SUNY Downstate Medical Center in New York threatened with closure

Healthcare workers and community residents are protesting a “transformative plan” that could result in the closure of State University of New York (SUNY) Downstate Medical Center in the East Flatbush neighborhood of Brooklyn. The neighborhood has already endured several hospital closures that have limited patients’ access to care and increased the burden on the remaining healthcare workers. On February 29, hundreds of people rallied in support of SUNY Downstate, shutting down the block where it is located. 

SUNY Downstate Medical Center. [Photo by Jim Henderson / CC BY-ND-NC 1.0]

The medical center is overseen by the SUNY Board of Trustees. Fifteen of the board’s 18 members are appointed by New York’s governor. Citing years of financial emergencies and structural problems, such as flooding and poor temperature control, SUNY Chancellor John B. King Jr. developed a plan with the ostensible goal of keeping the facility afloat. 

Governor Kathy Hochul, a Democrat, embraced the plan, which her office claims would provide a modernized facility and protect healthcare jobs. But initiating the plan would mean that SUNY Downstate would no longer operate at its facility in East Flatbush and no longer provide inpatient services. Workers and area residents say that the plan is a closure in all but name. 

“Brooklyn needs this hospital,” Dr. Joel Gernsheimer, an emergency physician at SUNY Downstate, told Brooklyn Paper. “We need not just the ER or the clinics, we need the inpatient services because we have a lot of sick patients and we don’t have a place to put them. And Kings County, where I also work, doesn’t have a place to put them.” 

SUNY Downstate is a teaching hospital in a predominantly African American neighborhood. It mainly serves patients with Medicaid and those with inadequate insurance. The hospital is one of two high-level perinatal care centers in Brooklyn. It is also the only medical facility in the borough that performs kidney transplants. Under the proposed plan it is unclear whether the kidney and perinatal care programs would still be provided in East Flatbush. In addition, without inpatient services, SUNY Downstate would lose revenue from Medicaid reimbursement. 

Hospital quality is “generally low across in Brooklyn and is lowest in communities with a large proportion of black residents,” according to a report that the state Health Department published in January. Despite the need for its services, SUNY Downstate has endured decades of disinvestment. 

In a statement in February, King advance several justifications for why the “transformative plan” is allegedly needed. He said that the hospital is operating with a $100 million deficit and claimed that the building is so dilapidated that it would cost SUNY more than $4 billion to repair it. He added that fewer than half of the hospital’s available beds are in regular use. 

The plan includes $300 million in capital investments and $200 million to enable community engagement in planning SUNY Downstate’s future. It would also transfer staff to nearby hospitals like Kings County Hospital Center, which is part of the NYC Health + Hospitals system of public hospitals. Moreover, as many as 345 workers at SUNY Downstate could lose their jobs.

If the proposal is adopted, “vital functions of Downstate will be drastically compromised,” department chairs at SUNY Downstate College of Medicine wrote in an open letter that was published in BK Reader. The plan would undermine the hospital’s core missions and harm the College of Medicine, they added. 

The department chairs also rebutted the arguments that King advanced to justify the “transformative plan.” They called the $100 million deficit temporary and attributed it to SUNY Downstate’s designation as a COVID-only hospital during the early part of the pandemic. The designation precluded normal operations at the hospital. They also questioned the claim that the hospital is falling apart and would cost $4 billion to repair. One of seven floors has been completely renovated, they noted. Furthermore, the new Ruth Bader Ginsburg Hospital, which is larger than SUNY Downstate, cost $923 million to build. 

The department heads also called King’s claim about the hospital’s daily census “disingenuous.” Although SUNY Downstate has more than 350 originally certified beds, it is staffed for the number of beds that can be occupied, which is about 180. The hospital’s average daily census is 150. 

Moreover, SUNY’s proposal to transfer inpatient care to a wing of Kings County Hospital, which is across the street from Downstate, “is entirely unrealistic,” according to the department heads. King’s County does not have the bed space to accommodate these patients, they asserted. Nor has Kings County agreed to the plan. 

One can be certain that improving healthcare in an underserved area is not the motivation for the “transformative plan.” The plan was developed and is being promoted by current and former officials of the Democratic Party, which represents the interests of Wall Street. King, the chancellor of SUNY, previously served as New York state’s education commissioner under Governor Andrew Cuomo. He subsequently became secretary of education under President Barack Obama. Many of the SUNY trustees have served in state government under Democratic governors such as Hochul and Cuomo. 

In New York, as throughout the country, the Democrats have a record of antagonism toward public health when it conflicts with the accumulation of private profit. At the beginning of the pandemic, Cuomo required nursing homes to accept residents who had tested positive for COVID-19. The policy resulted in more than 15,000 deaths: a figure that Cuomo tried to cover up. Today, the Democrats are promoting the lie that the pandemic is over, and all measures to track the virus, isolate infected individuals and control transmission have been abandoned. 

At the national level, the Democrats’ main priorities are the escalation of the war against Russia in Ukraine, which threatens to become a nuclear conflagration, and the continued support of Israel’s genocide against the Palestinians in Gaza. This slaughter is part of an unfolding third world war, which the Democrats are working to expand. President Joe Biden has ordered attacks on alleged Iranian proxies in Iraq and Syria and has also overseen arms deliveries and provocative official visits to Taiwan, which are intended to provoke a military response by China. 

The “transformative plan” for SUNY Downstate has also emerged amid tens of thousands of layoffs in the healthcare industry. Layoffs have recently occurred at University of Chicago (180 workers); John Muir Health in Concord, California (164 workers); and Novant Health in Winston-Salem, North Carolina (160 workers), to name only a few. The systematic downsizing of healthcare is being pursued, even amid the second largest wave of the pandemic, in order shore up profits for the private health systems. It is also intended to suppress rising working class opposition by creating mass unemployment. 

In Brooklyn and around the world, the fight to safeguard public health and to provide universal access to the best medical care requires a fight against the capitalist profit system, which subordinates critical social needs to the drive for private enrichment. Victory in this struggle requires a struggle against both capitalist parties, based on the working class, in the fight for the socialist reorganization of society.