The Observation Deck

Notes to self:

Forget about the Hospital as a bad real estate deal. Think about it as a murder mystery.

The Setting

The location is in Lakewood, Ohio; a moderate size inner ring suburb of Cleveland. The area is sometimes called the North Coast or North East Ohio. It is a region of declining population that is slowly losing economic and political clout.

Cuyahoga County, with the largest and poorest population, is reduced to offering hundreds of millions in subsidies to sports teams, convention centers and various non-profits. Companies like American Greetings are offered $100 million subsidies in an effort to stem the tide. Additional millions in subsidies are offered to convince people to move to the downtown area.

Each community is left with little option but to engage in economic cannibalism. They are reduced to spending money to bribe people to move from one side of town to the other. A zero sum game that breads desperation at City Halls across the region.

The Crime

The crime was the murder of Lakewood hospital. Lakewood Hospital was a thriving independent hospital with nearly $140 million in revenue and over 35,000 annual ER visits. The Hospital was blessed with over $100 million in cash and liquid investments, modern equipment and a large and diverse customer base. And it was profitable, very profitable.

Metro Health, a leading healthcare provider in the region, offered to invest $100 million in the facility and guarantee at least 1,000 jobs. It was open to a lease, a lease purchase or outright purchase or any other arrangement that could be agreed on.

The Suspects

Ed Fitzgerald – An ex-Mayor of Lakewood who began planning the crime before he was first elected Mayor.
Michael Summers, who succeeded Fitzgerald, began the decanting process. The decanting process was the policy to slowly move the Hospitals most profitable business to Cleveland Clinic facilities. He and his predecessor packed the LHA Board with their friends, relatives and political allies. “The Hospital is not closing” was the battle cry.

City Council
David Anderson
Sam O’Leary
John Litten
Tom Bullock –
Cindy Marx
Mary Louise Madigan

What were their motivations, a promotion at a Cuyahoga County government job or an endorsement for higher office? Those running recently made no mention of the Hospital deal in their election campaigns. Why? Fear? Shame?

Tom Bullock is said have used his influence to alter board records. Is that a crime? Why risk so much to close a Hospital? Why wouldn’t even one member of Council stand up for the institution? Why?

Mary Louise Madigan used her influence on Council to sabotage the hospital and used her votes on Council weaken the Hospital. Why?
What to think about that? To paraphrase Rick from the movie Casablanca: “I don’t object to a corrupt politician. It’s a cut rate one that I object to”.

New members of Council- will they seek the truth or will they settle in to a comfortable sinecure?

The LHA Board

What type of Board members engages in a secretive effort to destroy the institution they were sworn to protect?
Ken Haber – We did not want to be involved in a bidding war
Ken Haber – It’s none of our business what the Clinic charges in administrative fees
Ellen Brzytwa – I have read a book. The book says hospitals are obsolete

Others – More interested in the social aspects of being on the board. Social climbers? In over their head? One board member stated privately that it was a bad deal. Why privately and not publically?

The Board should have been independent, in theory at least. The reality was that the board was run by a small clique who had their own interests at heart. The needs of the community were not considered. Why?

The Local Media

The Plain Dealer. What needs to be said? The paper has printed numerous articles and editorials about the lack of economic growth in the region, the desperate state of the job market and the importance of preserving every job we have. But when a City is about to lose 1,500 jobs there is silence.

A special mention goes to Brett Larkin at the Plain Dealer. He loves to write about open government, honesty in government, importance of access to health care and the problems of the inner ring suburb. Yet he was openly hostile to Lakewood Hospital and rooted for its closure. He had nothing to say when the City openly defied the courts in an effort to hide public documents.

Did his support of regionalization affect his judgment? Much of his writing about regionalization can be summed up in the phrase, If Lakewood (and other cities) didn’t exist Cleveland would prosper.

A coincidence? When asked about coincidence Sherlock Holmes said, “The universe is rarely so lazy”.

Local broad cast media

They made some small attempt to report objectively but each report was followed by a call from the Cleveland Clinic. The not so subtle message was: How much money do we spend on advertising?

County Government

The closure of the Hospital will increase urban sprawl and yet our County government was all in. Why?

The Cleveland Clinic

The Clinic is a profitable $7 billion corporation that uses its tax free status to out muscle the competition. Its most recent financial statements report charity care of about $80 million. You don’t get that big without being a fierce competitor.

Like Tammany Hall supporter George Washington Plunkitt said, “I saw my opportunities and I took em”.

Motive

The rewards for the suspects were pretty small. The rewards for the City were non-existent. The Subsidium report stated that there was no material benefit to the city in the deal.

The Clinic seems to have reaped the biggest reward but the suspects could have cut the Clinic out of the deal at any time. Why give a way so much for so little? But wait! Were the rewards so little? Little to the city yes, but what about the individuals involved? Was there a series of secret as yet to be discovered side deals?
Who gained the most? What did they gain?

The motivation is still something of a mystery. Maybe there is no motive. Maybe all of them were deceived. Maybe their desperate attempts at cover ups, their verbal and legal assaults on people who ask questions and their abuse of public power stem from the simple fact that that got snookered and are embarrassed to admit it.

Can you write a mystery novel without a motive?

Any motive as well as the tools of implementation can only be ascribed to the Cleveland Clinic. It was the only recipient of any benefits. All the others that you mentioned were simply chumps, played by the Clinic for its desired outcome.

Stan Austin wrote:Any motive as well as the tools of implementation can only be ascribed to the Cleveland Clinic. It was the only recipient of any benefits. All the others that you mentioned were simply chumps, played by the Clinic for its desired outcome.

Mr. Austin - so it appears, which is why I will never give the Clinic a pass on this.
Mr. Call - nicely if not beautifully summarized. Hear, hear!

Just one more thing, sir.....

Or things, as it were...

A few things missing here would likely include a cigar, an old raincoat, and a faded blue-gray 1959 Peugeot 403 convertible.

Back to the re-runs...

And what did the Chumps get? Maybe peanuts. Thanks for the shrewd managing guys.

Mais plutôt l'image d'une pipe.... D'accord?

On joue plus que des banjos à Lakewood mes amis....D'accord?

Retour au banjo et aux destins de la vie, citoyen...

okey dokey!

I finally found a way to achieve complete agreement on the 'Deck.

Write in French!

Retour au banjo!

While I'm personally a firm believer in the right to and value of a full accounting, on an important public policy act like this, I have doubts there there is any plot-redefining mystery still unsolved. I would say that a complete big picture has basically been available, for those interested in it, for at least a couple of years now.

It seems that we largely know what resources were lost to the public, and what (claimed) gains replaced them, and have formed our opinions on whether or not this represents a net positive. We know who was ultimately responsible, because whoever else may have been involved, public officials gave their assent to this in a public meeting. A number had conflicts of interest, but we know many of those. A couple were within days of leaving office, but we know which. Others did so right after successfully appealing to voters, but without having clearly informed voters that this was how they would dispose of this known issue; we know who they are also.

As for motive, I think this probably presents limited interest, given the above. I once wrote almost 1,200 words speculating on possible motivations, and felt like a convincing explanation is entirely possible without any direct quid pro quo bargains, secret or otherwise.

Of course if any do exist we should know about them. And as noted, I believe that a complete airing of the record is appropriate anyway because this was important public business…

…on which basis I suspect that the much, much protracted opposition to such an airing will perpetuate a lingering suspicion that some mysterious secret remains hidden.

I have no idea. I can say that from my layman's perspective, the 20 months of various defenses offered against a related public record lawsuit are tough to square with a sincere willingness to let complete, or even mostly complete, records of public business be public.

As I recall, these defenses have relied heavily on things like "these requests don't make sense," "all the paper would be too burdensome," "searching electronic records would be too burdensome also," and least reassuringly, "we don't have to." As best I can discern, the case is now deep into the weeds of challenging the acceptability of responses to motions to responses to motions. Which seems, again to a layman, like it might invite the analysis recently suggested in another local lawsuit: that the extent of protest is remarkable, and ultimately a choice.

Last year's release of a large number of records which obviously did exist and could be released, but seemingly would have remained undisclosed absent court intervention, does suggest that there is a choice being made.

Whatever my own guess, therefore, it's just difficult to insist that some significant secret definitely does not exist.

Mr. Call's image of the pipe may be instructive.

It reminds us that the illustration of a pipe is not itself a pipe.

Like a good Agatha Christie mystery, I will suggest that we are not even half-way through the novel.

We've also seen one very interesting "red-herring" crop-up recently.

Why would anyone go so far as to forge an official-looking press release from the Ohio Attorney General related to the Lakewood elections on the hospital issues?

This was a crime and an obvious one.

Could that have been done to scare-off a "detective" like ourselves who was looking too closely at documents that the City did not control?

Stan Austin wrote:Any motive as well as the tools of implementation can only be ascribed to the Cleveland Clinic. It was the only recipient of any benefits. All the others that you mentioned were simply chumps, played by the Clinic for its desired outcome.

Sheriff Austin,

Lakewood benefited handsomely with the following wisdom:

"The strategic vision of healthcare for the Lakewood community is based on the knowledge healthcare is changing from facility- and physician-based paradigm, designed to care for the sick, to a population based effort that aims to improve the health of an entire community by helping people live healthier lives treating their health conditions early to prevent chronic diseases, and reducing the need for "sick care" in hospitals. This is the future of healthcare."


This is not a pipe. Lakewood is no longer an entire community--it is two halves.

Brian Essi wrote:

Stan Austin wrote:Any motive as well as the tools of implementation can only be ascribed to the Cleveland Clinic. It was the only recipient of any benefits. All the others that you mentioned were simply chumps, played by the Clinic for its desired outcome.

Sheriff Austin,

Lakewood benefited handsomely with the following wisdom:

"The strategic vision of healthcare for the Lakewood community is based on the knowledge healthcare is changing from facility- and physician-based paradigm, designed to care for the sick, to a population based effort that aims to improve the health of an entire community by helping people live healthier lives treating their health conditions early to prevent chronic diseases, and reducing the need for "sick care" in hospitals. This is the future of healthcare."

Thus, enabling the City of Lakewood to propose giving away the former Lakewood Hospital to its preferred developer for nothing along with $7 to $10 million dollar in site preparation value. Nice package!