On June 26, 2019, Philadelphia’s privately owned Hahnemann University Hospital declared that all medical care would cease within 90 days. The property is to be sold to a real estate developer for likely conversion into luxury condominiums. Founded in 1848, Hahnemann treated 40,000 patients a year, employed 3,000 healthcare workers, and was a Level 1 trauma center. The closure was announced with no warning and with no regard for the thousands of human lives that depend on this hospital. It was considered a “safety net” hospital, providing healthcare to those who would otherwise not receive it. Its patients were overwhelmingly drawn from the most impoverished layers of the working class, a vulnerable population with few healthcare options to begin with.
Hahnemann’s capitalist owners proposed to parcel its patients out to other area hospitals, all of which are already overburdened and understaffed. The hospital was a vital part of the emergency health system in the city, and its closure has already led to dire consequences for countless people. Samir Sonti, spokesperson for the Pennsylvania Association of Staff Nurses and Allied Professionals (PASNAP), which represented Hahnemann’s nurses, explained: “When seconds matter, for a gunshot victim or a heart attack patient or anyone else, longer wait times, more crammed ERs with fewer resources to deal with more patients is a matter of life and death.”
The rich, who have the money and resources to go to whichever hospital they wish, are not affected by the closure. It is the working class of Philadelphia that has suffered yet another blow, victims of the generalized crisis of healthcare in this country. Medical debt is now the leading cause of personal bankruptcy in the US. Medical care is so obscenely expensive that many workers ignore serious health issues to avoid life-destroying bills. Americans spent $3.65 trillion on healthcare in 2018. Private hospitals, insurance companies, and pharmaceutical giants rake in massive profits by holding essential medical services hostage.
There has been a growing mood of discontent about this crisis, reflected in the call for “Medicare for All.” The increasing popularity of this demand is a significant and positive development, but socialists must also recognize the limitations of this specific proposal. The abolition of private insurance is not enough. It must be combined with the nationalization under workers’ control of the entire healthcare industry.
This was painfully clear in the case of Hahnemann. The end of private insurance would certainly be a step forward. However, as long as hospitals remain in private hands, nothing can stop the capitalists from selling them off to property tycoons in the pursuit of higher profits. The hospital sat in the heart of Center City Philadelphia, a few blocks from City Hall. The value of the land was estimated to be far higher than the value of the hospital itself. Two-thirds of the hospital’s patients were on government healthcare, many were impoverished, and many were immigrants. All of this meant that there was less profit to be made by keeping the hospital open. The hospital was bought in 2018 by Joel Freedman and his private equity company Paladin Healthcare. It is a common practice for private equity firms to buy up businesses and then dissolve them to sell the real estate. In all likelihood, Paladin Healthcare wanted the hospital solely for the land it sat on.
The two major unions that represented Hahnemann’s workers, PASNAP and National Union of Hospital and Health Care Employees (NUHHCE), spoke out against the closure. But they offered no militant resistance, despite the thousands of workers facing job losses. This is not the fault of the union workers. Instead, it highlights the organic conservatism of the labor leaders. The NUHHCE leadership says it has a plan to work with the city to rezone the property so that it can only be used for healthcare. But this is a half-baked, bureaucratic solution that is unlikely to succeed. And even if it did, when profits dictate, the city could always rezone again. This is typical of the stagnant trade union leaders, who are more comfortable cutting ineffective deals with capitalist politicians than leading their members in militant struggles.
The closure could still be stopped in its tracks if the labor leaders mobilized Hahnemann’s workers and the broader working class, linking the fight to keep the hospital open with the struggle for universal healthcare and worker’s rights. They could demand that the city of Philadelphia or the Commonwealth of Pennsylvania use the power of eminent domain to place the hospital under public ownership and control. Unfortunately, this is not likely to happen. However, there will be similar closures and struggles in the future, and we must draw the necessary lessons from this capitalist-made disaster.
The crisis of capitalism affects every aspect of our lives. Socialists believe that human health and well being should not be determined by chaotic market forces and the whims of capitalists looking for an easy buck. Even with Medicare for All, the crisis will continue as long as any part of the healthcare system remains under the control of big business and private equity firms. Healthcare must be fully socialized from top to bottom and run in the public interest under democratic worker’s control. Every hospital, clinic, dental office, research facility, medical equipment factory, and pharmaceutical plant should be integrated into a unified healthcare system in which every part works together to guarantee high standards of public health for all.