When Concern-Trolling Oligarchs Attack

One way that hospital CEOs justify their increasingly obscene pay packages is to market the hospitals they run as "health systems" instead of hospitals. This is especially true when a private corporation (Continuum Health Partners) buys up several struggling charity hospitals at bargain basement prices and then merges them all into one behemoth.
They justify enriching themselves and their shareholders off the backs of the poor and the sick by occasionally voicing great concern for their treat-and-dump clientele. They run expensive ad campaigns, including videos which aired during the televised Academy Awards show.

One of the easier and more cost-effective ways to accomplish this onerous marketing task, though, is to publish an ad disguised as an op-ed in the New York Times.

And lest the wealthy Wall Street investors in Kenneth L. Davis's Mount Sinai Health System conglomerate of providers become unduly concerned about his concern for the poor, he enlisted as his Times co-author one of the best friends that Wall Street ever had: former Treasury Secretary and Citibank CEO Robert Rubin. There hasn't been this much deference to the sensitivities of the rich since 2015, when Mount Sinai officially dropped the Roosevelt name from the Roosevelt Hospital it subsumed in the interests of cost-cutting.

The gist of their concern-trolling Times piece is this: If only the poor and the sick didn't live in such crappy housing situations and had more to eat, then the poor and the sick wouldn't be straining our country's precious for-profit Health Systems to the absolute breaking point!

Now, why didn't we think of that before Rubin and Davis deigned to enlighten us about their awesome discovery, which seemingly ranks right up there with the unearthing of King Tut's Tomb? And to get us properly prepped for the absolute genius of their Eureka moment, the Times even cooperatively headlines the piece: "A Secret to Better Health Care."

D'oh!

Rubin and Davis start out by honestly admitting that American Health Systems are indeed a complete mess. But that mess is really the fault of other systems, such as the food stamp system and the housing system.

If our spending on social programs were (sic) more in line with other developed countries, our health care costs would fall. That means that as policymakers evaluate a social program, they should weigh not only its direct and second-order benefits — from reducing crime and recidivism to increasing productivity — but also its effect on lowering federal health care costs.

This demonizes the poor and the sick by conflating poverty and illness with crime. We must spend more on social programs, not because it is the right and the humane thing to do,  but because a little extra spending on poor people is better for the bottom line of both the System and the investor class. The goal is to get the laggards producing.

The impetus, or hook, for this op-ed appears to be the case of a recently-released Mount Sinai System patient who became trapped in his New York high-rise apartment when the elevator broke down. A System social worker prevailed upon management to make repairs, because the patient otherwise would have been unable to score his heart failure medication and (if he survived) then put an even greater strain on The System with a premature readmission and even possible denial of his untimely insurance claim.

If the System can suggest better nutrition and housing for its customers, it will also be less prone to lawsuits for releasing them too soon into horrible living conditions. It will help absolve them of responsibility when System management shows itself willing to suggest in the New York Times that mold be ameliorated and elevators repaired.

But no concern-trolling neoliberal manifesto could ever be complete without the oligarchs also insisting that the crime-prone lazy poor and sick also have some "skin in the game." Citing a study conducted by the RAND Corporation, Rubin and Davis continue:

And once in stable housing, beneficiaries can better pursue public benefits and job opportunities.The Los Angeles program showed even greater cost savings, according to a study by the nonpartisan RAND Corporation. After receiving housing assistance, beneficiaries’ costs to the public health system plummeted. Inpatient services fell by 75 percent. Over all, the study found that, even accounting for the increased housing costs, recipients’ total social service and health care costs fell by 20 percent. And beneficiaries showed signs of reduced involvement in crime and improved mental health.

Notice how smoothly they pivot from the trapped man with heart failure to the miracle of all those sick and poor people suddenly getting law-abiding and spry and enthused about finding a job, and without the government even having to implement a federal jobs system with a living wage!

It's just too bad that the Times's big reveal of The System's Secret to Health doesn't also clue us in about the location of all those wonderful job opportunities. But as long as the message is bipartisan or nonpartisan, it's just got to be good. For rich people, especially.

My published response to the New York Times:

This column is so rich.

Pssst... want to know the real secret? The US oligarchy doesn't want our market-based mess of a health care system to be replaced by guaranteed single payer insurance.

 But rather than come right out and admit it, Mr. Rubin recommends a little stitch here and a little stitch there to repair a tattered social safety net that, it just so happens, he had a large role in shredding back when he was one of Bill Clinton's main economic advisers.

It was Rubin who also urged Clinton to work with House Speaker Newt "Contract With America" Gingrich to dismantle welfare. It was Rubin who wanted Social Security privatized. Thank goodness that our great national heroine, Monica Lewinsky, came along when she did and ruined that scheme before tens of millions of precarious lives were further ruined in the selfish interests of Wall Street.

 Thanks to deficit hawks like Rubin and 40 years of neoliberal austerity, our average national life expectancy has plummeted for the third straight year. If our oligarchic "thought leaders" really cared, they'd also be espousing enhanced Social Security benefits and better legal protections for tenants against greedy landlords. Decent housing shouldn't be limited to fixing broken elevators and slapping bleach on moldy walls. The rents are too damned high!

  Mr. Davis,co-author of this piece, is among the highest paid hospital CEOs, his compensation having risen to $12 million in 2017. 

Wealth inequality is the real killer.

As Dean Baker points out, Robert Rubin also was behind the 1990s repeal of the Glass-Steagall Act deregulating Wall Street, which led to the collapse of the housing market in 2008, and the subsequent evictions of 10 million people from their homes. Rubin made a personal fortune from the bursting of the housing bubble. Most people have never recovered.

Was the man trapped in his apartment and suffering heart failure also a victim of Rubin's policies? Was he living in substandard housing because Wall Street had forced him out of his original home when he lost his job and couldn't pay the rent or the mortgage?

The New York Times op-ed doesn't say. 

It's a secret.