SXSW looms, Seton's dubious deal, the war moves closer, the city silences the music, and the new GOP loves deficits.
Through the Looking Glass I: Seven years ago Seton Healthcare Network assumed the administration of Brackenridge Hospital because of its budgetary troubles. This responsibility was a public trust: Seton, though private, was working for us, Austin citizens. Recently, a group of responsible civic leaders began talking about a hospital district for Travis County -- the discussion, though very welcome, is several decades late; if such a district existed the Brackenridge crisis wouldn't have occurred. The hospital district would have taxing authority, thus spreading health care costs more equitably throughout the county. Now, the city bears the greatest burden.
Seton has been involved in the district planning discussions. Less than a decade after assuming the public trust, while participating in these talks, Seton revealed its almost-completed plans to build its own Children's Hospital, closing most of the existing operation. This would be taking over Brackenridge's most lucrative and only profitable division.
The hospital district first needs legislative approval and will then be on the ballot, probably in November. Many will oppose it because it means new taxes, especially for noncity county residents. Losing Children's would give critics another argument against the district. City leaders have argued that creating the district would be tax neutral for Austin residents -- city property taxes could be cut as hospital taxes were implemented. If Seton takes over Children's this won't be true; the new tax will create an overall increase for city taxpayers. The cost of operating Brackenridge without Children's would still be the city's responsibility. Given the current economic climate, removing Children's from the equation makes getting voter approval for the district more difficult.
Seton's brazen act of corporate self-interest and its at-best-misleading participation in planning discussions should have resulted in a citywide hue and cry. Instead, our city leaders whined a bit, then indicated that there was little they could or would do to stop this. Initially, however, the hospital was to move far north, which alienated everyone, especially the concerned doctors. As a compromise, Seton decided to try to move to the old Mueller Airport. Under the new proposal (as currently described) Seton will still own this new hospital, but if they leave Brackenridge in less than 53 years (the 23 years left on their current lease extended by 30) they'll owe the city $50 million. If the city removes them, it owes Seton $50 million. It's not entirely clear who has crafted this "deal," since the city manager says as far as she's concerned, Seton and the city are still in discussions. Maybe it's Tweedledee and Tweedledum?
Any deal that offers money if a contract isn't honored just doesn't inspire much confidence; shouldn't it be assumed the contract is binding? Given that Children's is worth between $100 million and $300 million, if the Seton management deal collapsed next year, $50 million for it effectively to purchase the hospital outright is a bargain. What about in 20 years, when Children's is worth so much more and $50 million so much less? The classic city of Austin endgame would have Seton at some point doing a lousy job. The city then throws Seton out without paying careful enough attention to the contract's details. Seton sues, ending up with $50 million and Children's Hospital.
Adding to my disillusioned state is a Feb. 10 Statesman editorial. It begins by perceptively (mis)quoting the Godfather's famous line, "I'll make them an offer they can't refuse." The classic one-sided Corleone deal is normally achieved by physical threat -- but the quote works just as well, unfortunately, when applied to Seton's political clout. The editorial, however, was in favor of the deal, not against it, offering almost surreal arguments. The deal breaker was that Seton wanted to own the hospital -- but the solution is that Seton owns the hospital. Building the hospital will be a great spur for redeveloping Mueller -- which is barren and unwanted -- except that the city is in fact negotiating a development contract with Catellus for the site, and many area businesses and nonprofits have added their names to the list of potential occupants.
Ultimately, this is an issue of civic vision. In one scenario, the county gets a hospital district, keeps Children's Hospital, and provides better health care with less taxes for all citizens well into the future. In the other, the creation of the hospital district becomes a bit iffier and, if it even happens, more expensive -- but Seton is more profitable. In a half-century or less, the city could re-inherit a crippled community hospital gushing red ink. The former scenario would lead to more equitable health care for all, the latter to a class stratification between patient haves and have-nots that would only grow more pronounced over time. This should be a fairly easy decision -- but, as always, we just have to wonder about the city's priorities and long-term planning strategies.
TTLG II: Let's Keep Austin Weird and love the live music scene, while doing everything to kill it. I can't think of any civic, state, or legal action taken against the scene without the perpetrators proclaiming their love for music as they bashed nails into its coffin. Last time out it was the noise ordinance, this time it's the no-smoking ordinance. Every one who has spoken up for the smoking ban has proclaimed their love of music and how after the clubs are smoke-free they'll be going out a lot more to hear live music. Clubs love the occasional (even very occasional) visitor and the destination-band ticket buyer. They survive on the people who go out to the clubs all the time, and those people like to drink and smoke. Read Andy Langer's cover story this issue. The live music club scene is going through very tough times. Despite all rhetoric to the contrary, the best the city can come up with is funding the music channel -- badly complemented by the noise and no-smoking ordinances.
The health fascists are particularly scary. Most of us have moral positions that are like a gas, ideas formed from opinion, attitude, and personal history. The health-legislation activists' positions are as real as rocks: Based in science, they are facts, not opinions. Someone suggested that respecting the rights of smokers is like allowing drinking and driving. Let's do that better -- driving is inherently dangerous, with even the best drivers in danger from accidents caused by irresponsible ones. Let's ban driving, then fried chicken, chicken-fried steak, fried in general, foods with trans fats and those with too much sugar. Let's go out there and pass, pass, pass laws and make this a healthier, safer country, no matter what the cost. Goodbye live music, welcome health.
TTLG III: We're going to war soon. The timetable for this war has been completely driven by this administration. First we asked Saddam a classic have-you-stopped-beating-your-wife question: "Do you have weapons of mass destruction?" If the answer was an immediate "Yes," we would have been shocked, pointing out that this violated agreements and Saddam's previous statements. Thus war. And forget psychological profiles; common sense dictated he wasn't going to say "Yes." Then we got the UN to send in inspectors. If they found the smoking gun -- war! If they didn't find the smoking gun, it was clearly being hidden -- war! The whole time we kept ratcheting up the pressure. Why? Since this war is prompted by the U.S. agenda rather than by imminent danger, couldn't we have slowed the timetable down to give our economy more time to recover, our intelligence more time to expand its activities, and our diplomats more time to convince allies?
With war closer to days than months away, Osama bin Laden is now declaring solidarity with the Iraqi people. It doesn't matter that he makes it clear that al Qaeda hates Iraq's secular government and Saddam -- the smokingest-of-smoking guns has been found: the direct link between 9/11 and Iraq. Now, if bin Laden were against this invasion wouldn't he have stayed quiet rather than urging worldwide resistance? Instead he chose this time to make the connection at least symbolically explicit. Last week's question again: What about the U.S.-led invasion of Iraq won't al Qaeda like?
TTLG IV: At dinner recently my friend Melba Whatley offered the theory that some Republicans relish the current economic crises because despite the devastating effects, it gives them the opportunity to cut not simply the fat but also the flesh, muscle, and bone from government. Though they are taking advantage of the opportunity, I argued no one was so craven and mendacious as to be happy about it. I stand corrected; according to this week's news from D.C., they are delighted and hope things get worse. Not the first time Melba's been right in our disagreements, but the first time I've admitted it in print. Through the looking glass ... I'm off to join the Walrus and the Carpenter for a walk, lunch, and further Seton compromise discussions.