Council’s response to critics: misdirection & hand-waving

The City of Lakewood web site now includes a FAQ about the proposed new “Master Agreement” with Cleveland Clinic. Naturally—given the disastrous proposal it defends—it is another muddle of evasions and internal contradictions.

The highlight, as such, was posted Friday at the Observation Deck forum:

Q: “What makes you trust the Clinic?”
A: “…Trust doesn’t enter in this. It’s about the numbers and the assurances in the legally binding agreement…”

Q: “Why can’t you detail all the services that will be available at the new health center?”
A: “The city doesn’t want to be in the business of micromanaging any health care providers’ services…”

So, it isn’t about trust, it’s about the “assurances in the legally binding agreement”. But there aren’t any assurances because we don’t “want to be in the business of micromanaging”.

The assertion that Lakewood will be guaranteed anything by a “legally binding agreement” with Cleveland Clinic is daft. Cleveland Clinic cheats. By contrast, Mayor Summers’s administration has already refused to support a lawsuit against the Clinic’s sabotage of the current agreement, and Summers himself said this fall that “I don’t believe in suing and auditing your way to success.”

Council, apparently, does not believe in examining the Cleveland Clinic decanting plan or administrative charges that have drained the life out of Lakewood Hospital. On Monday, Councilman David Anderson confessed that he still does not have “clarity” about the mysterious expenses that ballooned nearly 900% in just a dozen years. The FAQ addresses the decanting plan with a mixture of bluster and sleight-of-hand. First declaring that “we will not assess blame to any particular party” and that “we will not answer questions for the Cleveland Clinic,” council then goes on to do just that: “We do not buy into the theatrical viewpoint or allegations that the Cleveland Clinic kept secrets from our tenant, Lakewood Hospital Association.”

This is pure misdirection. No one is concerned by whether or not Cleveland Clinic kept secrets from LHA, as LHA has long been indistinguishable from Cleveland Clinic. (Examine any of the ads and mailings from LHA in recent months, all of which were graphically the obvious product of Clinic design guidelines.) Naturally “The Lakewood Hospital Association… has found no violation in its agreement with the Clinic.” The Clinic’s interpretation is by definition the LHA’s interpretation. Council’s proposal that Lakewood has absolutely no enforceable rights is, nonetheless, being tested in court, despite furious efforts by Clinic lawyers to conceal details in which council is apparently uninterested.

Meanwhile, even if council’s interpretation of the 1996 agreement were granted for argument’s sake, this is all the more reason to avoid yoking Lakewood health care even more tightly to Cleveland Clinic’s profit motive. Particularly when alternatives are not only available, but actively seeking us out. Council’s FAQ does not even pretend to offer a reason for turning away Surgical Development Partners.

The suggestion that “we must act because LHA is running out of money” fails on multiple grounds: 1) even by its own accounting, LHA’s losses are not nearly urgent enough to justify council rushing through the liquidation of Lakewood Hospital in 15 days; 2) the LHA losses are, as noted, substantially attributable to parasitic fees imposed without explanation by the very same Cleveland Clinic that council proposes as a remedy for Lakewood Hospital; and 3) trying to solve long-term problems with one bad agreement with Cleveland Clinic by entering an even worse agreement with Cleveland Clinic is simply beyond reason.

Council has convinced itself that Lakewood Hospital’s losses are the product of “market forces that are changing health care delivery in Every City USA.” This ignores the decanting plan, this ignores unexplained administrative expenses, and this ignores the conclusion of council’s own report by Huron Consulting: “the Lakewood community has a sufficient population base to support an inpatient hospital with a modest number of beds.” (p. 71)

Nearly four months after the city posted Huron’s report as “Huron-Consulting-Final-report.pdf” council is, now, trying to invalidate this conclusion on the basis of spoken comments delivered at an August 17 Committee of the Whole meeting. This attempt is less than compelling for a variety of reasons:

  • Like council itself, the Huron report appears not to have accounted for either the decanting plan or Cleveland Clinic’s excessive administrative expenses in estimating Lakewood Hospital’s viability, on which basis Huron’s range of scenarios should be regarded as worst-case, only.
  • As observed by Save Lakewood Hospital upon its initial release, the Huron report “is, judged as a whole, painstakingly noncommittal.” If any conclusions whatsoever are to be made based on the report, it seems reasonable to limit these to the report, itself. If “The Huron report” is, instead, to encompass every statement made by an agency that explicitly wishes to avoid committing itself any more than necessary, then its whole utility becomes questionable.
  • In this circumstance, it would then seem wiser for council to stick to “the business of dealing with reality.” While independent studies are well worth consideration, in reality hospitals are viable and thriving in towns and even counties with populations less than half that of Lakewood. This reality complicates any suggestion that “the city could ONLY support a hospital if that hospital could capture 100 percent of the market.” As does the reality that a hospital operator with an extensive track record of success turning around hospitals in trouble wants to get involved with Lakewood.

It seems likely that the citizens of Lakewood—who own Lakewood Hospital and employ city council—would prefer that council demonstrate more interest in the reality of an alternative to the disastrous maladministration of Cleveland Clinic. As the money which council is allegedly so concerned about is, also, ultimately the citizens’ money, council should concern itself less with justifying its own assumptions and elective ignorance, and concern itself more with engaging the reality of alternatives.