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How Will A Deal To Buy A Non-Profit Medical Center Affect Detroit?

Vanguard Health Systems, a major for-profit company out of Tennessee, appears set to make a staggering $1.5-billion outlay to buy and upgrade the Detroit Medical Center, a non-profit hospital complex that has earned a serious reputation for caring for some of the city's poorest residents, among others.

Wayne County Executive Robert Ficano said the deal is bigger than the investments in Ford Field, Comerica Park and Campus Martius combined. Civic booster and DMC board member Roger Penske called the deal a home run.
While it's good to know that Vanguard Health Systems recognizes the value and importance of the DMC, I'm anxious about what happens when a for-profit takes over a not-for-profit that plays as critical a role in the city as the Detroit Medical Center. Will providing care to poor and working-class patients continue to be a priority now that turning a profit is so essential? Vanguard has committed to keeping all eight of the DMC's hospitals open for 10 years after the deal, but what happens after that if the coffers aren't bulging? How will Vanguard's money-making goals impact DMC's ongoing work in training medical professionals in and around Detroit?
So far, of course, everyone is saying all the right things about the potential of this deal, about the jobs it could generate, about the patients and professionals it could draw into the city. Sounds great, really. But, as welcome as the cash infusion could be, the DMC seemed to be getting the job done even before the proposed effort to turn it into a cash cow.
He said the DMC has made money for six years, but banks and investors have balked at lending the nonprofit money for new projects, given the DMC's $639 million in bond and pension debt, hefty losses caring for the poor as Michigan's largest safety net provider and the city's declining population.
Yeah, caring for poor people has never been a big-money enterprise, I get that. (Will impending health-care reform change any of this?) Still, it's important work that Detroit cannot afford to see evaporate under the intense glare of some penny-pinching CFO.
Blue Cross Blue Shield of Michigan CEO Dan Loepp said he hoped the deal would not compromise care to poor people. "We encourage careful consideration and review of this transaction," he said.
I like the idea of new resources and new people being drawn in to the DMC. But I also can't help but worry about whom might ultimately be driven off.
What are your thoughts on this new, potentially history-making investment in Detroit and the Detroit Medical Center? Will the investment prove fruitful for the DMC and the city in the long haul? Will Vanguard turn a profit without adversely affecting the DMC's ability to provide affordable, quality care to working-class Detroiters? Do you like this proposed deal or not?
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  • 1

    Darryl,

    I worked on the Detroit Medical Center as a young Architect Intern the summer that the Deal came together.

    It was the Brainchild of Charlie Blessing who I consider to have been the only legitimate Planner that the City has ever had.

    He brought in Jerry Crane to run the project and they pulled together all the key people in all the adjacent Hospitals and got them to see the huge advantage of going in together.

    I remember the day that the Agreement was signed, that Jerry's wife had a baby and his Certificate of Architectural Registration arrived. Big Day.

    Jerry was a Fullbirght Fellow and from England. Charlie took a liking to him and got him under his wing.

    I built models at the time... a time honored thing in Architecture... giving you a God's eye view of things.

    By all accounts the Detroit Medical center has simply been getting better and better all the time and it's inclusion into the Wayne Medical School has been a great move.

    So your concern is a good one Darryl, a very important one as we enter the era of rapidly decreasing utility of the common man. Robots are taking over so things have to be rethought. TC Mits is in for a rough one.

    When you look around SE Michigan you can see lots of relatively new hospitals that have been abandoned.
    In a way the Hospitals have been leading the Abandonment charge.

    But who was watching over this mad dash movement of putting up new Hospitals all over the place?

    No one, Just like the City of Detroit, Planning ceased to exist.

    The Republican philosophy took hold... people calling themselves planners were disparaged by the Republican Politicos.

    Communists! Comunists, they would scream!.. In tones of sarchastic derision!

    So being a planner was someting to hide.

    And so look at what has happened...

    It's a mess, a REAL, COSTLY mess!

    The old Protestant epithets against irrationality.. Profligate!, Debauched!, Dissolute, Wasteful! really do obtain.

    How is it that such plunderous, stupid moves could be made???

    The only real answer is to do what Carol Goss did... bring in some Demographers, one branch of Planning, and apply some real rationality before the Republicans start screaming and tunrning rationality into a dirty word again. DDD really will be a saving grace.

    So we get to hear this morning that the Republicans in Texas have eliminated Thomas Jefferson's name from all School Texts. Hmmm they must dislike miscegenation or something... nutcases all.

    Bill

  • 3

    Both Vanguard and the city, I imagine, are counting on the president's health insurance reform passing today. It is very clear that the passage of the bill will relieve urban hospitals of their current burden as the funders-of-last-resort for the uninsured--a group that tends to be overrepresented among poorer, minority city populations. All this was pointed out last week in Detroit at New Detroit's summit on media and community called, "Taking Charge of Our Story." (See http://ourdetroitstory.com ) The man pointing out this economic reality was Professor Thomas Sugrue, historian and urban expert at the University of Pennsylvania and author of "Origins of the Urban Crisis," the definitive history of the decline of Detroit and other Rust Belt cities from the 1920s to the 1960s. Video of Sugrue's remarks can be found on freep.com.

  • 4

    Thanks Darryl,

    I had several roommates at the University of Michigan who were Anthro majors.

    Michigan was very proud of it's Anthro Department and from what I could gather they saw themselves in the forefront.

    And one of their precepts was that Technology is the Fundamental Determinant of Culture.

    Being an Architectural Student that seemed right to me.

    They seemed to have a broad definition of Technology which was about man's means of deriving sustinance and sustaining the lifestyle.

    Surely that is true of Farming where for centuries the % of people devoted to that life was in the high 60% range. And the most shocking statistic that I ever saw was that farming as an occupation now accounts for less than 2% of the population.

    That is beyond dramatic. And it happened because of guys named Cyrus and John Deere and Henry and such. They invented these labor saving devices that totally altered the lifestyle. Something similar could be said about housewifery. I remember when Monday was washday, and the clothes were placed out on the line and Tuesday when the Ironing was done. So Whirlpool and Frigidare and Ironrite stepped in and whammo! things changed and drudgery time was greatly shortened.

    There was an Architectural historian named Sigfried Guideon and he wrote "Space, Time and Architecture" and another interesting book named "Mechanization Takes Command" which was about Mass Production.

    Virtually everything is mass produced and in heavy manufacturing, aided by the advances in the computer software, the Robots are doing an awful lot of work.

    Computerization seems to be taking on or instigating Mechanization, Phase II where these very smart robots are not only relieving us of the drudgery, they are relieving us of our jobs.

    Which was it, "Brave New World" or the ominous "1984" talked about some seemingly really absurd things like spraying Verbena in the air and mass copulations and such.

    Might have had selected the wrong plant... ;D.

    But this really calls for some pretty hard thinking.

    One of my friends bought both Ford and GM stock the day that it hit bottom. And the market seems to be in a great recovery but last month Ford layed off another 400 or so.

    So what happens with the people?

    When I see the young men walking around with their pants haging below their buttox revealing some fancy boxers, and hanging on the front to keep them from entirely falling, of course I laugh to myself.

    But it does strike me that they are wearing "hapless pants". Everything seems so hapless, no future at all.
    No point in pulling your pants up if you aren't going to work.

    When some neighbors asked me to watch 'Roger and Me' last summer I was stunned and of course disgusted. I was at GMI in Flint in the heyday. I couldn't watch it when it first came out. What we saw is contracting down into Detroit now.

    My wife and I raised a niece and a nephew for 3 years and they seemed to be coming along fine. Except that family members were teasing Nathaniel about sounding like me so, my Sister in Law told her Daughters to "take them back or they won't be yours".

    Of course we cried and wandered about the empty house and watched a kind of disintegration with the schooling. It was very painful. Still Is.

    There finally was the realization that it was a mistake but it was already too late.

    So I think that it is wrong to keep giving money to those laid off without making them do something for the money. There is so much to be done and I don't get that these people cannot be allowed to do something productive. It's simply stupid. Pay for work well done instills pride.

    Money is really people time earned through work normally. Yes money does have it's own rules and can work upon itself if you know what you are doing.

    Everyone does need the medium of exchange but it must be handed out intelligently.

    When The King Band went to China I was astonished by how very wonderful the roads were constructed (not one crack) and that the Highway Signs were both in Chinese Characters and immediately adjacent there were the words in English. In reality we could drive all over China and know exactly where we were.

    And the thing that was most astonishing was the way the roads were landscaped and cared for.
    The median was very narrow with the same corrugated, galvanized guard rails that we have and in the center were plantings of colorful shrubs that alternated.. lots of Rose of Sharon and you could see women come out from the farmland and get down and hand clip the grass and trim the shrubs, and on the outside of the highwas were banks of Staghorn Sumac and immediately behind these were closely banked in Willow trees and just behind them were rows of Locust trees. It was astounding because we saw millions and millions of trees acting like an oriental screeen. I commented to the tour guied that I'll bet that the sumac looks unbelievably beautiful in the fall and he raised his eyebrows and said Yes!

    FDR knew what to do with laid off people. I don't get that we don't get that now! Obama has an Architect on the Cabinet. Probably the closest that our Profession has gotten to the President since Jefferson. What the heck is the matter with him? Did Harvard ruin him or undereducate him? He should have developed a long list of things needed caring for by now.

    Tell me all you want about Private Enterprise that you wish but Private Enterprise is opting for Robots. Ever call one of those companies? It takes a lot of hard work and some cleverness at times to talk with a real human being.

    If Obama can't see to it soon, there will be huge protests in Washington, not just Roger Moore doing his rather but pointed fun antics.

    So Technology IS really taking over and what then are we going to do with the human beings?

    Something that the Republicans really don't wish to think about.

    The Republican Philosophy really has done a horrible about face since Lincoln's time and it is a mean, vicious, failed philosophy now.

    I have a friend who is Michigan's finest Tax Accountant and she was telling me that it is really horrible "out there"... unbelievably bad. The D word is the appropriate word.. Not Detroit, but real Depression.

    So while the Stock Market is rising and Ford is doing well, the people aren't and she says that it cuts though everything, Race, Income bracket, Religion, it's a horror story.

    Did Susan Tompor tell people what was happening and what to do? Not really.

    In college I almost got flunked in Planning for reading Jane Jacobs", "Life and Death in the Great American Cities." The book came out too late to save our Chinatown... yes we did have a Chinatown but it was picked up by Dianne Edgecomb and Mary Anne and they saved Greektown.

    The assinine Demolition advocates almost got their way save for some very smart people.

    Is that possible today? Doesn't look like it does it?

    I bought Jane Jacobs' last book when it came out in 2004 and couldn't read it: "Dark Age Ahead". Picked it up last night and had to read the last chapter at 4:00 this morning because I could not bear the title and what it meant.

    Seems appropriate now, very appropriate.

    It seems to me that we have to move into something like a permanent government task generator and employment agency and it had better be generated with integrity.

    Bill

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