Long Story Short: Sicklists
illustration by JP Thimot
ECMC takes a hit
You may already know that public and privately-owned hospitals cannot turn away patients in need of emergency care, regardless of their ability to pay. Public hospitals cannot refuse any care—emergency or not—thanks to the Emergency Medical and Treatment Labor Act (EMTLA). This means that a public hospital is the best option for the uninsured poor. In Buffalo, that’s Erie County Medical Center (ECMC). Thanks to Congress, things just got tougher for ECMC.
Guaranteed hospital care for the indigent is a moral imperative, but it’s economically problematic. First, people seeking costly emergency care might never have needed it, if they had received regular healthcare through a primary physician. Second, someone still has to pay for the care the poor receive, namely taxpayers and the insured, through federal aid to hospitals, and higher insurance premiums. The Affordable Care Act was supposed to largely eradicate these problems, and while it helped, it fell short of its goals. Why that happened is a subject for another post.
On October 1, Congress cut federal Medicaid expenditures by failing to reinstate the Disproportionate Share Hospital fund (DSH), which reimburses hospitals for service to the indigent and uninsured. To some, the idea sounds pretty good. The funds are part of the Affordable Care Act, so Republicans support the idea. But here’s the problem: Medicaid reimbursement to ECMC will be slashed from $44 million to $15 million dollars. This will have "a significantly negative impact on our ability to provide quality healthcare to the patients we serve," according to ECMC spokesman Peter Cutler. Based on previous years costs, this will leave the hospital with a significant deficit. And who will pick up the tab for this loss? One way or another, it will be taxpayers.
Almost thirty-one percent of Erie County residents receive Medicaid benefits. There is a widespread belief among the white population that these recipients are mostly black and Hispanic. That’s not the case. Whites in Erie County comprise the majority of people on public assistance. In fact, Caucasians collect more benefits than all other races combined.
No matter how you slice it, the public pays for everyone’s healthcare. We pay through higher hospital costs, higher insurance costs, or through taxes. Often that’s money spent on costly hospital care for the poor, rather than regular primary care through affordable insurance. Of course, the United States is the only developed country on earth that has such a system. If the Disproportionate Share Hospital funds are not restored by Congress, the quality of service at ECMC will go down, or New York taxpayers will have to make up the loss. Probably some of both.
The Central Terminal at risk
Buffalo’s neglected Central Terminal train station has made the top-twenty-five cultural treasures urgently needing attention, according to the Manhattan-based World Monuments Fund (WMF). The organization’s watch list comprises historically important structures from around the world that are threatened by “warfare, natural disaster, climate change, or urbanization.” The Central Terminal falls into none of these categories. For us it’s de-urbanization, negligence, and shortsightedness.
The magnificent Art Deco station, with its seventeen-story clock tower, has been an East Side landmark since opening in 1929. It was shuttered a mere fifty years later, a victim of the then-new interstate highway system and the growing popularity of air travel. The building was abandoned and left to deteriorate. Much of its interior décor was criminally stripped before the nonprofit Central Terminal Restoration Corporation took control. For a good idea of its former grandeur, see the movie Marshal, which brings the terminal back to its bygone splendor through Hollywood magic.
The terminal was recently passed over for development as a new train station in favor of a downtown site, which surprised a lot of people because, you know, it’s already a train station. The WMF is calling “for investment in the redevelopment of the Buffalo Central Terminal to give new life to this architectural landmark,” which is what many local preservationists have been saying for years. It’s great to have an international watchdog group add their voice to the chorus, but will it make a difference?
The Central Terminal is in good company among endangered buildings. Check out the full list:
1. Disaster Sites of the Caribbean, the Gulf, and Mexico
2. Government House, St. John’s, Antigua and Barbuda
3. Sirius Building, Millers Point, Sydney, Australia
4. Ramal Talca-Constitución, Talca Province, Chile
5. Grand Theater, Prince Kung’s Mansion, Beijing, China
6. Eliyahu Hanavi Synagogue, Alexandria, Egypt
7. Takiyyat of al-Gulshani, Cairo, Egypt
8. Potager du Roi, Versailles, France
9. Post-Independence Architecture of Delhi, India
10. Al-Hadba’ Minaret, Mosul, Iraq
11. Lifta, Jerusalem, Israel
12. Amatrice, Italy
13. Kagawa Prefectural Gymnasium, Takamatsu, Kagawa Prefecture, Japan
14. Jewish Quarter of Essaouira, Morocco
15. Sukur Cultural Landscape, Madagali Local Government Area, Nigeria
16. Historic Karachi, Pakistan
17. Cerro de Oro, Cañete Valley, Peru
18. Tebaida Leonesa, El Bierzo, León, Spain
19. Souk of Aleppo, Aleppo, Syria
20. Chao Phraya River, Bangkok, Thailand
21. Blackpool Piers, Blackpool, United Kingdom
22. Buffalo Central Terminal, Buffalo, New York, United States
23. Alabama Civil Rights Sites, Alabama, United States
24. Old City of Ta’izz, Ta’izz, Yemen
25. Matobo Hills Cultural Landscape, Matobo, Matabeleland South, Zimbabwe
Will this change things, or just add to our embarrassment over the lack of action? Jim Hycner, chairman of the Central Terminal Restoration Corporation is optimistic about the building’s future, and he thinks the watch list “honor” will help. There have been several reuse proposals in recent years, and of course, it could have been a train station again. And so Buffalo makes another top twenty-five list.
A meeting of like minds
The first Congressman to support Donald Trump in his bid for President met with the man who is now a heartbeat away from the presidency. The heady scent of money was in the air.
Vice President Mike Pence popped into town briefly Tuesday for some glad-handing and fundraising in advance of the 2018 elections. He is also on a US tour to convince taxpayers that President Trump’s tax reform plan would benefit the average citizen. Fifty-two percent of Americans aren’t buying that, while thirty-four percent support the plan (according to a recent poll).
It’s not really surprising, since bipartisan experts say the plan primarily benefits the wealthy, and hurts highly taxed states like New York. I’m surprised Democrats have not labeled this a job-killing plan. Because if it actually accomplished the President’s goal of simplifying the IRS code so anyone can easily do their own taxes, it would put 1.2 million United States’ tax preparers out of work. (In comparison, the entire coal mining industry employs just 76,572 people.)
Part of the fundraiser took place at Salvatore's Italian Gardens restaurant, which, to DC Patricians, must seem fittingly like the Roman Forum. Congressman Chris Collins was there to greet Pence. Those in attendance describe the event as a mutual love-fest between Pence and Collins, each of whom effusively praised the other. The $400,000 dollars raised will go into Collins’ campaign coffers, which have recently taken a hit. Collins has been spending heavily on lawyers since The Office of Congressional Ethics and the House Ethics Committee has been investigating him for possible violations of House rules and federal laws.
One thing you can say for both Pence and Collins, they are very loyal to the President. Each has publicly supported Trump’s every statement, proposal, and tweet, no matter how outlandish, and regardless of what they may think privately. Pence of course, would like to be President himself someday, so backing the boss is his only option. At the moment though, he serves as the best argument against Trump’s impeachment. Collins? There’s no explaining that.
Bruce Adams is a longtime contributor to Buffalo Spree.
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