Rousing 2011 #OWS speech reminds us of role of St. Vincent's Hospital on 9/11

Read your lipservice on 9/11, but we have no full-service hospital below 14th Street since St. Vincent's closed. #Rudin @Partnership4NYC

— Louis Flores (@maslowsneeds) September 11, 2014

1199's Kevin Finnegan to NYC community hospital patients : Kiss Off !

Cuomo “first governor we haven’t gotten into a fight with in a long time,” said Kevin Finnegan. http://t.co/XsqYPbIMaw @1199SEIU #saveLICH

— Louis Flores (@maslowsneeds) September 2, 2014

The corrupt political mercenaries running unions lead rank and file astray. 1199's Finnegan is Cuomo's lackey. @HammerDaily

— Louis Flores (@maslowsneeds) September 2, 2014

Turning their backs on LICH, de Blasio and Cuomo stir up community and activist anger

Mayor de Blasio has gone back on his campaign promise to support "hospitals, not condos." And the governor, well, Gov. Cuomo has been trying to close Brooklyn hospitals from Day One.

RELATED LICH closure causing growing political backlash in Brooklyn ; Mayor, Governor under pressure (The Brooklyn Daily Eagle) Healthcare As Bargaining Chips in New York City Politics // The Pelican Brief (NYC : News & Analysis)

Disappointment in Mayor Bill de Blasio is turning into community outrage as residents of Brooklyn come to grips with how the mayor's office waged a duplicitous campaign in regards to Long Island College Hospital, or LICH as it is better known. Publicly, Mayor de Blasio was giving lip service to saving LICH, but privately, some community activists are now saying that the mayor's staff was trying to bully healthcare activists into supporting the closure of the hospital so that a large real estate developer could convert the complex medical campus into luxury condos. The reality of the mayor's duplicitious nature, while shocking to grassroots activists, comes as no surprise to astute political observers of how the real corrupt nature of the broken political system works in New York City. Mayor de Blasio stormed into office during last year's mayoral election with the aid of a corrupt Super PAC undercuting his chief rival and with promises to provide a clean break from the Bloomberg-Quinn administration. The mayor's empty and meaningless campaign promises weren't made, because he believed in them, but because his campaign consultants knew that the electorate was desperate for change, and that this messaging would help him win the election -- a prediction that turned out to be correct, but that would not fix the broken political system, because that was never the de Blasio campaign's intention. The latest revelation of the mayor's duplicitous administration comes from an article about LICH in The Brooklyn Daily Eagle : Following SUNY’s announcement on Friday that it had reached an “agreement in principle” to sell the LICH campus in Cobble Hill to Fortis for development into condos, local officials representing the LICH catchment area issued a statement putting them on the opposite side of the fence with the Mayor, who pushed for the deal. While campaigning on the theme of "hospitals, not condos," De Blasio has apparently moderated his stance since becoming Mayor, saying that an urgent care center and "stand-alone ER" planned for the site will preserve health care for northwestern Brooklyn. Sources told the Brooklyn Eagle that in February the Mayor's staff put pressure on the community groups fighting for LICH to support Fortis. The growing political scandal over Mayor de Blasio's betrayal of his campaign promise to save LICH is just the latest example of how the economic realities will fracture Democratic unity : On the city level, nobody knows how the mayor will pay for expansion of pre-kinder, making good on union backpay demands, and fighting income inequality. On the state level, Gov. Andrew Cuomo will use pension IOU vouchers and hospital closings to pay for the $2 billion election year tax cut gimmicks needed to fluff his troubled re-election campaign. Caught in between are healthcare and other social needs reform activists, who are looking to the twin Democratic politicians of New York, asking, "Where's the liberal leadership we can count on ?" But this fracturing of Democratic unity is only coming about because of how Mayor de Blasio and Gov. Cuomo have deceived voters into believing that the Democratic political elite can deliver an overhaul of the broken political system that never answers the demands made by communitys. The elite Democratic politicians will never deliver social, economic, or legal reforms when they are as beholdened to real estate developers as are Mayor de Blasio and Gov. Cuomo. One of Gov. Cuomo's first acts in office was to empanel a controversial Medicaid Redesign Team that has instituted a scorched earth campaign of austerity cuts to the poorest New Yorkers, those who rely on Medicaid for their healthcare. Part of the governor's austerity cuts was to push for the closure of full service hospitals, where the poor and the uninsured seek life-saving, but expensive, healthcare services. His controversial push for more hospital closings came on the heels of the controversial closure of St. Vincent's Hospital in Manhattan, which is being now redeveloped into a $1 billion luxury condo and townhouse complex by the billionaire Rudin family. Because of income and wealth disparities, many of the state's poor people are concentrated in New York City, making it an easy target to close hospitals with a charity mission serving the poor and the uninsured. The governor's plan to cut healthcare costs to the poor was expanded under Obamacare, as more and more poor people qualified for Medicaid, a move that forced Gov. Cuomo to close even more charity hospitals. To augment hospital closings, the Obamacare expansion of the New York State Medicaid program makes it difficult for poor people to receive prescriptions for life-saving, but expensive, prescription medications, like cholesterol-fighting medications and other prescription medications for people with long-term diseases or disorders, like irritable bowel syndrome or other functional gastro-intestinal disorders. Against this backdrop of austerity cuts, the closure of LICH on Mayor de Blasio's and Gov. Cuomo's joint watch is opening the eyes of healthcare activists to the unseemly political reality that Demcoratic politicians, even those that self-annoint themselves as "progressives," are just as neoliberal in their need to make austerity cuts to the poor and to the sick as the former center-right administration of Michael Bloomberg and former New York City Council Speaker Christine Quinn. Furthermore, if Mayor Bill de Blasio was uncommitted to saving LICH from the start, in spite of his campaign demands for a moratorium on hospital closings, then this doesn't bode well for Interfaith Medical Center, also in Brooklyn, which has been targeted for closure, as well, by Medicaid Redesign Team hatchetman Stephen Berger and Gov. Cuomo. Even as the 1199 healthcare union protests the job losses and healthcare cuts by corporate-minded CEO's, note that 1199 strong-armed the Working Families Party to endorse the re-election campaign of Gov. Cuomo, whose very own Medicaid Redesign Team implimented large-scale healthcare cuts, including the outsourcing to Mr. Berger the effort to keep closing city hospitals that have resulted in still yet further healthcare union job losses, not including the negative impact to public health. How long will it take healthcare activists and other grassroots advocates fighting for unfinished healthcare reforms, such as the adoption of a single-payer healthcare system in New York state to replace Obamacare, before they wake up to see how the corrupt political operatives of some healthcare unions, drunk on the corrupt political Kool-Aid of "business as usual," keep neoliberal Democratic politicians in office, who have no intentions of ever delivering the healthcare reforms that the community demands ?

Bill de Blasio - Hospital Closing Crisis Flyer

The wave of hospital closings continue into the de Blasio-Mark-Viverito administration from the Bloomberg-Quinn administration, because lying, cheating politicians, first promise to meet community demands to save our hospitals, but then turn out to fail to live up to their campaign promises.

2014-05-22 Bill de Blasio Hospital Closings Flyer by Connaissable

Too bad HHC didn't backstop LICH's restructuring plan

From the Demand a Hospital Listserv :

Begin forwarded message:

From: Demand A Hospital
Subject: Too bad HHC didn't backstop LICH's restructuring plan
Date: 7 mai 2014 11:42:47 UTC-04:00
To: Demand A Hospital
Bcc: lflores22@gmail.com
Reply-To: demandahospital@gmail.com

Dear All :

The latest in-depth news about the end of full-service hospital care at Long Island College Hospital comes from Capital New York :

Officials from the de Blasio administration, including Emma Wolfe, were concerned that the winning bid to buy LICH from SUNY was not commercially feasible. Brooklyn Health Partners was the sole bidder for LICH to submit a plan to continue full-service hospital care at LICH, said to be a major concern to the community and to Mayor Bill de Blasio, but Brooklyn Health Partners has lacked a state license to operate a hospital, an area where the city's network of hospitals, the Health and Hospitals Corporation, could have provided valuable, non-financial assistance by proposing an HHC affiliation with Brooklyn Health Partners. However, the city never proposed any such affiliation, in spite of it being in the best interest to public health. Meanwhile, time may have run out on Brooklyn Health Partners's bid for LICH, even as Brooklyn Health Partners continues its search for a partnering hospital system, which could, amongst other things, sponsor an operating license.

City and state officials expressed outrage after it was revealed that Brooklyn Health Partners had planned to use a secret plan for massive real estate development on LICH's footprint to subsidize full-service hospital care at LICH, somewhat reminiscent of Rudin Management Company's original plan for St. Vincent's Hospital. The community's painful experience with what Rudin's reckless plans did to St. Vincent's still weighs heavily on the minds of New Yorkers, and that experience may have influenced the city's sudden opposition to Brooklyn Health Partners' plans for LICH. But government officials never sought to provide a combination of restrictions and assistance to the winning bidder for LICH to prevent such drastic real estate speculation in the first place.

Recall how the city rejected the community's demand to "land-lock" the zoning on the property of St. Vincent's Hospital after its final bankruptcy filing. Community activists even organized a sit-in protest over this very issue.

Watch : 4 Community Activists arrested In HANDS OFF ST. VINCENT's protest (YouTube) : https://www.youtube.com/watch?v=qcToWCh5VhU

Read more : The end of the full-service hospital in Cobble Hill (Capital New York) : http://www.capitalnewyork.com/article/city-hall/2014/05/8544898/end-full-service-hospital-cobble-hill

Adding hospital-only restrictions to the deed(s) of LICH's property, coupled with critical support, like extending HHC's operating license to Brooklyn Health Partners, would have been one way for the city to have responsibly supported its intention to continue full-service hospital care at LICH. Some hold out hope that SUNY will sell LICH to the second-place bidder, Peebles Corporation. But SUNY's governance board, which has been on a months-long scorched earth campaign to sabotage LICH, has no motivation to save the hospital it's been desperately trying to close in a move to appease hospital closing czar Stephen Berger and Gov. Andrew Cuomo.

If by small chance Peebles Corporation is awarded its second-place bid for LICH, it may mark another instance when North Shore-LIJ stands to make financial gains from the closure of another full-service hospital in New York. North Shore-LIJ is a partner in Peebles Corporation' plan to build an urgent care center complex at LICH. As part of the Berger Commission's drive to close St. John's Queens Hospital and Mary Immaculate Hospital, both in Queens, the state Department of Health made a $3.5 million grant to North Shore-LIJ to expand emergency room services at its Forest Hill and Franklin sites. A year later, North Shore-LIJ received another state grant of $5.3 million to open an urgent care center in Rego Park, Queens, following the closures of St. John's and Mary Immaculate. After the closing of St. Vincent's, North Shore-LIJ received yet another $9.4 million grant to open a failed urgent care center in Chelsea. North Shore-LIJ also received for free its use of the old O'Toole Building, which is being redeveloped into a glorified urgent care center in the West Village. Now, North Shore-LIJ may again stand to gain from its venture deal for LICH. The Peebles Corporation plan for LICH involves plans for the development of some luxury housing, providing a financial windfall to the next owners of LICH's valuable real estate. LICH's medical campus sits on land said to be worth as much as $500 million. North Shore-LIJ CEO Michael Dowling served on Gov. Cuomo's Medicaid Redesign Team, which has pushed for further hospital closings on top of the closures made under the previous Berger Commission. There is further appearance of cronyism in ties between Peebles and SUNY. Peebles Corporation is headed by Don Peebles, who has political ties to SUNY chairman H. Carl McCall, Crain's New York Business has reported.

SUNY's disposition of LICH is expected to be made final on May 22.

Read more : SUNY Nixes Deal With Winning Bidder to Run Long Island College Hospital (DNAinfo) : http://www.dnainfo.com/new-york/20140505/cobble-hill/suny-ends-lich-talks-with-brooklyn-health-partners

Read more : Top LICH pitch implodes, leaving luxury developer up next (The Brooklyn Paper) : http://www.brooklynpaper.com/stories/37/19/dtg-lich-plan-implosion-2014-05-09-bk_37_19.html

Read more : LICH bidder Peebles has ties to SUNY board chair McCall (Crain's New York Business) : http://www.crainsnewyork.com/article/20140402/REAL_ESTATE/140409967/lich-bidder-has-ties-to-suny-board-chair

Thank you for all that you do.

---------- Forwarded message ----------
From: Demand A Hospital
Date: Mon, Dec 23, 2013 at 8:42 PM
Subject: Can / Should HHC Save LICH and Interfaith ?
To: Demand A Hospital

Dear All :

Last week, SUNY Board of Trustees chairman Carl McCall offered to hand over Long Island College Hospital (LICH) to New York City once mayor-elect Bill de Blasio takes office, telling The New York Times that “I would love to meet with him and give him the keys to the hospital.” Mr. McCall said of his offer to transfer LICH to the next mayor.

http://www.nytimes.com/2013/12/18/nyregion/suny-withdraws-development-plan-for-troubled-brooklyn-hospital.html

In a separate report last week, another SUNY board member was quoted as saying that talks should be explored about possibly transferring LICH to the city's Health and Hospitals Corporation (HHC).

http://online.wsj.com/news/articles/SB10001424052702303949504579264803802600962

Given recent reports that Mayor Michael Bloomberg is leaving the city with a municipal budget surplus of approximately $2.4 billion, should consideration be given to transferring both LICH and Interfaith Medical Center, both located in Brooklyn, to HHC ?

http://www.nydailynews.com/new-york/de-blasio-inherits-2-4b-surplus-challenges-article-1.1553616

Just today, Interfaith won a reprieve of a few more months.

http://newyork.cbslocal.com/2013/12/23/state-steps-in-to-keep-brooklyns-interfaith-medical-center-open/

Perhaps now is the time for the city to consider this stop-gap measure in order to guarantee full-service hospital care for Brooklyn, an option that was never made available for St. Vincent's Hospital by the Bloomberg-Quinn administration ?

If Gov. Andrew Cuomo won't fully fund healthcare in New York State, should we look to municipal resources ? For now, the resources exist at the city level. Since Albany seems intent on abdicating leadership on healthcare, should City Hall take action to finally stabilize city hospitals, so that our hospitals can adequately meet the expanded needs anticipated by new waves of insured patients under Obamacare ? Share your opinions with the mayor-elect at : info@billdeblasio.com

Thank you for all that you do.

P.S. Update on mysterious medical facility. The Lenox Hill urgent care center, which took millions in state money and then closed, was not the medical facility implicated by the Moreland Commission. The questionable facility, which took millions in state funding but failed to provide healthcare, was reportedly revealed to be Relief Resources Inc., and this facility is said to be tied to powerful Albany lobbyists.

http://nypost.com/2013/12/08/brooklyn-agency-fits-description-of-mystery-nonprofit/

-- -- -- -- -- -- -- -- -- -- -- -- -- -- -- --

Tell Gov. Andrew Cuomo to stop closing our hospitals : 1 (518) 474-8390

You can also tweet your concerns to Gov. Cuomo at : @NYGovCuomo

North Shore-LIJ : Making Money Through State Grants From Hospital Closings

PUBLISHED : MON, 14 APR 2014, 08:59 PM
UPDATED : TUES, 15 APR 2014, 11:15 AM

Before and after some New York hospital closings, North Shore-LIJ successfully lobbied for state grants to fund its expansion plans.

Here's some intrigue, which the corrupt Moreland Commission should have investigated, about the granting of state money and an anti-trust loophole to a politically-connected ally of Gov. Andrew Cuomo's.

After three hospitals closed in New York City, North Shore-LIJ scored almost $20 million in state grants to help it make further inroads into the Manhattan and Queens hospital markets. The grants were backdoor funding that the state Department of Health provided existing healthcare facilities to temporarily expand their capacity in order for the state to facilitate wholesale hospital closures sought first by the Berger Commission and later by the Medicaid Redesign Team.

North Shore-LIJ received another $10 million grant after Hurricane Sandy, further demonstrating how politically astute the Long Island hospital chain has become in raking in grant money from hospital closings and natural disasters.

• RELATED : As part of the Berger Commission drive to close St. John's Queens Hospital and Mary Immaculate Hospital, the state Department of Health made a $3.5 million grant to North Shore-LIJ to "expand inpatient capacity and emergency room services at its Forest Hills and Franklin sites." (NYS Department of Health)
• RELATED : North Shore-LIJ opened an urgent care center in Rego Park, Queens, in 2010, following the 2009 Berger Commission bankruptcy and closures of St. John’s Queens Hospital and Mary Immaculate Hospital. The expansion of North Shore-LIJ into New York City was paid for by a $5.3 million grant from the state Department of Health. (The New York Post)
• RELATED : The state awarded a $9.4 million grant last spring to Lenox Hill Hospital/North Shore-LIJ to operate an urgent care center in Greenwich Village. (North Shore-LIJ will open an urgent care-center on West 20th Street * The Wall Street Journal)
• RELATED : Sixteen months after the North Shore-LIJ opened an urgent care center in Manhattan after St. Vincent’s Hospital closed, the system has closed the urgent center due to a lack of use, pocketing the $9.4 million grant. (North Shore-LIJ closes NYC urgent care center near St. Vincent's Hospital * Long Island Business News)
• RELATED : State officials are sparring over a bill that would allow Nassau Health Care Corp. join with North Shore-LIJ with blanket immunity from antitrust laws. (Schneiderman raises antitrust concerns over NuHealth/North Shore-LIJ partnership * Newsday)
• RELATED : Despite antitrust objections by State Attorney General Eric Schneiderman, Gov. Andrew M. Cuomo signed into law a bill that allows Nassau Health Care Corp. to collaborate with North Shore-LIJ with blanket antitrust immunity. (Despite antitrust objections, Cuomo approves NuHealth/North Shore-LIJ partnership * Newsday)

Whether it wants to either receive grant money to help fuel its expansion plans, lobby for blanket antitrust immunity to provide cover for its expansion plans, or to get a cut from grant money related to Hurricane Sandy as new funding streams, North Shore-LIJ gets exactly what it wants.

Helping North Shore-LIJ navigate through the sleazy swamp of corrupt Albany grant-making politics is North Shore-LIJ CEO Michael Dowling, who served as a co-chair on Gov. Andrew Cuomo's Medicaid Redesign Team effort to close hospitals and make scorched earth austerity cuts to healthcare. In 2010, North Shore-LIJ CEO Dowling was paid an astronomical $2.9 million in compensation, even though the hospital system is set up as a non-profit, yeah right.

In the above YouTube video recorded in 2011, Mr. Dowling described to community activist Jim Fouratt how the bankruptcy estate of St. Vincent's Hospital donated for free valuable property that North Shore-LIJ plans to use for an urgent care center on Seventh Avenue South. No word yet on how many millions in state grants were received by North Shore-LIJ in respect of this new iteration of an urgent care center, which is set to open this year.

Putting New Yorkers in jail because of healthcare cuts, lack of housing, and racist policing, but blaming mental illness

The Editorial Board of The New York Times thinks that enrolling all jail inmates into Medicaid will solve the "mental health" crisis of jail inmates. What a joke !

How many people with mental health needs end up in jail, because of each of a lack of a specialized municipal healthcare system that should first provide people with the full-service mental healthcare treatments that they may need and the NYPD's continued use of its "broken windows" theory of policing that deliberately targets people with the least and people with hardships for incarceration ?

• RELATED : The Mentally Ill, Behind Bars (The New York Times)

The Editorial Board worries about discharged inmates receiving post-detention care, but what about providing healthcare and support so that people don't become jail inmates in the first place ? Why doesn't The New York Times oppose policing tactics that lead to the arrest of people solely because they may be homeless, may be poor, or may have unmet healthcare needs ? The systematic closing of so many of New York City's full-service hospitals, including specialize mental health hospitals like Holliswood Hospital of Queens, added to a broken municipal shelter system and the lack of affordable housing, leave people with special needs with fewer and fewer places to go. Mix in Police Commissioner William Bratton's crackdown on the poor, and you have a perfect storm that puts people into jail for all the wrong reasons. How do we even know that jail inmates are truly even "mentally ill" ? Maybe some inmates are just plain discouraged as a direct result of either their dire economic circumstances or being targeted for arrest by police for being poor or being of color ?

Furthermore, the Editorial Board's Medicaid advocacy falls short of the realities of the broken healthcare system. So many experienced healthcare providers don't accept, and many specialized medications aren't covered by, Medicaid. By railroading inmates into a Medicaid healthcare plan that doesn't allow access to a full-range of healthcare treatment, I don't know what good the Editorial Board really expects will happen. Have members of The New York Times' Editorial Board ever tried getting an appointment with a good doctor, or filling a prescription, on Medicaid ? How do we know whether people on Medicaid with mental healthcare needs aren't being driven into incarceration by their failed healthcare coverage, the hospital closing crisis, and Commissioner Bratton's crackdown on poor people of color ? Where's the safety net ?

Three Brooklyn Hospitals Face Down-sizing, Despite Billions in State and City Resources

No Political Commitment to Save Hospitals

Brookdale Hospital, Interfaith Medical Center, and Wyckoff Heights Medical Center will now have to down-size in order to survive, aides to Gov. Andrew Cuomo said today. No mention was made if Long Island College Hospital, a fourth Brooklyn hospital that has been targeted for closure by Gov. Cuomo, would survive the chopping block.

As part of a controversial Medicaid waiver, New York state must reduce inpatient hospital beds across the board in accordance with the wishes of Stephen Berger, a New York investment banker and member of a working group of Gov. Cuomo's Medicaid Redesign Team. Since 2006, Mr. Berger has overseen the closure or down-sizing of 11 hospitals in New York City alone.

• RELATED : Healthcare As Bargaining Chips in New York City Politics // The Pelican Brief (Updated)
• RELATED : Bill de Blasio, New York Liberals, and the Veal Pen (Updated)

Gov. Cuomo wants to use some of the money from the Medicaid waiver to down-size hospitals into urgent care centers, emergency units, and specialized treatment facilities. “We will be able to fund the structural and rebuilding needed to transform hospitals so they can be profitable and thrive and remain open,” one aide to Gov. Cuomo said.

Because the Medicaid waiver was negotiated in secret, it is not known if any of the down-sized facilities in Brooklyn will "transform" into spin-offs as for-profit healthcare corporations.

No response, yet, from New York City Mayor Bill de Blasio, who campaigned outside the former St. Vincent's Hospital with a promise to stop hospital closings.

Billion in Surplus State and City Budgets

Gov. Cuomo says that New York state has no money to save our hospitals, yet he is spending "surplus" state tax money that was "made" by closing entire hospitals. From this "pot of gold," the governor is offering tax breaks to the wealthy and to corporations, so much so that the Moral Monday movement is now coming to Albany, to fight the irresponsible way in which Gov. Cuomo has politicized state tax dollars. Many observers note that Gov. Cuomo is diverting "surplus" money from healthcare cuts to cozy up to corporate supporters in order to increase his margin of victory in his re-election bid later this year as a way to launch a campaign for the 2016 presidential race.

• RELATED : In election year, governor is in a giving mood, except for healthcare
• RELATED : Moral Mondays Come to Albany : Morality Meet Cuomo's Budget
• RELATED : Gov. Andrew Cuomo's 2016 Presidential Machinations

Mayor de Blasio has also attracted some scrutiny in how he's using tax money. The new mayor enjoys a $3 billion budget surplus, and the city stands to make an additional $1 billion from the sale of new air rights around Grand Central Terminal as part of the mayor's plan to rezone the east side of Midtown Manhattan. But so far, Mayor de Blasio has not proposed to use any of these resources to save two hospitals on the verge of closure, Long Island College Hospital or Interfaith Medical Center, both in Brooklyn.

• RELATED : Budget Puzzle for Mayor : What to Do With a Surplus That May Top $3 Billion
• RELATED : City Council Postpones Decision on $1 Billion Midtown Air Rights Sale

As each of Gov. Cuomo and Mayor de Blasio plan their next budgets, now is the time to hold them to account to save our community hospitals.

Brooklyn Beep Eric Adams Caught in Web of Medicaid Redesign Team, de Blasio, and Cuomo Machinations

Politicians are playing a deadly game with people's lives over the hospital closings crisis that is gripping New York City. But very few politicians own up to the fact that the hospital closing crisis is being manufactured by both the state government under an Orwellian plan first under the Berger Commission and later under the Medicaid Redesign Team, originally dating back to at least 2006.

On NY1, you were defending downsizing LICH. To stop hospital closings, you need to stand up to both mayor and governor. @BPEricAdams

— StopNYMRT (@StopNYMRT) February 10, 2014

• RELATED : Watching the Political Chess Pieces Move on the $10 billion New York State Medicaid Waiver

Because Mayor Bill de Blasio took advantage of health care unions concerned with hospital closings, his mayoral campaign catapulted over former Council Speaker Christine Quinn's own campaign in last year's mayoral election. But now that the mayor is loath to come up with the city tax dollars to actually bail out Long Island College Hospital and Interfaith Medical Center, the lesser-ranking city officials are left in a quandry : afraid to hold the mayor accountable to his campaign promises, but still let to have to "go through the motions" to quell union and voter anger over how quickly the mayor and the Public Advocate's office have abandoned any concrete plans to save full-service hospital care at LICH and Interfaith.

Watching the Political Chess Pieces Move on the $10 billion New York State Medicaid Waiver

• UPDATED : $10 billion truth serum (The New York Daily News * 03 Feb 2014)

The political machinations at play over Cuomo's reëlection pork slush fund

Last month, New York Democratic Gov. Andrew Cuomo insulted Republicans by saying that "extreme conservatives" of the GOP had no place in New York state. How can Gov. Cuomo insult the political party that controls the House, which controls federal funding ? Ideological differences aside, the political reality is that Gov. Cuomo should keep the state on good terms with Republicans in order to "work the system," seeing as he is such a political insider, especially given how Gov. Cuomo is waiting on $10 billion in federal Medicaid funds to divert into pork projects in this year's budget to fluff his reëlection campaign. Health and Human Services Secretary Kathleen Sebelius is absolutely correct is not wanting to cross the GOP on this Medicaid waiver, because setting the frank realities aside (Like, who exacerbated the hospital closing crisis but Cuomo himself !!), why would the GOP want to see the Obama administration give a $10 billion re-electioneering slush fund to Gov. Cuomo after Gov. Cuomo just trashed the GOP ? If Obama/Sebelius have total discretion over approving this waiver, then President Obama may pay the price with amped-up vitriol from the GOP. It seems like Gov. Cuomo was flat out stupid to insult the GOP. Unless he was trying to score cheap political points by just using extremist talk, like one of my friends told me the other day . Even then, it was stupid.

• RELATED : Washington Politics Threaten 10 billion Cuomo Reelection Pork Slush Fund Spending (New York magazine * 29 Jan 2014)

There could be more than just normal beastly Washington politics causing the delay in the Medicaid waiver. If you want to really look behind the curtain, you might find former Secretary of State Hillary Clinton's people causing the delay, too. President Obama supports Mrs. Clinton in her presumed campaign for the 2016 Democratic presidential nomination, so the last thing President Obama would want to do is to help prop up Gov. Cuomo's reëlectioneering pork plans with the $10 billion Medicaid waiver that Gov. Cuomo plans to turn into a slush fund. These monies are purported to be "savings," but they are in fact money that was gutted from Medicaid from the poorest people, preventing them from being able to access full-service hospital, comprehensive medical, or Level 1 Trauma care in times of emergency. Cuomo's plans for these monies have nothing to do with helping to fund Obamacare expansion plans, but, instead, to dole out for his reëlection campaign purposes. He is sleazy like that, and there's no way to expect that Gov. Cuomo will do the right and honorable thing with this kind of windfall. And Mrs. Clinton's people know that, too, and if you were Mrs. Clinton, why would you want to see your primary challenger make use of a $10 billion slush fund like that ? Mrs. Clinton's machine is slowly taking back control of the DNC, so there's that added motivation to block/cut the waiver, too.

• UPDATED : New York may have to give back some Medicaid funding (Capital New York * 03 Feb 2014)

Added to the political pressures on the $10 billion waiver is New York City mayor Bill de Blasio's tax hike for the rich. If the $10 billion is delayed or cut, then Gov. Cuomo will not have the money to fund the mayor's expansion of pre-kinder classes as he had promised, making it easier for Mayor de Blasio to argue that he needs his tax increase. Mayor de Blasio is also doing his best to see to it that Mrs. Clinton comes out on top of Gov. Cuomo, so the mayor has a partial motivation to see to it that the Medicaid waiver is delayed or cut, even to the detriment of NYC hospitals.

Bill de Blasio says Hillary Clinton would make a GREAT President.

— Gloria Pazmino (@GloriaPazmino) January 30, 2014

• RELATED : Friction Between de Blasio, Cuomo is Early Posturing for 2016 (Battery Park TV * 22 Jan 2014)

At the joint appearance by the mayor and governor, the governor and the mayor only committed to preserving emergency care in Brooklyn -- (the same bait-and-switch talk that former Council Speaker Christine Quinn shifted to regarding St. Vincent's) -- and the governor and mayor specifically refused to say that they'd save "full-service" hospital care. So, that $10 billion isn't going to be used to save Interfaith Medical Center or Long Island College Hospital as we would all like to see. The only way that Mayor de Blasio would go along with pressuring Secretary Sebelius to make good on the whole $10 billion waiver is if Gov. Cuomo promised to share some of that slush fund with NYC -- which we already know will not be used to save Brooklyn hospitals. The mayor is under tremendous budgetary pressure to deliver on approximately $7 billion in union contracts, and he needs all the money he can get.

The dark side question is : are "Leftists" really trusting the governor and the mayor to let some of that $10 billion trickle down to voters ? It's been my argument that, since I saw James Capalino campaign for BDB, the de Blasio administration would be controlled by lobbyists. Lobbyists are going to instruct the governor and the mayor on how to spend that money. My darkest fear is the people will not benefit from the money at all. Maybe the unions will get better contracts, but people who don't have lobbyists working for them will get nothing. As it is, the karma of this money is already questionable, since it represents Medicaid healthcare cuts to the poorest New Yorkers.

Lastly, I want to point out that President Obama himself may want to delay or cut the $10 billion. The president's administation has been a complete disaster. His last saving grace is to try to take credit for the rise of the (fake (read : no-reform)) progressivism that's emerging out of the new crop of (poser) politicians in New York City. President Obama himself may want to delay or cut the Medicaid waiver so that he can take credit for an income tax hike on the 1% for which the mayor is lobbying. The tax hike is a good thing, but all these backroom machinations and other mixed-motivations are what are at play. There's no way to predict what will happen, because these pieces keep moving....

SIDEBAR : If Staten Island Congressman Michael Grimm leaves office, the GOP will have less reason to care about New York. I hate myself for thinking like this, but we actually need a powerplayer GOP politician in New York to help focus the GOP on the dire economics of New York state. If we go completely blue, why would the GOP-controlled House care about us anymore ? President Obama's too weak to lead the Democrats to take back control of the House this November, so we are stuck with the GOP for the next few years. Insulting them doesn't work, not when Gov. Cuomo has his hands out, begging for a slush fund.

Bronx Man Dies After Waiting Hours For E.R. To Treat His Rash

Berger Commission and Medicaid Redesign Team hospital closings created failures that have led to long E.R. wait times in New York

• From The Gothamist : Man Dies After Waiting Hours For ER To Treat His Rash

A Bronx man who went to Saint Barnabas Hospital to get his rash checked out was found dead in the emergency room waiting room after an eight hour wait. John Verrier, 30, went to St. Barnabas at 10 p.m. last Sunday night; he was found dead by a security guard around 6:40 a.m. the next day. "He was found stiff, blue and cold," a hospital employee told ABC News. "He died because [there's] not enough staff to take care of the number of patients we see each day. We need more staff at Saint Barnabas."

Verrier had his vitals taken when he first got to the hospital, then told to wait for a doctor to see him. Hospital spokesman Steve Clark told the Post that Verrier's name was called "two or three times" between his arrival and 2 a.m. A security guard passed through the waiting room around 2 a.m. to wake up the many homeless people who sleep there, and Verrier was "moving, he was alive." Then when the security guard passed again around 6 a.m., he was dead.

Clark added that an in-house review found “all guidelines were met.” But the hospital worker who spoke to ABC said nobody was really checking on him: "There's no policy in place to check the waiting room to see if people waiting to be seen are still there or still alive." That worker says Verrier's name was called over the PA three times, but "based on number of people in the waiting room it is impossible to check on each person physically."

New York State is ranked 46th in the country in overall emergency room waiting time. St. Barnabas is the worst in the city when it comes to the average time patients spent in the emergency room before being sent home: it's 306 minutes there, compared to a 155 minute wait statewide and the average 137 minute wait nationally.

• RELATED : Industry sources said recent hospital closures have contributed to longer wait times. You could die waiting in New York hospitals * The New York Post
• RELATED : Former New York Lt. Gov. Richard Ravitch asks how Gov. Andrew Cuomo can propose $2 billion in tax cuts in the face of great social needs. Richard Ravitch’s Reaction to the Budget Plan * Capital Tonight (Registration Required)

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Tell Gov. Andrew Cuomo to stop closing our hospitals : 1 (518) 474-8390

You can also tweet your concerns to Gov. Cuomo at : @NYGovCuomo

Healthcare As Bargaining Chips in New York City Politics // The Pelican Brief (Updated)

Getting Your Piece Of The Pie After It Gets Taken Away From Somebody Else

Housing Works CEO Charles King, left, agreed to going along with making $17 billion in healthcare cuts. Stephen Berger is a budget hatchet man, who leads a special subcommittee of neoliberal Gov. Andrew Cuomo's controversial Medicaid Redesign Team trying to close hospitals in Brooklyn. Thomas Farley, right, is the do-nothing city health commissioner responsible for continuing years of municipal policy that failed to keep community hospitals open or to finally develop a comprehensive, city-wide AIDS agenda.

• RELATED : Watching the Political Chess Pieces Move on the $10 billion New York State Medicaid Waiver
• RELATED : You Could Die Waiting In A New York City Emergency Room

Word on the Street : Whereas Mayor Bill de Blasio doesn't have enough money to make good on unions' demands for retroactive backpay and raises, he's in a quandary about how to bring down the unions' demands, but still make them feel like he "appreciates" them.

Whereas Mayor de Blasio keeps being all talk about his "progressive reform agenda," he's rightly raising expectations amongst reform activists that he's actually going to deliver changes on major social, legal, and economic issues that went neglected for the last 20 years of Republican City Hall rule.

Now, therefore, the intersection of these two circumstances is creating a troubling development : There's talk amongst some political insiders that Mayor de Blasio may offer one union largely responsible for his electoral win with a lower contract in exchange for being given backroom access to selecting one of the city commissioners that would have some oversight of that union.

Isn't this how Wall Street games the system ? We already have Scott Stringer, a slimy career weasel, in charge of the Comptroller's Office. Knowing Stringer's situational ethics, he's no doubt ready to sell access and influence in exchange for campaign donations to make another campaign run for higher office the next time the situation presents itself. We say that this is wrong when it is done by the political right, or by the 1%. But what happens when it's done by the left ?

A sordid theory about how corruption spreads : dividing the community for expedient political gain, leaving everybody triangulated from criticising the corruption.

1199, formerly headed by Obama administration political operative Patrick Gaspard, is a close advisor to Mayor de Blasio. Judging by how Mr. Gaspard sold out on his union's dedication to healthcare advocacy by agreeing to the wave of Berger Commission hospital closings ordered by former Republican Gov. George Pataki and by Gov. Pataki's own political operative, Wall Street investment banker Stephen Berger, Mr. de Blasio is hoping to resurrect the evil playbook of corruption in the contract negotiations between City Hall and 1199.

Here's how.

Trading A Lower Labor Compensation Contract In Exchange For Naming The Next Health Commish

Corruption doesn't have to always be about breaking the law, it could be about corrupting the democratic process that should be at the start be advocating transparency and a fully public participation in all decisions in matters of the public's own governance, especially major decisions, like picking the next city health commissioner. This role is vital, and the fact that we've had Thomas Farley for the last four years, only shows the kind of damage that having an impotent health commission can cause : Mr. Farley has not done one thing to stop the lingering Berger Commission hospital closings, nor the next wave of hospital closings called for by neoliberal Democratic Gov. Andrew Cuomo under his own Berger-like apparatus, the Medicaid Redesign Team.

How bad would it really be if 1199 gets given the right to pick the next health commissioner in exchange for accepting a lower labor compensation contract from Mayor de Blasio ?

For one thing, how do we know that the political direction of 1199 will act independently in the best interests of the patients it cares for ? Or how about making sure that the political leadership of 1199 will make decisions independently in the best interests of its membership ? Under Mr. Gaspard, the union never challenged the Berger Commission hospital closings, and it even took a seat at the table for the Medicaid Redesign Team. George Gresham, the President of 1199 SEIU United Healthcare Workers East, sits on the MRT panel.

As much as I am pro-labor and pro-letting labor get an inside track to making major political decisions, what troubles me is that 1199 is not independent. It was a major political supporter of the mayor, back when he was a no-hope candidate, so far distant from the front-runners that nobody took him seriously. In getting the chance to pick or vet the next health commissioner, can 1199, based on its track record, really and truly be counted on doing the right thing for the emergency room-full service hospital needing public ? Or is it going to make a deal that will catapult its current top crop of political directors into their next jobs, like, say, the next presidential campaign political consultant, White House political director, or ambassador to South Africa ?

Why is nobody asking why is Mayor de Blasio linking labor compensation contract negotiations with picking the next healthcare commissioner ? It's because Mayor de Blasio plans on being disingenuous in his union contract talks, and it matters naught to the mayor that he's going to divide the community by confusing discussions that should only be about backpay and raises with picking the next health commissioner. If the mayor cared about public input, he would automatically -- and without needing to subvert important agency picks as bargaining chips -- involve all stakeholders in his decision-making for the next health commissioner. That is to say, the public AND 1199 AND critical healthcare community groups should have a say in the next healthcare commissioner at the same time when the mayor should be having rigorous union contract talks with 1199. One has nothing to do with the other. But this kind of mentality, of offering two birds in the bush for one in the hand is what dishonest negotiations are all about. Rather than have 1199 say, "Yes, and …," you had the mayor saying, "No, but…."

Other Examples of How Critical Healthcare and Social Services Decisions Get Made Half-Assed By "Community Leaders," With No Full Public Involvement or Accountability // The Hunger Games

This kind of offering one group a piece of pie only after having first withdrawn that same piece from somebody else is what happened when some large New York City community and non-profit organizations went along with the Medicaid Redesign Team's cuts to healthcare for the poor in exchange for a few coins for homeless housing programs. Again, you had community groups agree to Gov. Cuomo's draconian austerity plans of closing more hospitals in New York City and making other healthcare cuts valued at upwards of $17 billion, over time, and for giving the sleazy neoliberal governor political cover to make these cuts, groups like Housing Works and GMHC were made promises that Gov. Cuomo would make a few million dollars available to homeless housing programs. Groups like Housing Works and GMHC have the provision of healthcare for the poor and the disenfranchised as part of their mission, but look at how they agreed to actions that were in contravention to other healthcare groups, with similar missions. Indeed, one need not look any further than how St. Vincent's Hospital, a former comprehensive AIDS center, Level I Trauma Center, and full-service hospital with a large HIV/AIDS patient load, was shut down under the calls for hospital closings. Don't these groups see that we are shooting ourselves in the foot ? Why does having to close hospitals be linked with making money available for homeless care programs ? What does one have to do with another ? We should be fighting for a healthcare system that covers everybody at the same time when we are fighting for the full resources to provide shelter to people, who are homeless. But only politicians, who are interested in expedient political gains would try to subvert one important community issue to another, and community group leaders should not be going along with this kind of corruption.

Another example comes to mind when the head of one homeless LGBT youth program turned on the head of another, all because politicians divide us, make us fight, for the crumbs that they throw at us.

But there is hope. Some groups, like the Legal Aid Society, and bloggers can reframe the conversation about budget cuts, failed government responses to the major social, legal, and economic issues of our time. The Legal Aid Society recently sued the city over its abdication of responsibility for providing shelter to homeless youth. Rather than being a victim to the rigged budget negotiations, the Legal Aid Society decided to make a demand for the FULL resources to address the problem at the same time when all we get is lip service that we can count on a truly progressive reform agenda from the de Blasio administration. If the public were truly able to see that backroom political machinations of insiders, operatives, and lobbyists don't fully answer the social, legal, and economic problems of our time, then the public would know that one of the first reforms we need is to demand a fully transparent and accessible process on every major de Blasio administration pick, especially with regard to the selection of the next health commissioner.

What's going to happen when the full membership of 1199 learns that their leadership may already be agreeing to undercut their labor contract negotiations ?

And what other healthcare advocacy groups, let alone the public itself, should have a seat at the table of talks if the mayor is convening such an apparatus for picking the next health commissioner ? ACT UP comes readily to mind. Who else ?

Making Matters Worse Than Patrick Gaspard Is Stanley Brezenoff

James Capalino, the real estate lobbyist, left, with Continuum CEO Stanley Brezenoff. Capalino was a paid lobbyist for the Rudin Family in their controversial $1 billion luxury conversion of St. Vincent's Hospital into an exclusive condo complex. Brezenoff raided the trust fund of Long Island College Hospital in an effort to suck it dry of resources.

Mr. Brezenoff, the head of Beth Israel Medical Center, may be on the outs with Continuum, Beth Israel's parent holding company, following the takeover by Mt. Sinai Medical Center of Continuum's hospitals. Likely trying to make a transition back to head the New York City Health and Hospitals Corporation, a position he once head in the early 1980's, or possibly as the next health commissioner, Mr. Brezenoff has already wormed his way into an unpaid advisory capacity to the de Blasio administration's new First Deputy Mayor, Anthony Shorris. When he was head of HHC during the early years of the AIDS crisis in New York City, Mr. Brezenoff failed to get in front of the outbreak, treatment, and prevention of AIDS. He has a record of failure in respect of public health. Why would Mayor de Blasio pick him ? Let's examine the kind of political machinations that would go into a decision like this….

Maybe Mr. Brezenoff's new administration position is meant as a stick to 1199 that any role that the union may be offered to have in picking the next health commissioner may be the union's effort to block Mr. Brezenoff from a higher healthcare capacity with the de Blasio administration ? Mr. Brezenoff's controversial role in trying to raid LICH, for example, of its assets would scare -- and distract -- any reasonable union to want to block his return to any supervisory role in formulation government healthcare policy.

What a wicked web we weave …. Let's hope the union membership are smart enough to demand transparency from their political operatives, the same way the public and community groups should demand transparency from the de Blasio administration, the same way that the Legal Aid Society didn't accept a bullshit government response to the homeless youth issue of today. There is a way to get to the root of the social, legal, and economic problems we face : we just have to have the courage to not let our demands for a full solution be subverted by either slimy politicians in exchange for "insider access," like the current 1199-health commish trade off that is being discussed around town, or by failed community group leaders in exchange for political protection, like the "What's in it for me" Patrick Gaspard model that other non-profit organization leaders are adopting with greater frequency.

If everybody would just focus on the fact that we are all in this together -- that we are all involved in one struggle to make the city/world a better place -- we wouldn't let slimy politicians and their political enablers subvert our needs. The "Yes, and" model is one of faith : there are enough resources for everybody. If we accept the "No, but" model from politicians, we'll never find the answers we seek, and, worse, we'll sabotage other activists and groups trying to seek the answers for their own issues. We have to be in this together, for one another, if we want to make a difference.

WNYC Is Looking For Help To Crack a Case of Albany Corruption

The $3 Million Mystery Medical Care Center

Are you http://t.co/zTynyQx7MW looking for this ? http://t.co/t03yRz2HJj @WNYC @NorthShoreLIJ @lenoxhill @AndreaWNYC @jkeefe

— StopNYMRT (@StopNYMRT) December 4, 2013

The WNYC reporters John Keefe and Andrea Bernstein are asking for the public's help to identify a medical care center in New York City, which has received $3 million in taxpayer money, but, which, according to the Moreland Commission's report on corruption, has few, if any, patients.

One may recall that the urgent care center operated by North Shore-LIJ/Lenox Hill Hospital in Chelsea was supposed to have received taxpayer money. But according to YELP, that urgent care center appears to now be closed.

Could this be the mysterious facility that has received millions in taxpayer money in exchange for providing nonexistent medical care services to the community ?

Stay tuned.

North Shore LIJ Medical Group - CLOSED - Chelsea - Manhattan, NY

Intentionally Deceptive Advertising ?

North Shore LIJ/Lenox Hill fraudulently labeling urgent care center as a "hospital." Do you agree ? @nycHealthy pic.twitter.com/FRyvAMvh9D

— StopNYMRT (@StopNYMRT) December 4, 2013

Another urgent care center, which North Shore-LIJ/Lenox Hill Hospital plan to operate near the $1 billion Rudin luxury condominium complex, is now being labeled as a "hospital," even though it does not have the facilities, medical specializations, or certifications to treat heart attack patients, according to New York City EMS Chief Abdo Nahmod.

Donate Your Twitter Account to : Stop New York Medicaid Redesign Team

Donate Your Twitter Account to : Stop New York Medicaid Redesign Team

Did Waves of Hospital Closings Impact Metro-North Derailment Passenger Emergency Trauma Treatment ?

From the Demand A Hospital list serve :

From:  Demand A Hospital <demandahospital@gmail.com>

Subject:  Corrected : Metro-North Derailment Injured Skip Nearer Level 1 Trauma Center

Date:  1 décembre 2013 20:19:14 UTC-05:00

To:  Demand A Hospital <demandahospital@gmail.com>

Corrected : 

Due to corrupt HTML code from the Newsday Web site, we are transmitting our prior e-mail in unformatted text.  Plus, we clarified the subject line.  

We apologize for the confusion.

- - - - - - - - - - - - 

Dear All :

Today was a sad day, following the tragic Metro-North train derailment in the Bronx.

For unexplained reasons, the Metro-North passengers injured today were dispersed amongst far-flung city hospitals, including Elmhurst Hospital Center, a Level I trauma center 13 miles away in Queens, even though St. Luke's/Roosevelt Hospital in Morningside Heights in Manhattan is less than 7 miles away.  

Following the wave of hospital closings under the Berger Commission, the Medicaid Redesign Team, and Superstorm Sandy, the capacity of New York City hospitals to handle mass trauma events remains in question.  

The following news report from Newsday indicates that some passengers have already been discharged after receiving emergency medical treatment, but many others remain hospitalized in critical condition.  Because time is of the essence when treating trauma patients, it's not yet known why some passengers were transported over longer distances, unnecessarily extending the time until some passengers received trauma care.

As we mourn the passengers, who died today, and as we wish those injured a speedy recovery, let's hope that city and state health officials recommit to the need to maintain capacity in our city and state hospital system for emergencies and accidents, especially mass events like this derailment.

Tonight, our thoughts are with the Metro-North passengers and their friends and families.  We owe it to each other to have a hospital system that maintains the necessary capacity and specialized medical staff to timely provide specialized Level I trauma care.

List of Level I Trauma Centers : http://www.health.ny.gov/professionals/ems/trauma2.htm

Newsday article link :  http://www.newsday.com/news/new-york/ntsb-on-scene-to-probe-fatal-metro-north-derailment-1.6521318

NTSB on scene to probe fatal Metro-North derailment

Originally published: December 1, 2013 8:32 AM

Updated: December 1, 2013 7:06 PM

By JENNIFER BARRIOS, EMILY NGO AND ALFONSO A. CASTILLO jennifer.barrios@newsday.com,emily.ngo@newsday.com,alfonso.castillo@newsday.com

Investigators are trying to determine what caused a Metro-North passenger train to jump off the rails on Sunday morning, killing four people, while on an area of track that New York's governor called "dangerous."

The National Transportation Safety Board began its investigation Sunday at the scene of the derailment, about 100 feet north of the Spuyten Duyvil station on the Hudson Line.

More than 100 passengers were on the train, and FDNY reported at least 67 victims, including four killed, 11 critically injured and six with serious injuries. Five NYPD officers on the train commuting to work were among the injured, sources said.

A source in law enforcement said the train operator told first responders that he had applied the brakes but that they did not work. However, authorities have not corroborated that as of yet.

However, Russ Quimby, a rail safety consultant and former member of the National Transportation Safety Board, said train brakes are usually designed with a failsafe and if they malfunction, the train is designed to come to a stop.

The law enforcement source also said speed may have been a factor.

The seven-car train derailed at about 7:20 a.m., according to MTA spokesman Aaron Donovan.

Three men and one woman were killed, the MTA said.

Crews will use a crane to lift up the overturned cars Sunday night to search "for any further fatalities" and to avoid further fuel spills, National Transportation Safety Board member Earl Weener said during a briefing at the scene. Gov. Andrew M. Cuomo had said earlier he believed all passengers had been accounted for on Sunday.

Weener said a "multidisciplinary team" will meet Sunday night to form sub-teams to examine the point of derailment, the train signal system, mechanical equipment, data from event recorders, maintenance and personnel records and survival factors.

Weener said the team will document the condition of all the cars before turning the equipment back over to Metro-North. It also will interview the derailed train's personnel.

"Our mission is to understand not just what happened but why it happened, with the intent of preventing it from happening again," Weener said.

He said the NTSB already had downloaded information from the train's data recorder, which contains information about the train's operation at the time of the derailment.

Cuomo said track repairs will only begin after the NTSB finishes its investigation, which will take a week to 10 days.

"Tomorrow, I think it's fair to say, commuters should plan on a long commute," Cuomo said.

The derailed train, which was being pushed from the rear by a diesel locomotive, had been headed from Poughkeepsie to Grand Central Terminal in Manhattan when it tumbled from the tracks on a sharp curve near where the Hudson River meets the Harlem River.

"That's a dangerous area of the track, just by design," Cuomo told CNN on Sunday. "That's a difficult area of the track, but that doesn't explain the crash, either."

But he added later: "It can't just be the curve."

Trains are supposed to reduce their speed to 30 mph at that spot, according to the MTA. Before that point, trains can travel as fast as 70 mph.

Cuomo said people were ejected from the train because the front and rear doors opened.

As the trains slid along the ground on their sides, he said, the train cars "were picking up rocks and dirt, tree limbs, debris."

Late Sunday, emergency workers continued to work by floodlight among the cars, which still lay on their sides or listed dangerously along the river, as emergency boats floated in the water and emergency vehicles sat with lights flashing.

Bodies of the dead and the injured had been carried out on stretchers, and no passengers remained aboard late Sunday, but a ladder used to access the train was left leaning against the second car.

Dozens of uniformed police officers, firefighters and other first responders were still on the scene, some directing car traffic away from the area.

Maria Herbert was aboard the derailed train, working as an assistant trainman, said her husband, William Herbert, 53, of upstate Wallkill.

Herbert said his wife called him minutes after the event, injured and sounding like she couldn't breathe.

"Thank God she's alive," he said. "If that train went into the water, it would have been worse. I think God stopped the train."

Herbert, who said he worked in the maintenance department of the MTA for 25 years, said he and his wife had often discussed maintenance issues on the curve where the train derailed on Sunday.

"She had been fearful about that area," Herbert said. "That curve is very sharp and that rail wears away."

FDNY Chief of Department Edward Kilduff said that three of the four people who died were found by first responders outside the train, and one was inside. All of the fatalities were from cars that had flipped onto their sides. Most of those injured had suffered blunt trauma, Kilduff said.

Rescuers had to cut open cars and use air bags to lift them off one or two people who were trapped underneath, Kilduff said.

Kilduff said the terrain posed a challenge to rescuers, some of whom had to carry their equipment to the area. "The stability of the cars was also a serious challenge," he said.

NYPD Commissioner Ray Kelly said the train's engineer was at a hospital in stable condition. "He's banged up, but conscious and alert," Kelly said at a news conference.

Media reports indicated the engineer was a 20-year veteran of the MTA and had made a statement to investigators.

Officials estimated more than 100 people were on the train -- much fewer than would have been riding during a workday.

If the train had been fully occupied, said FDNY Commissioner Salvatore J. Cassano, it would have been a tremendous disaster.

MTA board member Charles Moerdler described the scene as "dreadful, awful, chaotic."

"There were rail cars scattered all over the place, plus an engine, and hundreds of rescue workers -- fire, police and voluntary ambulance -- working feverishly together with canines," said Moerdler, who noted that the train came off the tracks along a "treacherous curve" and in an area where leaves are known to fall on tracks, making for dangerous, slippery rail conditions.

Quimby, a rail safety consultant who worked for 22 years as an NTSB crash investigator, said the curvature of the rail, and the speed at which the train traveled, would be among several factors examined in the NTSB probe.

He said curved rail can be susceptible to derailments because the centrifugal force of a train when it comes through a turn can, over time, gradually cause rails to separate from each other.

The group would likely be headed by a doctor of psychology who would examine any factors that could have taken the engineer's attention away from his job, including fatigue that could have caused him to "nod off," mobile devices, or drugs or alcohol. The engineer would give blood and urine samples for toxicological testing, he said.

Quimby said a type of event recorder that is standard on most commuter trains would likely provide answers to how fast it was moving when it derailed, and whether brakes were applied. He said he has never seen an instance of brake failure causing a commuter train to derail, because brake systems are generally designed with failsafes. If the brakes malfunction, a train automatically will come to a stop, he said.

Anthony Botallico, general chairman of the Association of Commuter Rail Employees -- the union representing Metro-North engineers and conductors -- said several train crew members were injured, as well as "extremely upset and traumatized."

"It's just a terrible tragedy, man," Botallico said. "My thoughts and prayers are going out to the family members and everybody who was killed. It's something that we're all feeling really hard right now."

The injured were taken to St. Barnabas Hospital, Montefiore Medical Center, Lincoln Medical and Mental Health Center and Jacobi Medical Center in the Bronx, New York-Presbyterian Hospital in Manhattan, and Elmhurst Hospital Center in Queens, authorities said.

Spokesman Steve Clark at St. Barnabas said 10 people were admitted to the hospital to stay overnight. So far, two have been officially discharged from the hospital. One is a 14-year-old boy who was traveling with his father and the other is a man in his mid 20s. Clark said many of the people who are staying are not critically injured except for two: a 43-year-old man with a spinal cord injury and a 21-year-old woman with a leg fracture.

A woman named Maria Ojito stopped by the hospital and told reporters she was a family friend of the 43 year-old man who suffered spinal cord injuries. She said his name is Samuel Rivera, Sr. and he had a son, also named Samuel Rivera, who was the 14 year-old boy who was released earlier, both from Ossining, NY. She said the two were headed into the city but she is not sure for what and the father was undergoing surgery right now and had been for ten hours as of 6 p.m. She said the elder Rivera worked for MTA but not sure doing what but that he was not in duty.

She said the family is "devastated" by the news.

New York-Presbyterian received a total of 17 patients, 14 of which were received at the emergency department, according to a release. Of the 14, four were critical and 10 were noncritical, the release said.

Jacobi Medical Center received 13 patients, all in stable condition. Several have since been discharged, according to a statement released by the hospital.

Kelly was scheduled to visit the five injured officers in the hospital. At least one -- a female officer who suffered fractured ribs and other injuries -- was at St. Barnabas Hospital.

Officials said at news conferences they don't believe any of those passengers who were seriously injured will die.

Those looking to check on the status of family members were asked to call the city's 311 information line, while those outside of New York City could access the city's 311 system by calling 212-639-9675.

A family center staffed by Red Cross and officials from the MTA was set up at John F. Kennedy High School in the Bronx.

Unlike air disasters, where authorities have complete passenger lists, there was no such list of who was on the Metro-North commuter train.

Politicians issued statements on the tragedy, including Mayor-elect Bill de Blasio, who said he was in contact with Kelly and was monitoring the situation.

A representative for Mayor Michael Bloomberg did not respond to a request for his whereabouts.

The White House issued a statement on Sunday, saying President Barack Obama had been briefed about the derailment and that his thoughts and prayers were with the friends and families of the victims.

Cuomo said Amtrak service between New York and Albany was resumed later Sunday.

Trains were moving through the derailment area at restricted speed, but service on the Hudson Line was suspended in both directions between Tarrytown and Grand Central on Sunday.

The Spuyten Duyvil station is off Edsall Avenue near Johnson Avenue in the Bronx, about 11 miles from Grand Central Terminal. The Henry Hudson Parkway passes over the area.

The derailment is the third major event to occur on Metro-North tracks in 2013 -- a year that has MTA officials have acknowledged has included a higher than normal number of safety-related incidents for its commuter railroads. In May, a Metro-North train derailed in Bridgeport, Conn, injuring 76 people. Less than two weeks later, a Metro-North train killed a track worker in West Haven, Conn.

And in July, a freight train derailed near the same location as Sunday's event.

With Maria Alvarez, Alfonso A. Castillo, Anthony M. DeStefano, Kevin Deutsch, Rita Deutsch, Tania Lopez, Ivan Pereira, David M. Schwartz, Nicholas Spangler, Andrei Berman and The Associated Press

-- 

Tell Gov. Andrew Cuomo to stop closing our hospitals :  1 (518) 474-8390

You can also tweet your concerns to Gov. Cuomo at :  @NYGovCuomo 

Contrasting "Narratives" on Medicaid, Hospital Budget Cuts Under Obamacare

#Gov1%, Hospital Budget Cuts, Medicaid Redesign Team, Stephen Berger, and GOP-Controlled States Take Toll on Life-Saving Emergency Care

Dr. Herbert Pardes, who used to lead New York-Presbyterian Hospital as president and CEO, earned $4.3 million in 2010, boosted by a $339,101 SERP payment. That came on top of a $6.8 million SERP payment that vested in 2008. (SERPs up! Hospital execs win big : Deferred plans boost chiefs' 'longevity pay' by millions of dollars * Crain's)

Dr. Pardes gave an interview on Channel 13 today, where he sounded pretty desperate to spin a win-win situation for patients under Obamacare. But there was a competing article published in The New York Times on the same day as his interview. The article showed that cuts to hospital budgets, caps on Medicaid, and refusals to expand Medicaid, and hospital closings was leading to serious life-threatening healthcare emergencies. Yet, Dr. Pardes remained ignorant of public health disaster caused by the wave of hospital closings instigated by Gov. Andrew Cuomo under Stephen Berger's Medicaid Redesign Team.

HERBERT PARDES: … I think to his credit, the Governor in New York did a good job in terms of putting a cap on the Medicaid budget. And he worked collaboratively with the providers and brought the cost down substantially.

So, the whole story isn’t beautiful, but there are parts which are.

RICHARD HEFFNER: But you’re saying, I gather … and that’s a beautiful point, if, if I understand correctly … that service is not going down, costs are not leveling because people are being less well served.

PARDES: Well, that’s exactly the kind of combined focus that people should undertake. Which is to say, bring costs down, but not at the expense of a clinical care of the patients. And we feel very strongly about that. So wherever we’ve taken out costs and there’s another part to this story, which is New York Presbyterian simply taking out costs … we’ve done it, but protected the clinical care aspect of our hospital. So … (More about the Dim Future of American Medicine * Thirteen.org)

If uninsured or underinsured patients have no insurance under Obamacare because Republican-led states opted out of expanding out of Medicaid, how do Obamacare supporters explain the draconian, scorched-earth campaign by Gov. Andrew Cuomo and Wall Street banker Stephen Berger's efforts to close hospitals, which are used as safety net care by the poor, before primary care is set up as a replacement ? Conveniently, it always goes unsaid how the closing of emergency rooms, full-service hospitals, and trauma centers will impact patients' likelihood of survivals (their healthcare outcomes) in life-threatening medical emergencies, when the next nearest full-service hospital or trauma center is further away ?

… A government subsidy, little known outside health policy circles but critical to the hospitals’ survival, is being sharply reduced under the new [Obamacare] health law.

The subsidy, which for years has helped defray the cost of uncompensated and undercompensated care, was cut substantially on the assumption that the hospitals would replace much of the lost income with payments for patients newly covered by Medicaid or private insurance. But now the hospitals in states like Georgia [, which like other Republican-led states, refused to broaden Medicaid after the Supreme Court in 2012 gave states the right to opt out, ] will get neither the new Medicaid patients nor most of the old subsidies, which many say are crucial to the mission of care for the poor. ...

… The cuts in subsidies for safety-net hospitals like Memorial [in Georgia] — those that deliver a significant amount of care to poor, uninsured or otherwise vulnerable patients — are set to total at least $18 billion through 2020. The government has projected that as much as $22 billion more in Medicare subsidies could be cut by 2019, depending partly on the change in the numbers of uninsured nationally.

The cuts are just one of the reductions in government reimbursements that are squeezing hospitals across the country. Some have already announced layoffs. In Georgia, three rural hospitals have closed this year. … (Cuts in Hospital Subsidies Threaten Safety-Net Care * The New York Times)

New York’s Ongoing Blackout: Hospitals in Lower Manhattan (Pro Publica) * St. Vincent’s Is the Lehman Brothers of Hospitals (New York magazine) * Governor Cuomo’s Medicaid cuts may kill 10 city hospitals (The New York Post)

Christine Quinn, Jennifer Cunningham, Stephen Berger, and Hospital Closings

How did Stephen Berger get away with closing so many hospitals? The story begins like this ....

An excerpt from Chapter 9 of Roots of Betrayal : The Ethics of Christine Quinn, available now for a free preview on Scribd :

The hospital closings called for by the Berger Commission were formulated at a time when only some hospital patients were covered by job-based health insurance, and hospitals were forced to write down the economic costs from treating underinsured and uninsured patients. The Berger Commission, headed by a Wall Street banker, Stephen Berger, was only capable of seeing the provision of full-service hospital care from perspective of profits, losses, and debts, instead of from the perspective of providing people with the human right to healthcare. “We have a history in this state of pumping money into the system and not letting hospitals close even if they should,” Mr. Berger told The New York Times, adding, “You have to right-size the system, you have to shrink it, that is No. 1.” In typical Wall Street fashion of divorcing any moral dilemma from situational ethics, hospital closings were pushed as inevitable, and patients were expected to have to deal with it. This was about a decade before "Obamacare" would extend healthcare coverage to millions of uninsured Americans. Back then, Mr. Berger observed overcapacity among hospitals, which had to be cut. However, in the future, Mr. Berger’s draconian cuts would prove to gut healthcare infrastructure leading up to the time when Obamacare would lead to a large influx of newly covered healthcare patients. But even without knowing that healthcare coverage would be expanded within the next decade, back then healthcare advocates knew about the dangers of past outbreaks, pandemics, and unforeseen uses of bioterrorism agents, such as anthrax. There were reasons why it was penny wise and dollar foolish to make drastic cuts to full-service hospital capacity in New York City.

One healthcare union, 1199/S.E.I.U., had to scramble to deal with the fallout over job losses from the impending hospital closings. Jennifer Cunningham, who at that time worked as a spokesperson and political operative for 1199 and would later go on to work for Christine as a political campaign consultant, was more concerned at the time about employee retraining and not about the interruption of patient-centered care. The hit list of hospitals that would be targeted for closure by the Berger Commission came to be known as the Berger Commission Report, and Christine, as chair of the City Council Health Committee, was largely absent from the initial public conversation in 2004 and 2005 around Mr. Berger’s recommendation for hospital closings. Taking her cue from former Speaker Gifford Miller’s precedent of maintaining silence on the controversial West Side Stadium until the project’s outcome was clear, Christine was not visible in the resistance movement to fight the Berger Commission Report’s recommendations until very late in 2006, when the City Council issued its own report just weeks before the Berger Commission Report’s final recommendations would go into effect on January 1, 2007.

Read more : Roots of Betrayal : The Ethics of Christine Quinn, available now for a free preview on Scribd.