Scott MacKay Commentary: What Memorial Closure Means For RI Health Care

Oct 20, 2017

Memorial Hospital in Pawtucket announced plans last week to close, citing financial troubles. RIPR political analyst Scott MacKay says that while politicians protest, no one should be surprised at this development. 


Memorial Hospital’s closing has brought down the wrath of a passel of Rhode Island pols. Among those protesting:  Attorney General Peter Kilmartin, Pawtucket Mayor Donald Grebien,  State Sen. Elizabeth Crowley, D-Central Falls, and Lt. Gov. Dan McKee all piled on as management announced the shuttering of the Blackstone Valley hospital.

Grebien accused hospital management of “giving up on an urban community” and putting profit ahead of people. Even the union representing nurses and other employees chimed in, saying the hospital turned its back on “Blackstone Valley families.”

Which begs the question: Just what did they expect of a hospital that was bleeding millions of dollars in red ink?

It appears that the political hierarchy has once again failed to evaluate the state’s medical care system in any comprehensive manner. As the pols crank out the angry press releases, Rhode Islanders should be asking just where they have been.

Back in 2013, the General  Assembly commissioned a report by the Health Care Planning and Accountability Council that said the state was on track to have an excess of 200 hospital beds by 2017. The report documented a drop in inpatient hospital stays by 11 percent between 2007 and 2010, compared to a national decline of less than 5 percent.

At the time, the Rhode Island Business Group on Health, a group of small business professionals concerned about rising health insurance costs, wanted the Assembly to create a commission to make binding recommendations on hospital closings and mergers.

As is too often the case at the Statehouse, this effort appears to have gathered dust on a shelf.  Lawmakers decided to take care of their own backyards, failing to consider the state’s whole health network and where individual hospitals fit.

Some years back, Landmark Medical Center in Woonsocket was allowed to invest in an ill-fated attempt to compete with the teaching hospitals in Providence for heart surgery patients. All that did was waste money. The program was soon abandoned.

More recently, Lifespan, the state’s largest hospital chain, sought approval to open a unit at Rhode Island Hospital to deliver babies, despite that hospital being a nine-iron golf swing away from Women & Infants, which specializes in, you guessed it, delivering babies.

Graft Rhode Island’s famous parochialism onto this issue and nothing much ever gets done in a rational, planned manner. As Robert Hackey, a professor of Health Policy at Providence College says, tackling issues on a regional basis “is a foreign concept” here.

Others who work in the state’s health care system or study it for a living agree that we have more hospital beds than Rhode Island needs or can support, says Anya Rader Wallack, who ran the state’s Obamacare program and is now a researcher at the Brown University School of Public Health.

Her sentiment is echoed by Dr. Michael Fine, the former director of the state’s health department. Fine, currently health policy advisor  in Central Falls, has for years advocated shifting more resources to  efficient primary care services from high-cost hospitals.

Fine says that no reliable research shows that the number of hospital beds in a community has any impact on the health of the population.

Health care wonks have for years advocated moving away from expensive fee-for-service, which  rewards hospitals for treating the sick and move to a system that emphasizes patient wellness.

It hasn’t happened.

Closing Memorial won’t mean the neglect of sick people. Two of New England’s premier teaching  hospitals – Rhode Island and Miriam – are less than seven miles from Memorial. Yet Rhode Island will lose out on training young doctors. More than one of every five primary care doctors in training are at Memorial through its partnership with Brown’s medical school. Without Memorial, it is inevitable that some of these residents will have to leave Rhode Island.

Gov. Gina Raimondo has emphasized luring jobs to Rhode Island from other states. The governor and Assembly leaders ought to figure out how to keep the medical jobs we already have, before another hospital goes the way of Memorial.

Scott MacKay’s commentary can be heard every Morning on Morning Edition at 6:45 and 8:45 and on All Things Considered at  5:44. You can also follow his political reporting and analysis at our On Politics blog at RIPR.org