Robert Whitcomb: Care New England and Partners; Fragile Freedom; Urban Shadows

Robert Whitcomb, Columnist

Robert Whitcomb: Care New England and Partners; Fragile Freedom; Urban Shadows

Robert Whitcomb
CNE-Partners; Fragile Freedom; Urban Shadows

 

Care New England (CNE) wants Partners HealthCare to acquire CNE, Rhode Island’s second biggest health system, and Partners, Massachusetts’s biggest system, seems eager to do so. (How much, if at all, did Partners first negotiate with Lifespan, Rhode Island’s biggest system, to do the same thing?) Care New England has been reporting big operating losses and Partners wants to keep growing. Thus this past week’s announcement that there’s a tentative agreement for Partners to take over CNE.

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Care New England includes Kent Hospital; Women & Infants Hospital; the VNA of Care New England; Butler Hospital, and The Providence Center (for mental and  behavioral health). It also includes Memorial Hospital, which CNE plans to sell to Prime Healthcare Foundation. It’s all officially “nonprofit’’. As they say, the main difference between a “nonprofit’ and a “for-profit’’ hospital is that the former doesn’t pay taxes (but can pay senior execs gigantic pay packages….)

Massachusetts regulators don’t want to let Partners (which owns, among other prestigious institutions, Massachusetts General and Brigham and Women’s hospitals) to get even more pricing power in Greater Boston than it has long had. So, Partners officials have decided to expand into the relatively close, and densely populated, Rhode Island area, as it already has into southern New Hampshire. Lots of customers.

The usually very interesting Jon Chesto, writing in The Boston Globe, noted:

“Getting bigger provides economies of scale, helpful for purchasing power and contract negotiations. There’s also the ability to swallow a hit in one corner of the empire, like that huge loss at Neighborhood Health Plan, Partners’ insurance business. And spreading risk among a bigger patient base becomes more crucial with  the rising number of plans that essentially reimburse health-care groups via a set, per-patient amount.’’

 
Here are some things that might happen if the acquisition is consummated:


·      Prices for treatment in CNE/Partners hospitals would rise; Partners is famous for high prices.
·      Given that Partners and the giant and hyper-prestigious Harvard Medical School are so closely tied, a takeover of CNE might well undermine the small Alpert Medical School at Brown University, with its teaching-hospital arrangements in Rhode Island. Patients’ snobbery about the real and imagined glories of  Boston and Harvard-linked hospitals would lead many more Rhode Islanders to try to use Partners’ Boston area hospitals, except for obstetric services, which tend to be very local.

·      Lifespan might very soon announce that it, too, will be bought by a bigger system, such as  Boston’s Caregroup Health System, which  also has Harvard connections and includes prestigious Beth Israel-Deaconess Medical Center and, probably soon, Lahey Hospital and Medical Center.

·      There would be big layoffs in the administrative staffs of what is now Care New England as management and money are concentrated in Boston.
·      The senior executives of Care New England would get big golden parachutes.
·      The takeover  would be one more sign that Providence is becoming an outlier of Boston. Given the wealth and importance of Greater Boston, that’s not entirely a bad thing.

 

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Nice attack - will terrorism push LePen over the top
How soon people forget the lessons of history, if they ever learned them in the first place.

“My grandparents are afraid of {Marine} Le Pen {the authoritarian right-wing candidate in the French presidential election},’’ Manon Coudray, 23, told The Washington Post. “They say she’s extreme, and that if she’s elected, we might have a war. I say maybe that’s a good thing.’’ (So much for the blood-soaked 20th Century in Europe.)


The article, headlined “A youth revolt in France boosts the far right,’’ is yet another chilling sign of the decline in support for democracy around the world as war is waged on it by corrupt and ruthless dictators, most notably Vladimir Putin, an ally of Ms. Le Pen. The election of a plutocratic, (would-be) autocratic and corrupt demagogue with little to no interest in supporting democracy abroad as president of the United States has accelerated the trend.


From Central and Eastern Europe to the Mideast to Latin America, freedom and democracy are in retreat, as observed by Freedom House and other monitors. And now it may even be threatened in its heartland – Western Europe and the United States, where civic virtue has long been in decay, in large part because of growing greed-based political corruption and the diversions and perversions of mass media, especially cable television and social media. Once you lose freedom and democracy it’s very, very hard to get them back.


The hopes spawned by the end of the Cold War that democracy would triumph around the world seem far, far away. And perhaps most people don’t really care.


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Now that most of us have filed our taxes, it might be good to shoot at a couple of clichés that right wingers particularly like. One is that people too poor to pay income taxes are complete freeloaders. In fact, these people, if they have jobs – and most do -- pay a much higher percentage of their income for Social Security and Medicare taxes (usually called collectively “payroll taxes’’) than do richer people. Another cliché is that illegal aliens don’t pay taxes. In fact, many do pay payroll taxes but they aren’t eligible to benefit from these programs these taxes fund. (No, I do not favor illegal immigration.)
 


Herb Weiss' smart column
And now, as Herb Weiss (an elderly-affairs expert) wrote in GoLocal a few days ago, we have a move underway by some Trump advisers and Republican lobbyists to eliminate the aforementioned payroll taxes used to fund Social Security and Medicare Part A. (Medicaid is financed from general budget funds.) The aim is to throw more people on the tender mercies of Wall Street to finance their retirements.


Associated Press writers Josh Boak and Stephen Ohlemacher reported: “This approach would give a worker earning $60,000 a year an additional $3,720 in take-home pay, a possible win that lawmakers could highlight back in their districts even though it would involve changing the funding mechanism for Social Security, according to a lobbyist, who asked for anonymity to discuss the proposal without disrupting early negotiations.’’
Well, yes, that might be an initially popular way to destroy Social Security. The George W. Bush administration tried to give Wall Street  lots of Social Security cash. But the public, understandably doubtful that people in the financial-services industry would put customers’ interests first, pushed back. Then came the Great Crash of 2008….


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Ah, the ambiguous joys of corporate welfare. Back a decade or  so ago, Blue Cross Blue Shield of Rhode Island promised to fill up a gleaming new headquarters building in downtown Providence with employees in return for a 20-year tax- stabilization deal. The building is designed to house 1,100 employees, which, it was hoped at the time the building went up, would add energy and money to the city. But that was then. Like just about all corporate promises, things can change without warning.

 

Now the health insurer has decided to move more than 125 jobs out of its Taj Mahal. What is particularly interesting is that that would leave only about 600 employees there, reports GoLocalProv. That suggests that a quiet exodus has been underway for some time. It’s hard to think of any such corporate-welfare deals that have not been broken. But then,  corporate chief executives come and go, as do the politicians who do the deals with them. Blame the guys who made the deals back then.

 

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Boston's growth
I like skyscrapers for the exuberance (or confidence or arrogance?) they express about a city. I wish we had more in Providence. So the Manhattanization of much of downtown Boston  per se doesn’t bother me. Seeing those towers from Boston Harbor and the shores of the Charles River can be exhilarating. But they don't work everywhere.

 

Consider that two glorious old churches – Trinity Church, on Copley Square and nearby Old South Church --  would all too often be put into shadows by a pair of towers (376 and 298 feet tall) planned for atop the soon-to-be-expanded Back Bay train and subway station.

 

I realize that the taller the buildings the more money the developer can make. But extreme building height can also undermine the very qualities that make a city attractive. Consider that the famous stained glass windows of the aforementioned churches would sometimes be put into the dark on sunny days by the shadow.

 

Then there’s the 750-foot tower that Millennium Partners wants to build downtown on Winthrop Square (where I worked one summer) — which will put some of the Boston Common in the shade. 

 

Boston, like all old cities, needs to find a better balance between dramatic height and human scale and between piles of new money and aesthetics. In Houston it doesn’t matter. I suspect that Bostonians would prefer that their old city continue to look more like London than Houston.

 

Shadows cast by skyscrapers are not bad in themselves. It depends on what’s being put in the shadows.

 

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The estimable Mike Tamburro, vice chairman of the Pawtucket Red Sox, told GoLocal that the team would lock in existing ticket prices if they get a new stadium. The PawSox “Family Ticket Plan’’ would keep children’s  tickets at $6, those for elderly people also at $6 and adult general admission at $9.

 

PawSox Ticket Price
The PawSox organization fears that many fans might think that ticket prices would have to surge to help pay for a new facility. Of course, this begs the question of what sort of private-public deal to put up a new stadium would look like to skeptical or outright hostile taxpayers.

 

On at least one construction goal the PawSox is right, if I interpret their remarks accurately. They want to put the stadium near the Blackstone River for maximum visibility.  Such a highly visible location would put pressure on the PawSox organization to make a new stadium attractive. Now if only there were  enough money (presumably there wouldn’t be) to put a roof on it so that it wouldn't be wasted space for five months a year.

 

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River herring are becoming scarcer along the New England coast for a variety of possible reasons, be they changing food chains, pollution, climate change – or commercial fishermen catching too many of these creatures for use by health- supplement companies promoting the benefits of omega 3.

 

Herring are an important food for many other fish. Their declining numbers ought to spark stepped-up conservation efforts by state and federal regulators. The states have a big role because while these fish mostly live in the sea, they return to rivers to spawn.

 

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The Chinese have long been presented as some sort of brake on the homicidal regime of the  Communist Kim dynasty in North Korea. But in fact the Communist Party regime in Beijing is a stout ally of the Kims, very much including the current thug-in-chief Kim Jong Un.  Beijing certainly does not want a unified, prosperous democratic Korea on their border as a counter-example to the Chinese dictatorship.

 

A recent example of this alliance came last year after the North Koreans launched a satellite. The South Koreans found sections of the booster rocket and discovered that many key parts came from firms based in China. Indeed, China has long supplied, and continues to supply, North Korea with high technology and hardware with which to threaten South Korea, Japan and the United States.

 

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I confess that I’ll miss a bit of Bill O’Reilly’s over-the-top arrogance, smugness, old-fashioned New York City area  accent and some of the news tidbits that his hard-working staff came up with him to bloviate on. (I gather he didn’t sexually harass all of them.) He always reminded me of a New York City tabloid newspaper newsman from about 1955.

 

He’s yet another example of a right-wing “family values’’ blowhard/hypocrite whose private life is  cesspool. He helped degrade American civic life, but his amen-chorus followers were willing to be accomplices.

 

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An old friend of mine told me that he avoids many social encounters these days not because of not liking how others act, but of disliking how he acts amidst the social anxiety accompanying many meetings.

 

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People complained this past week of the cold damp weather, but that weather means  that we’ll have an extended lush spring.

 

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RIPTA's turning system
Those RIPTA buses with disembodied speakers that warn pedestrians and other drivers that the vehicles are about to turn have an eerie, ghostly effect but are a good addition to city safety.

 

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It’s too bad that Massachusetts officials have chickened out for now on a plan to create a colony of endangered timber rattlesnakes on uninhabited (by people)_ Mt.  Zion Island in  the Quabbin Reservoir. These creatures were once an important part of the ecosystem of the area, in part,  believe it or not, as  food for eagles and other creatures.

 

Their presence on the island would have also  helped protect this little bit of wilderness by scaring off the worst and messiest predators in the area – people.


The 50 Greatest Living Rhode Islanders

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