Beth Israel Hospital Hangs By A Thread

A Community Betrayed

By Arthur Schwartz

About a half-million people live south of 23rd Street in Manhattan. The Village and Tribeca are mostly white and somewhat older — but with a growing younger professional population. We have housing projects above 14th Street to the west, and lining the East River below 14th Street. In the East Side Zip Codes 10002 and 10009, 25% of the population is on Social Security and 25% receive Social Security Disability.

If Beth Israel Hospital closes, we will have only one small (not full-service) hospital below the Brooklyn Bridge. On the west side the southmost hospital is Roosevelt (Mt. Sinai West) on 59th Street.

The Blame Game

Beth Israel is a lesson in the blame game. Greedy hospital executives. Our governor. Local politicians who give up too easily.

Mount Sinai twice announced that it wanted to close Beth Israel in September 2023. Even though they were supposed to wait for approval by the NY State Department of Health (DOH), by late November, when they held a required public meeting, hundreds of doctors and nurses were already gone. The DOH was looking the other way and the plan, approved or not, was to close by March 31, 2024. Even when publicly embarrassing reports got the DOH to issue a Cease and Desist Order, Mt. Sinai rolled along. According to them, the hospital, which had been stripped of its money-making departments like heart surgery and maternity, was losing $100 million a year.

The Legal Process

I was part of a team of lawyers who stepped in to get a Temporary Restraining Order. And from February 15 – 24, 2024, that stay was in place, even though the DOH approved the closure and said “open another urgent care center a few blocks away.” Even through reports of closing, 45-50,000 patients used the Beth Israel Emergency Room that year. If the hospital closed, thousands of people would have had to travel uptown to Bellevue and NYU-Langone, where overcrowded emergency rooms saw people waiting days, even weeks for treatment. “No big deal,” said the DOH – reflecting Governor Hochul’s desire to cut hospital capacity, in her DOGE-like elimination of state health services.

On February 24, Crains New York, a business magazine, profiled me in an article titled-Meet Arthur Schwartz, the Pro Bono Lawyer Standing Between Beth Israel and the Bulldozer. At noon, Supreme Court Judge Jeffrey Pearlman lifted the stay and dismissed the lawsuit, finding that the approval was not “arbitrary and capricious.” Minutes later, knowing an appellate court was likely to reissue an injunction, Mt. Sinai began moving 80 in-patients out of the hospital. Nurses called me frantically. Patients were lined up like cattle, on gurneys, waiting for ambulances to take them to another hospital. By the close of February 27, all in-patients were gone, the Intensive Care Unit was dismantled and the rooms decimated. Mt. Sinai announced that the emergency room would stay open until March 26. They added that our lawsuit had cost them over $200 million and was running at $3 million a week.

On February 28, an Appellate Division judge issued an order prohibiting any “further closure.” At noon that day, local elected officials held an open Zoom meeting with Mt. Sinai officials to discuss the “transition.” One elected official started by saying, “Well, the lawsuit is over, so let’s discuss the next steps.” I interjected that the lawsuit was not over (we hadn’t yet heard about the new court stay) and the discussion continued, mostly politely, about the new Urgent Care Center on 14th and 2nd. Then the Appellate Court issued the stay.

The court asked for submission of further arguments by March 17. Big signs went up on Beth Israel, inside and out, “This Hospital Will be Closed at Midnight on March 26th.” I threatened to seek a contempt order, since the appellate injunction was in effect. The Mt. Sinai lawyer, Paul Weiss (the same firm that just promised to do $40 million in free work on projects determined by Donald Trump after he threatened them) argued with me, but they had the signs taken down on the night of March 25. On March 26, I got press calls asking for a comment about the last day of Beth Israel, which had served our community since 1888. I told them that the hospital remained open. Mt Sinai had taken down the signs but did not tell the media.

As we go to press, ambulances keep arriving at the Beth Israel Emergency Room, and over 100 people a day arrive for treatment. We are in a trench, with enemy forces all around, but the fight is not over.

How did we get here?

The first problem was the decade-long unchecked move towards hospital consolidation. There are only five major hospital systems left in New York City: Mt. Sinai, NYU-Langone, Presbyterian, Northwell-LIJ, and Montefiore. They have bought almost every non-profit hospital in NYC. Then there are six city hospitals and the state-owned Downstate in Brooklyn (which Hochul has tried to close). There are less than half the beds per New Yorker than there were 20 years ago. These big systems only talk about bottom lines. The Mt Sinai system generated $23 billion in revenue in 2023. Even Beth Israel, which was “losing money,” generated $3 billion in 2024. It’s all about money, and executives with multimillion dollar contracts who rarely talk about health care. And they hate the fact that they are required to take Medicaid, because NY State reimburses far less than private insurers.

The second problem has been NY Governors. They have been concerned about spending too much on health care, and they see hospital beds and emergency rooms as villains. Governor Paterson could have saved St. Vincent’s, but it required a higher Medicaid reimbursement rate so he said “no.” Things slowed a bit under Governor Cuomo, and everyone understood the need for hospital capacity during the COVID Pandemic. Mt. Sinai announce in 2021 that it was not going to close Beth Israel and was going make $1 billion in investments to upgrade it. But Governor Hochul, bless her soul, is a huge fan of hospital closures, and the pace has rapidly picked up during her four years in office.

The third problem, and I say this as a Democratic District Leader since 1995, is that our local elected officials did not do their job. Most of them sent aides to meetings, a few showed up at the public meeting in November 2023. They all signed letters calling on Mt. Sinai to stop, but that was it. They did not use their offices to help rally the public, they did not join the lawsuit, they did not publicly denounce Governor Hochul and the DOH. A few showed up at rallies organized by the Community Coalition to Save Beth Israel. But most, if not all, did nothing forceful, with the excuse that it would be harder to meet with the DOH and Mt. Sinai if they did that. But those meetings yielded little. Keith Powers, the City Council Member for Stuyvesant Town, across from Beth Israel, has been a no-show — and he wants to be Borough President. Assembly Member Debra Glick, for the area west of 1st Avenue below 14th Street, signed a few letters, but was otherwise absent. Forget about Mayor Adams.

What’s next?

As we assess who to elect as Mayor, Borough President and City Council Member east of 6th Avenue, keep this in mind. We NEED elected officials who will work as community organizers. And next year, when we vote for Governor, remember what Kathy Hochul did.

Is the fight over? Not yet. The odds are long. But there is a lot we should learn as we face the future, with federal services being stripped, especially Medicaid and Medicare. I predict Roosevelt Hospital will be next on the Mt. Sinai chopping block.