The Observation Deck

The Future of Healthcare In Lakewood

First, let me get my personal opinion out of the way.

I, personally, would never rely upon Build-Lakewood to advance any agenda on healthcare.

Healthcare is a crucial public good that must not be sacrificed in order to advance general commercial business concerns.

This is exactly what their successful campaign to close Lakewood Hospital and donate the closed hospital to a developer has achieved.

However, because Build-Lakewood was successful in achieving the adoption and enactment of its public policy agenda, we now have to live with it and understand what it really means for us.

Here's what Mayor Summers tell us:

"[...] we are focused on being the healthiest community in the country. Currently there is a convergence of health care related investments that offer a unique opportunity to become healthier."

The "new model of healthcare and wellness" advocated by Build-Lakewood and adopted by civic leadership, that we have heard so much about over the past 3 years, is not an investment model at all, but exactly the opposite--radical disinvestment in local healthcare.

The Disinvestment Model for Local Healthcare

Here is the factual evidence for the disinvestment model:

1. All hospital-based services closed down.

2. Medical office building serving hospital torn down.

3. Key independent physicians serving the hospital relocated or retired.

4. Loss of valuable and significant levels of charity care previously provided by hospital.

5. Highly-skilled professional and semi-professional healthcare jobs relocated to other communities.

6. Significant changes to emergency-preparedness infrastructure of the city.

7. Award-recognized community hospital to be torn down.

(Thousands of words, that I do not need to repeat here, have been written about the community, financial, and economic value of the disinvestment reflected in points No. 1 thru No. 7.)

8. Charitable funds raised and invested to support hospital severed from dedicated hospital support and reorganized for regional use (no longer Lakewood specific.)

9. New medical office building (Family Health Center) built on site of old medical office building consolidates mostly preexisting non-hospital medical services.

10. New medical office building (Family Health Center) maintains emergency room functionality; provides additional services to under-served community.

11. Healthy Lakewood Foundation -- thinly-funded and not yet operational after two and a half years -- will have only modest impacts on wellness-related goals due to limited revenue.

When the mayor talks about convergence he is not talking about points No. 1 thru No. 7. The "new model of healthcare and wellness" depends on the final points on this list.

Build-Lakewood Healthcare Objectives In Action -- A Model for 2024

There is enough information in publicly-available documents that we can reasonably attempt to model some of the dollar values that will be available for healthcare in Lakewood in 2024 under the Build-Lakewood public policy agenda. Where I have actual numbers from documents, I have used them. In some instances, like Three Arches, I have had to propose reasonable estimates based on approximated values.

This illustrates the actual effects of the Build-Lakewood public policy agenda in action. --Diminished available funds and demolished public assets.
I have also posted a PDF copy for general use.

Parma Has Hospitals, Lakewood Has None

Yes, note the plural on hospitals.

Another quick comparison that you can do.

Take a moment and use Google to search the phrase "hospitals in Parma". --Go to the map and look at all the hospital "pins".

You will immediately see that Parma is significantly better prepared for a natural disaster than Lakewood.

Parma is the second largest suburb, Lakewood is the third largest.

List Grows Longer -- The Disinvestment Model For Healthcare in Lakewood

Please read this list carefully.

This list reflects the intentions and achievements of Build-Lakewood and its supporters. I've added a couple of additional factual points.

1. All hospital-based services closed down.

2. Medical office building serving hospital torn down.

3. Key independent physicians serving the hospital relocated or retired.

4. Loss of valuable and significant levels of charity care previously provided by hospital.

5. Highly-skilled professional and semi-professional healthcare jobs relocated to other communities.

6. Significant changes to emergency-preparedness infrastructure of the city.

7. Award-recognized community hospital to be torn down.

A. "Hospital" removed from the Third Amended Charter to eliminate future possibilities within our home rule powers.

B. Loss of healthcare data analytics and the Community Health Needs Assessment reports formerly prepared by Lakewood Hospital.

Social and Healthcare Safety Net Dismantled

Lakewood now has fewer physical and financial assets for the delivery of healthcare than it did in 2015 and it changed its municipal charter to remove hospital operations from its scope of governance.

For more than three years now, multiple public relations firms have spent thousands-upon-thousands of dollars promoting an illusion -- the illusion that residents of Lakewood are receiving a “new model of healthcare and wellness”.

However, the truth is:

Long-term public healthcare infrastructure that served the residents was intentionally dismantled to the long-term detriment of residents; and the value of this public infrastructure was transferred or diffused to the benefit of other communities, but more crucially to mundane commercial development purposes.

This all came at a high, but largely invisible, cost to the social and healthcare safety net of our city.

We can credit Build-Lakewood with much of this including the substantial sums that were spent on advertising and marketing their agenda to achieve economic development at any cost.

Mr. Kindt, Build Lakewood was never meant as a serious advocate for development in Lakewood. Build Lakewood was a shill shell organization meant to provide cover for the Mayors plan to move Lakewood Hospital to Avon. Now that its mission is accomplished its mission is over.

Bill Call wrote:Mr. Kindt, Build Lakewood was never meant as a serious advocate for development in Lakewood. Build Lakewood was a shill shell organization meant to provide cover for the Mayors plan to move Lakewood Hospital to Avon. Now that its mission is accomplished its mission is over.

Bill

I disagree, BuildLakewood was created to give a false narrative, blow smoke to confuse, and have public meetings to try and convince residents they thought of closing the hospital and BUILDING a multi use strip mall, and giving the rest of the LHF/Lakewood Health Care assets to a small group to of friends of the Mayor, that had zero success elsewhere to play with.

The Clinic, side story, and the Mayor unable to comment was nothing more than the magician's assistant in the magic trick of making $200 million in public assets disappear, POOF!





Presto changeo , "What if there was nothing there?" The point of no return...

.

Bill Call wrote:Mr. Kindt, Build Lakewood was never meant as a serious advocate for development in Lakewood. Build Lakewood was a shill shell organization meant to provide cover for the Mayors plan to move Lakewood Hospital to Avon. Now that its mission is accomplished its mission is over.

Please recognize that I am reviewing the past record of this local group (Build-Lakewood) and how that past record is likely to affect future major public subsidies and radically diminished healthcare services.

No local group (with the exception perhaps of Lakewood Hospital Association) has been more involved in such a major transformation of our city as Build-Lakewood.

Yes, the city administration has been instrumental in this transformation as well, but Build-Lakewood was well-organized, highly adversarial, and spent serious funds to affect important local ballot initiatives.

Guess What? The Tin Foil Hat Crowd Was Correct

Civic leaders and Build-Lakewood supporters derided members of Save Lakewood Hospital, and anyone else for that matter, as sentimentalists, geriatric cases, and the Tin Foil Hat Crowd.

Take a look at this table again and you can see that Save Lakewood Hospital was correct in it advocacy for the retention of an operational Lakewood Hospital.

It is all in the numbers. These are numbers collated from existing public documents (many posted here or on the city website).
This Is A Reasonable Picture Of Funds Available For "The Healthiest City In The Country."

Enough Funds To Build Two Hospitals

Lakewood Hospital will be demolished this year or next.

However, as a result of the adoption of the Build-Lakewood agenda, there is a tremendous amount of money (tens of millions of dollars) sitting around in various investment accounts; only a thin fraction of which will actually be expended annually for community health and wellness.

This is a very static approach to serving the actual present and pressing needs of low-income families in Lakewood.

This is the Build-Lakewood approach. Park the money in foundations, pay staff, and then distribute a small percentage of remaining investment revenues as grants. As grants to other non-profits they will again have to meet staff compensation needs or other internal cost needs before they impact the community.

These funds will be further diluted because they are not all fully dedicated to local Lakewood needs.

Keep in mind that the funds in these foundations are large enough to build two modern hospitals

Any hospital would generate more cash flow, serve more families, and have more sheer local economic impact than funds managed passively to generate revenue for grant distribution.

However, this is the public policy choice our civic leadership has insisted upon -- the public policy option that on a long-term basis delivers the least benefits to the community.

Other civic leaders in other suburbs are focused on new hospital infrastructure -- Avon, Beachwood, Cleveland Heights, Medina, Parma.

In Lakewood, our leadership dismantles what all communities really need.

The investment pools that I am describing are all Lakewood Hospital-related. They result from the liquidation of the hospital under the Master Agreement and the severing of the hospital foundation from its original dedicated charitable mission to support that hospital.

Investment Risk

The investments held by the Three Arches Foundation and those that will be held by the Healthy Lakewood Foundation are subject to normal investment risks, some of which can be substantial or severe.

The Great Recession of 2008-2010 is not that far behind us. Regulatory fixes associated with that event have been dismantled. Are the stock and bond markets any less volatile than previously? No, probably more volatile.

So, in some future scenarios, there may be years when disbursements for grants are limited due to market contractions.

Protected Risk

Let's contrast investment risk for charitable foundations with other non-profit risks that can actually enjoy various types of risk protection.

For instance, a hospital!

Unlike investment pools, a hospital can acquire a wide range of insurance protections (policies) to mitigate or cover certain types of loss.

This insurance protection has been augumented by Ohio statutes that further limit amounts and types of damages that can be collected.

What is fascinating about a hospital is that it has an obligation to spin-out charity care to the community.

That's how a hospital losses its money -- by distributing more services to those in need.

This disequilibrium (of loss) is balanced by the scale of charges to other users that effectively covers the cost of this obligation.

The system is actually designed to do this.

Neither the Three Arches Foundation nor the Healthy Lakewood Foundation will ever be able to provide the care and support equal to that provided by any average hospital.

Dynamic Healthcare Services versus Static Investment Pools

Formerly there was a hospital that delivered healthcare services to Lakewood residents and others on a 24/7 basis providing employment to as many as 1,662 individuals.

These services were paid for by insurance, Medicare, Medicaid and individuals; thus generating some pretty massive cash-flows to the providers that also splashed out into the local economy as a very beneficial side-effect, not to mention all of the charity care delivered.

These dynamic hospital services are exactly what Parma enjoys. Let's contrast Parma with Lakewood.

The policy choice in Lakewood was to convert these dynamic healthcare services into static corporate investment pools.

Let's be clear that the investments held by the Three Arches Foundation and to be held by the Healthy Lakewood Foundation will largely be held in corporate bonds or corporate bond funds. These investment pools will be invested outside the region for non-healthcare purposes. Only the post-expense investment income will be available for use in the region.

It is still an open question as to how much of this post-expense investment income will actually be used to support community health and wellness in Lakewood.

The vast amount of the dollars of the "health care related investments" touted by Mayor Summers (Destination Lakewood 2018, p. 2) are actually investments in out-of-state corporate bonds or corporate bond funds.

This represents tens-of-millions of dollars disconnected from local healthcare needs.

Your thoughts? It may be because I haven't attended meetings but this explanation was new to me.