people of this city. It is a sin and a shame. But I tell you this sisters and brothers, that as much of a sin and a shame that this is, we bear witness today, that when a conscious-minded rainbow mosaic, coalition of righteous-minded people get together, we let it be known that not on our watch will this happen. For we have in a national leader, somebody who don’t worry about the polls telling him what’s popular or what’s not. Somebody who’s been standing with the nurses, and the doctors, and the union workers whether it’s popular or not. Someone who understands that healthcare is not a commodity. Somebody who knows, being a long-distance runner for justice, as Dr. Cornel West calls him. Who understands that Medicare for All is a human right in the United States of America. We bear witness, as the great abolitionist Frederick Douglas once said that, “Power concedes nothing without a demand,” and we’re making the damn demand today that Hahnemann stays open.

Briahna Joy Gray:  After the speeches, the protest turned into a march, which circled the hospital block drawing in community members as we processed. We just walked by a kebab cart, a shawarma cart, the guy working inside is also chanting, “Keep it open, keep it open.” Community members from across the ideological spectrum came out. If anything was clear, it was that this hospital closure didn’t just affect one group in particular, and it was going to take an entire diverse coalition to save it. 

What made you feel so strongly to come out today?

Osborne Hart:  Well, first of all, I’m for universal health care for all, and what not, and I’m also a candidate for mayor here. Socialist Workers Party. Yeah. I’m one of the three candidates in Pennsylvania. I’ve been in Pittsburgh supporting our candidate for city council with a similar thing that’s happening there, with the UPMC draconian rules busting the union. This thing around Hahnemann has been going on for several years now.

Briahna Joy Gray:  That was Osborne Hart who, in addition to running for mayor on the SWP ticket, is a Walmart worker, an activist for black, immigrant and women’s rights and against imperialist wars, antisemitism, and police brutality. What I loved about talking to him was his strong grasp of solidarity as a political tool.

Osborne Hart:  The rural hospitals, and Pennsylvania is big. I’ve been in Texas, I was in Utah, and they’re closing these hospitals, and they always try to pin it as an urban question, but it’s general. It’s another way they try to divide us. I mean, United States is a big population, and there’s a lot between New York and LA of working people, and we see how deep this crisis is. We need to break independently, begin to mobilize. I think one of the big examples in the last couple of years, a year and a half, is what happened in West Virginia. Those teachers were vilified. “All the kids are going to be at home, there are going to be drugs, this, that and the other,” but they stood by and they won. They won 55 counties. Unprecedented. That’s a little thing I think is below the surface.

 I happen to work at Walmart, the largest employer in the country and in the world. A couple of places, Germany, I think in the UK, they’re organized and they’ll fight for you, but… The majority of people… I work at out at Springfield, a lot of single mothers, two and three jobs, part-time, no benefits, the draconian attendance policy that Walmart has, that needs a union, and that’s what I’m for. We have to look to solidarity. I told some of my coworkers to come here. Why this is important? It’s a lesson of independent political action. I remember a few years ago on the 50th anniversary of the Voting Rights bill… matter of fact, it was organized by (inaudible). 

 I was running for mayor in that race. It was a big banner almost the side of the building, Lyndon Baines Johnson, 65. Signing. Oh, great thing. There were media from all over the world. It was actually impressive. They said, “Well, what about this?” I said, “Well, if you think about it, Lyndon Baines Johnson didn’t wake up that morning, come down the East Room and sign.” What was happening in the streets in the United States then? Massive Civil Rights Movement, that’s what won it.

 I’d say to people, look and see what we have in common, as a class. It’s two basic classes in society and there’s a whole majority of working people, working farmers who are catching hell. We create the wealth in society, so we have to organize independent politically and ultimately working people need political power. The Civil Rights Movement, I mean, the victory of that, it was a social revolution. Overturned the system that determined our people, every aspect of our life. That was the biggest division in the US post-radical reconstruction in the 20th century, and that united working class. Yes, there’s still racism and whatnot, yes. But that defeated the system, and that was a big lesson in the unity of the working class. I think what’s happening in the United States and in the world, is a deep economic, political and moral crisis. It’s a system.

Briahna Joy Gray:  It’s important to recognize, but what’s happening to Hahnemann is systemic and the solutions will largely be systemic as well. We need Medicare for All to get rid of our for-profit healthcare system. In the meantime, until Bernie is president, well, we fight. 

 Has the mood changed at each of the protests? As you know, basically the status of the hospital and the likelihood of preventing this closure has shifted?

Protester:  I think a lot of the protests are different. The one on Tuesday was more of a socialist alternative type crowd. They were all asking to publicly fund this hospital, it’s what we need to do. City or state need to take over and drastically ASAP. This is a crisis, economic crisis and a health crisis. Number one, we need to think about people’s lives, but this is going to be affecting so many people’s jobs. It’s not just the nurses, and we need to be thinking about them, but it comes down to even… I’ve been a bike messenger. I’ve delivered the slides here, the inter-office mail here. I mean, even the people that were on the other side, the food court, it’s a trickling effect all throughout Philadelphia. It’s not just going to be just in this building. A lot of people don’t grasp that. It’s going to affect a lot of people.

Protester:  We’re going to fight as long as we can fight for our patients for this really vulnerable population that need a voice. As nurses, we’re patient advocates and this is what we’re doing. This has been like working in a MASH unit for the last 15 years. The only reason, really, that we’re here is for the patient population because we believe in taking care of those that are in need. 

Protester:  Patients over profits. Patients over profits. 

Briahna Joy Gray:  Over the weekend, Bernie Sanders was so moved that he decided to take a detour from his planned schedule to join protesters in front of the hospital and decry the for-profit health care system that put the hospital at risk in the first place

Bernie Sanders:  The issue that brings us here today is not complicated. At a time when our country faces a major health care crisis, when 80 million Americans are either uninsured or underinsured, including tens of thousands of people here in the Philadelphia area, we should be moving, we must be moving forward to guarantee healthcare to all people as a right. And we should not be talking about shutting down a major hospital and converting that property into hotels or condos or some other real estate opportunity. 

So today, we send a very loud and clear message to Mr. Joel Freedman. And that is do not shut down this hospital. Work with local officials, work with the unions and the people of the city, and keep this hospital open.

Disgracefully, disgracefully, as all of you know, we have an infant mortality rate in this country, which is much too high, and we ask how much higher will it become if this hospital is shut down?

At a time when the mortality rate for women giving birth, especially African-American women, is much too high, we ask how many more mothers will die if this hospital is shut down?  

If an investment banker like Joel Freedman is able to shut down Hahnemann and make a huge profit by turning this hospital into luxury condos, it will send a signal to every vulture fund on Wall Street that they can do the same thing in community after community after community.  

We cannot and we will not allow that to happen.  And that is why I will be very soon introducing legislation in the Senate to establish a $20 billion emergency trust fund to help states and local communities purchase hospitals that are in financial distress.  

Briahna Joy Gray:  Now, Joe Biden has said that he doesn’t think a handful of billionaires are the problem in this country. Bernie Sanders, by contrast, isn’t afraid to confront them head on. I think it’s Bernie’s approach that will help save Americans from falling victim to corporate greed, and perhaps Hahnemann Hospital, too.

That’s it for this week. As always, please share your ideas and feedback at [email protected], or send us a tweet with the hashtag #HearTheBern. If you haven’t already, please take a moment to rate, review, or like us on Apple podcasts, SoundCloud, or wherever you’re listening. Transcripts will be up soon. Until next time.