Letter: 03/02/2008 - Hospital's woes rooted in Plainfield's past - Courier

[Letter to the Editor, Sunday, March 2, 2008]

Muhlenberg's woes rooted in Plainfield's past

By HAROLD S. YOOD

With a great deal of sadness, and a degree of astonishment, I read about the planned closing of Muhlenberg Medical Center.

I personally have a sense of loss for the institution where my father, who began his practice in Plainfield around 1911, was a staff member until 1946. My brother served an internship there in the late '30s. I was on the active staff from 1946 to 1991.

During the early '80s, I was president of the medical staff. The quality of that staff was outstanding and the Plainfield area enjoyed a degree of medical care that equaled that of many university hospitals.

Now, not only is Plainfield going to be without the resource of available hospital facilities, but the loss of over 1,000 jobs is going to further increase the economic woes that besiege this city. No one has realistically addressed the questions of access for those depending upon public transportation. Nor do they focus on the deleterious effects and perhaps increased fatalities due to the increased time for critical patients to reach definitive hospital facilities.

What has caused this disaster?

Historically, the roots go back to the depression years of the '30s, when Plainfield had a well-organized welfare system that acted as a magnet for migrants from the South seeking a better life. Plainfield became one of the first cities in the country to have mandated school busing, which social reformers felt would correct racial imbalance in the school system. Instead this began the exodus to the "hills" of an affluent white population. The riots of the late '60s accelerated the changes in the social and economic demographics in the city.

A degree of blame for Muhlenberg's demise must be assumed by those area's residents who chose other hospitals rather than share a semi-private room with Plainfielders.

The most obvious blame lies in the overwhelming costs of uncompensated "charitable" medical care. At a state and local level, a Democratic-led government, whose party advocates universal health care, has refused sufficient wherewithal to the institutions that bore the load of that care.

Medicare has continually short-changed compensation to both physicians and hospitals in relation to the cost of living.

The commercial carriers have been only interested in their bottom line, not the quality of care their insured received. There have been insurers, including Blue Cross, that have boycotted hospitals, including Muhlenberg, for not signing disastrous low reimbursement contracts.

Due to fear of "their competition," hospitals often agreed to contracts that failed to meet true costs of delivering care. The administrations hope to make up the loss by charging irresponsible prohibitive high fees to the uninsured. Overall, "Not For Profit Hospital" trustees have failed in their fiduciary responsibility to the public.

As medical director from 1990 to 2001 for the now-defunct Central New Jersey Independent Practitioners Association, a group of several hundred physicians in Middlesex and Union counties that contracted to provide medical services for insurance companies such as Aetna, Cigna, and New York Life, I am well aware of the continuous negative relationship of those carriers to the "providers" of health care.

Fault must also be shared by the local political hierarchy which, in regard to Plainfield's health and economical woes, often has seemed to say one thing, yet in areas where it should have influence, has given the impression of acting differently.

Sometimes the leadership appears to be more interested in potential patronage rather that community welfare. An example can be found in the yet-to-be-approved city budget due July 2007, in which almost every section has a line item, often substantial, for professional contracts. By law, they do not require competitive bids but can be awarded to whomever the administration desires.

There are other causes that I do not have the time or space to dwell upon, for the health care disaster that is facing not only Plainfield but the rest of the country.

I would hope that it is not too late to find an acceptable remedy for the local crisis. That would take a concerted effort by all with influence.

Harold S. Yood, MD, lives in Plainfield.

[Note: Dr. Yood served on Muhlenberg's medical staff from 1946 to 1991. Subsequent to that he was medical director of the Central New Jersey Independent Practitioners Association until 2001. He is a longtime, thoughtful observer of the Plainfield scene who used to be seen -- and heard -- frequently at City Council meetings. A true friend of Plainfield. -- Dan Damon]

Link to online story HERE.