Delivered to 15,000 Plainfield "doorsteps" Monday, Wednesday, Friday & Sunday

Tuesday, July 8, 2008

Muhlenberg: The Washington Post gets it right...mostly

In making the front page of the Washington Post (see here), Muhlenberg has become the national poster child for the vexed questions of charity care and hospital closures.

There is a reason the Washington Post is considered one of the country's two national newspapers and the story does not disappoint: the writing is crisp, well-researched, and covers much of the breadth of the story. But not all, or -- in my humble opinion -- even the most important point.

But first, the good parts.

All those who have labored mightily in the 'Save Muhlenberg' struggle deserve a tremendous amount of credit for bringing Muhlenberg's crisis -- and the plight of similar hospitals -- to national attention. Without the weekly meetings, the planning, the rallying, the posters in store and home and car windows, the letters to the editor, all the thousands of little details and efforts, this heroic story would have been lost in the buzz.

And it cannot have hurt that the Courier News, Gannett's local paper, has devoted copious ink to the story -- both by its award-winning writer Brandon Lausch and (before he took early retirement) its health beat reporter Clem Fiorentino, as well as heavy play on the editorial page (I count EIGHT editorials in 2008 alone).
All of which provided invaluable background and context for the Post's reporter if he checked it. [The Courier contrasts sharply with the Ledger (O Ledger! Our Ledger! Where are you?!), where the editorial decision from on high appears to have been to limit coverage (not the fault of Plainfield's beat reporter, Alexi Friedman).]

Keith Richburg, the WashPost reporter, covers the bases: the financial costs to Solaris, the impact on the poor and uninsured, the alarm among the state's hospitals over deteriorating finances, and interviews with hospital users and local activists. Huzzah!

But the story suffers from TWO GLARING WEAKNESSES.

First, the RACISM.

We only have to get as far as the fourth paragraph to find --
The situation has come to a head in this city of 48,000 people -- majority black, largely poor and with many new immigrants moving in. (Emphasis added.)
Here we go again. Majority minority communities must be 'largely poor', right?

This common racist assumption just doesn't stand the light of day. Take a look at the 2000 United States Census and see for yourself --
Median household income: Plainfield - $46,683 | US - $41,994
Median family income: Plainfield - $50,774 | US - $50,046
Families below poverty level: Plainfield - 12.2% | US - 9.2%
Individuals below poverty level: Plainfield - 15.9% | US - 12.4%
Plainfield families making between $50,000 and $99,999 - 33.8%
Plainfield families making over $100,000 - 17.0%

Data are from the Census' American FactFinder pages (more here).

Plainfield does NOT compare shabbily with the rest of the country in either family income or household income. And, while the number of families and individuals below the poverty level is above the national medians, it is hardly by a margin such as to earn the term 'largely poor'. Even the harshest statistic, that nearly one in six residents is below the poverty level hardly means 'largely', and is only 3.5% above the NATIONAL median. Plainfield is NOT Camden, or East St. Louis, or Oakland. Or, may I dare say, Washington, D.C.

The Washington Post's bias only echoes that I once found as the city's public information officer -- ranging everywhere from my contacts with the New York Times and the AP to the cable and TV news channels back in 2005, our annus horribilis with 15 homicides.

Isn't it time the media grew up and moved on? Does a largely white-dominated media STILL need to assert its superiority by defining majority minority communities as 'mostly poor'? Where we are looking at the high probability of having an African American president, I certainly hope not. And the Washington Post is just as good a place to begin as any other.

Second, the

One simply cannot discuss public policy and public policy decisions in New Jersey without putting POLITICS in the picture.

As City Council candidate Annie McWilliams so eloquently put it in her testimony to the Health Advisory Commission in June, Muhlenberg simply does NOT meet the criteria set out by the state's own commission appointed to 'rationalize' hospital closings. To wit, we are not in an area that is 'overbedded' and by every measure, we ARE in an area serving an underserved and indigent population.

The problem, as always, is the spinelessness of our political leaders in the face of difficult decisions that might anger voters. Far safer to close Muhlenberg, in a reliably Democratic stronghold like Plainfield, than to discuss closing other hospitals where voters might go to the GOP if angered. After all, next year will feature both gubernatorial and legislative races.

Having intently followed Muhlenberg's application a number of years ago for a cardiac surgery license, it was illustrative to see that though Muhlenberg's application was deemed masterful, compelling and accurate, the licenses would instead go to hospitals in Hudson and Essex counties and South Jersey. Three years later, the Hudson County hospital had yet to fund the program or build a facility. But they had the license, which is what counts. In New Jersey, compelling can't trump clout.

At the time, that license was projected to be a lifesaver for Muhlenberg, for which the clouds were already on the horizon. Assemblyman Jerry Green proved to be powerless against the mightier pols of Hudson and Essex.

For those of us who were paying attention, it seemed that only a concerted effort on behalf of Muhlenberg by both Solaris and the city could save the day. Mayor McWilliams proposed a 'medical enterprise zone' which would have brought the financial and other advantages of the state's Enterprise Zone program to the Muhlenberg/Park Avenue corridor. Alas, Mayor Robinson-Briggs never picked up on the concept and it was apparently abandoned.

Solaris seems to have calculated that it was better to try and save JFK than to have both hospitals go under (the April 2007 subdivision of the Muhlenberg property should have been a warning).

Of course, this is background that would have been very difficult, if not impossible, for a reporter writing on deadline to ferret out -- especially if players like Solaris or political figures were loath to cast themselves in anything but the best light.

Nevertheless, the lack of this angle leaves the promise of this story unfulfilled, making it merely good as opposed to outstanding.

Richburg's closing quote from Jim Colvin, UCC pastor and Muhlenberg activist, that "from a 'survival of the fittest' standpoint, it makes sense" evoked what has been my experience of the politics of health care in New Jersey all along, that it is remarkably evocative of Alfred Lord Tennyson's famous lines --
Who trusted God was love indeed
And love Creation's final law
Tho' Nature, red in tooth and claw
With ravine*, shriek'd against his creed

where, in our experience, political expediency trumps all else.

And is it wrong to conclude that what Plainfield is facing is 'genocide lite'?

*'Ravine' is a variant of 'rapine' -- see here.

-- Dan Damon

View today's CLIPS here. Not getting your own CLIPS email daily? Click here to subscribe.


olddoc said...

Wish I had written this article. Perhaps there may be some increased national interest but will not change the sacking of Plainfield's health wealth. The politicos will have nothing to do with intervention with the State DHSS. I understand that both US Senators had been contacted and were outstanding by their lack of interest.

meagan said...

There was a full page 'ad' in the Star Ledger yesterday 'thanking' Gerry green for his leadership in the Health Care Task Force. It was signed by JFK, Muhlenberg, Overlook, RWJ, St. Peter's, Somerset and Trinitas Hospitals, in addition to the Neighborhood Health Services Corp and the Plainfield Rescue Squad. What is this expenive 'ad' all about? I'm confused.

Anonymous said...

Dan, there is little question that Plainfield is a great city in so many important ways that it would be difficult to number all of them in any kind of reasonably brief note. However, I think your comments about racism are only half-right. (Disclosure: The face at the keyboard here is white.)

"Largely poor" is a poor gloss. Admittedly. Offensive, clumsy, stupid, and yes, latently racist when luridly paired with "majority black." But the percentage of poor-er residents in town is unquestionably higher than in some surrounding communities, and this plays directly into the WP story's point about unreimbursed care.

Families below the poverty level:
National: 9.2%
Plainfield: 12.2%
North Plainfield: 4.4%
Edison: 3.3%
South Plainfield: 2.3%
Scotch Plains: 2.0%
Green Brook: 1.7%
Dunellen: 1.4%

I won't even bother with Fanwood, Westfield or Warren. But you can see Plainfield's percentage of poorer families is nearly three times that of North Plainfield, whose population is well under half that of Plainfield's.

To my mind, data cannot be racist -- only the mind interpreting them can be. Plainfield is not, as you write, "Camden, or East St. Louis, or Oakland" -- but Plainfield doesn't exist in a vacuum or on an island. The majority of the people who receive care at Muhlenberg are those from the surrounding community, and that community has a higher level of lower-income residents than other bordering areas.

That point should have been made in a more nuanced way by the WP. Nevertheless, the majority of Plainfield's residents are black, and it does have a much higher percentage of poorer residents than all of its neighbors. (These are not facts that should cause shame, by the way. They're a result of shameful recent and longer-term American history.)

None of this is an argument that Solaris is justified in closing Muhlenberg either. I think it's disgraceful that access to healthcare should be predicated on revenue or patients' income levels. But if you accept that, then you'd have to be willing to place blame just as much on the national and especially state models as you would on Solaris.

Dan said...

As Plainfielders and residents of the communities that are serviced by Muhlenberg, I think we understand this quite well.

What happens when the Washington Post writes about our community is that suddenly the whole world -- literally -- is parsing every written word to form an idea of the story and its import, including the town which it describes.

Shorthand descriptions like the reporter used, which he wrote to me were based on comments by local people he interviewed but did not further check out, affect the perceptions people have about our community quite apart from the context of the struggle to save Muhlenberg. This kind of casual remark leads to a form of mental redlining that influences how everyone from editors and reporters who cover Plainfield news to businesses and families thinking of locating in Plainfield view and react to the community.

We owe it to ourselves to keep that in mind when we are given an opportunity to put Plainfield's case before a larger audience, as in when interviewed by major national media.