Election Day: Vote AGAINST Issue 64

Tuesday, November 8 is decision day on the ordinance that closed Lakewood Hospital. If you disapprove of the deal that closed Lakewood Hospital, vote against Issue 64.

Polls open at 6:30 a.m. and close at  7:30 p.m. If you need a ride to the polls, e-mail or call 440-341-5626.

Some polling locations in Lakewood changed in 2015, so confirm your polling place here. Bring identification, such as a driver’s license, military ID, utility bill, bank statement, paycheck, etc. (Consult a complete list of valid ID here.)

If you have a vote-by-mail ballot, you have until 7:30 p.m. to get your vote counted.

  • The best option is to take your ballot directly to the Board of Elections at 2925 Euclid Avenue in Cleveland.
  • If you need transport to the Board of Elections, please e-mail or call 440-341-5626.
  • You can vote at the polls, instead. You will receive a provisional ballot, which will not be verified on Election Day, but it will be counted eventually.
  • You cannot return your ballot by mail at this point.

Please help repeal the deal that closed Lakewood Hospital, by voting against Issue 64. Issue 64 is the last item on your ballot, on page 3.

Image of Issue 64 on November's ballot
Please vote “Against the Ordinance” on Issue 64

Issue 64 means bare-bones healthcare in Lakewood

What may be the biggest failing of Issue 64 is exactly what its backers claim that it secures: quality healthcare in Lakewood. Much like the Cleveland Clinic’s “Vision for Tomorrow” plan, a wide gap separates Issue 64’s marketing and what it actually provides.

  1. The ordinance that is now up for a vote as Issue 64 closed Lakewood Hospital, eliminating the majority of services, including crucial lifesaving treatments.
  2. Issue 64 keeps Lakewood healthcare limited, with a noncompete clause that prevents the Cleveland Clinic’s competitors from offering any service on the hospital site, even though it still belongs to Lakewood.
  3. In return for protecting the Cleveland Clinic’s market share, Lakewood gets no guarantees. Issue 64 specifically allows for eliminating even the limited emergency care which remains, just as the Clinic has already done elsewhere in northeast Ohio.

Limited Care

National Nurses United states plainly that “Communities need access to a full service hospital, including comprehensive emergency departments.” Local healthcare advocate Yvonka Hall, director of the Northeast Ohio Black Health Coalition, adds that the services left after a hospital closes are not only “bare-bones,” but are selected for their profitability rather than for their importance to patient health.

Residents who have turned to Lakewood’s ER in recent months have discovered this first-hand. When Marjorie Harris suffered a stroke, the Lakewood ER’s message to her husband was blunt: “don’t call us.” The Cleveland Clinic’s mobile stroke unit was nowhere near Lakewood. Local EMS rushed Ms. Harris to Fairview Hospital, but staff there could not help, either. Only after a second detour to the Clinic’s main campus did Ms. Harris finally undergo surgery, nearly four hours after her stroke.

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Hope and Realism

There are few attractions to closing Lakewood Hospital, ultimately. It leaves Lakewood with fewer jobs, much-reduced local healthcare, and an economic headwind for years to come. It’s difficult to deny that we deserve a better deal.

But are there really other options, besides the Cleveland Clinic’s offer of minimal services and a small share of hospital property which we already owned? There are obviously other hospital systems besides the Cleveland Clinic, but is it plausible that one would come to Lakewood?

It’s more than plausible, because hospital systems aren’t like cable companies.

Cable firms have essentially divided up markets among themselves, and simply will not enter each other’s territory to compete. Comcast doesn’t offer service in Cox’s territory, and vice versa. Although big hospital systems’ approach may look similar, it’s much less static.

Reasonable people can argue over how well market competition works in healthcare, overall, but hospital systems definitely compete. The Cleveland Clinic makes great fuss about its first hospital in Lorain County, but there are other hospitals already in the area; opening Avon Hospital is a perfect example of one system trying to expand into others’ territory. It’s by no means unique, and Becker’s Hospital Review is full of such maneuvering.

Unlike cable lines which are generally locked up by one company, hospitals simply don’t have such built-in monopolies, no matter how much they might like them. This is why the Cleveland Clinic has pushed for a noncompete clause in Lakewood: without it, competition is a very real threat.

Competition is possible even if MetroHealth and University Hospitals should decline a new invitation to operate Lakewood Hospital. There is more to Northeast Ohio healthcare than UH, Metro and the Clinic. Out of Ohio’s 100 largest employers, fully 15 are hospital systems. (Children’s hospitals account for a few more). Besides Cleveland’s big three, another four systems already operate hospitals within an hour’s drive of Lakewood.

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Ohio Nurses recommend vote against Issue 64

Ohio nurses affiliated with National Nurses United, America’s largest association of RNs, has recommended voting against Lakewood Issue 64.

“Protecting access to healthcare in our communities is essential,” Ohio Nurses emphasized in a recent statement. Dismissing the marketing around Issue 64, the union was firm in warning that the controversial deal to close Lakewood Hospital would not protect essential healthcare in Lakewood.

National Nurses United has consistently spoken out on the need for genuine, local hospital services. Echoing the comments of other healthcare professionals, NNU has warned “Time is life — delays are deadly.”

Without local hospitals, patients who “discover they require true emergency services would need to be rushed to a hospital emergency room, perhaps along heavily trafficked roads,” NNU affirms. “Transport alone can result in long delays depending on ambulance and staff availability, which can put lives at risk. Communities need access to a full service hospital.”

The nurses union joins a growing movement that rejects Issue 64 as a bad deal for Lakewood. In addition to Save Lakewood Hospital and many businesses throughout Lakewood, thousands of citizens have formally petitioned to overturn the deal. Progressive reform organization Ohio Revolution has endorsed a vote against 64, as have former congressman Dennis Kucinich and Tristan Rader of the Cuyahoga County Progressive Caucus.

Retired city council member Nancy Roth, who was directly involved with negotiating the hospital’s lease to Cleveland Clinic, has also recommended voting against 64. In a recent letter to the editor, Roth commented “I would have expected that public properties would be sold to the highest bidder through an open bidding process. It would have never crossed my mind that an ordinance adopted by City Council would include a non-compete clause that gives the Clinic power over the use of a City-owned facility.”

Lakewood can vote nurses’ values, and reject radically limited local healthcare, by voting AGAINST Issue 64 on page three of November’s ballot.

Deal to Close Lakewood Hospital Shorts Taxpayers by $278 Million

A key argument for breaking the Cleveland Clinic’s lease on Lakewood Hospital and closing the facility has collapsed – courtesy of the Cleveland Clinic.

The Lakewood Observer recently broke the story of a Cleveland Clinic document acknowledging, unambiguously, a $278 million liability under a lease which Lakewood council voted to discard as part of the deal that closed the hospital.

The Clinic document completely disproves arguments that Lakewood Hospital could not have remained open through the lease’s 10 remaining years. As the Observer story notes, Lakewood city law director Kevin Butler’s contrary opinion was “the most important reason cited by City Council when they authorized Butler to negotiate” an agreement terminating the lease and closing the hospital.

Cleveland Clinic acknowledges owing $278 million to Lakewood
Cleveland Clinic document obtained in legal discovery process

The same story finds that the Clinic paid only $9.6 million to acquire hospital assets, plus associated benefits including the write-off of lease obligations. The Observer cites City Hall’s own filing with the state auditor. The discovery is particularly inconvenient for supporters of the hospital deal, who have claimed that it brings Lakewood more than $100 million in new investment.

Next month, Lakewood voters can reject the deal that liquidated the hospital by voting against Issue 64.

We Deserve a Better Future than Issue 64

Issue 64 is a bad deal for Lakewood, right now.

It fails a test of long-term, big-picture values just as badly.

In the big picture, our communities must prioritize sustainability in the decisions we make. In many ways walkable, densely populated Lakewood is a model for more sustainable development—but Issue 64 turns away from a sustainable future and back toward failed models of the past.

Sustainability inherently requires both local action, and a holistic outlook, and Issue 64 should be judged on its local and its regional impacts. In assessing sustainability, shutting down Lakewood’s publicly owned hospital and opening a private hospital in Avon cannot be judged separately.

Avon is not only much smaller than Lakewood, it’s also much more sprawling. The population density of Lakewood is more than 9,000 people per square mile, while Avon’s is barely 1,000. As a result, Lakewood has the highest walk score in Ohio, while Avon ranks in the bottom five.

Lakewood is crisscrossed by transit routes, while the the planned Avon Hospital is miles from any transit line:

RTA routes through Lakewood
RTA routes through Lakewood
Lorain County Transit and planned Avon Hospital
Lorain County Transit and planned Avon Hospital

Compact, walkable cities like Lakewood are healthier for individuals, more economically productive, and much more compatible with the low-carbon future necessary to keep our planet safe. Pushing needed services and Lakewood’s largest employer to a car-dependent landscape would take us backward, not forward.

Even if part of this plan is outside the direct control of Lakewood, we can still pursue better options than simply conforming to a harmful trend. Lakewood can continue to offer a better alternative, by rejecting Issue 64 and its restricted future. Investors recognize the attraction of cities like Lakewood. We can defeat the noncompete clause on our hospital property, and restore real healthcare as well as job opportunities.

We deserve a better deal, and so does our future. Vote against Issue 64.

See also:

Do the Math

The most important number in assessing issue 64 is 100%. The Lakewood public already owned 100% of Lakewood Hospital, including equipment, property, cash and other assets. What Issue 64 presents as “investment” is just a portion of the public’s own resources, left over after a big transaction fee.

The hospital’s 1996 lease to the Cleveland Clinic was only a lease. A press release from the city stated that it guaranteed Lakewood’s ownership of all hospital assets. A recent State Auditor’s report references “the City-owned Lakewood Hospital.”

The total value of the public’s hospital assets was at least $120 million. The 2015 hospital financial statement listed $50 million in liquid assets. A consultants’ report to the Hospital Association suggested a possible value of $70 million for the hospital itself, which is a conservative figure; investment banking methods based on annual revenues point toward an even higher value.

At most, Issue 64 might eventually return $40 million of taxpayers’ own assets. The deal assigns to Lakewood cash and properties—all of which belonged to us already—worth around $22.6 million. Another $16.5 million goes into a broadly defined “wellness foundation.”

That leaves $80 million of public assets, privatized without compensation.

The bigger picture, meanwhile, confirms that there’s no investment headed Lakewood’s way from Issue 64. The deal closing Lakewood Hospital eliminates a dozen or more needed medical services, along with nearly 1,000 jobs. A real investment would leave our economy and health services better off, not set them back.

We deserve a better deal.

Voting Information

Be sure that your vote against Issue 64 will be counted—check important dates and other information from the county board of elections.

Early Voting

You can request a vote-by-mail ballot now through the morning of November 5. Most registered voters have received a form in the mail, recently, and you can also download one here.

The Board of Elections has now begun supplying vote-by-mail ballots to voters who have requested them. You can request a vote-by-mail ballot up until noon on November 5—but your ballot must be returned to the Board of Elections or postmarked by November 7, to be counted. (Vote-by-mail ballots cannot be accepted at your polling place, only at the Board of Elections.)

In-person early voting at the Board of Elections is also underway. The board has posted hours here and is located at 2925 Euclid Avenue, Cleveland. November 7 is the last day of in-person early voting.

Election Day: Tuesday, November 8

To vote on Election Day, confirm your polling place here. Polls open at 6:30 a.m. and close at 7:30 p.m. Bring identification, such as a driver’s license, military ID, utility bill, bank statement, paycheck, etc. (Consult a complete list of valid ID here.)

If you need a ride to the polls, call 216-586-2401.

The Ballot

Sample ballots are now available at the Board of Elections web site. Look for Issue 64 on page three of your ballot, and please vote against the ordinance.

Glass walls alone don’t make for “state of the art”

In an older city like Lakewood, any new construction can appear to represent the future. Particularly if it’s a relatively recent architectural style in a city of traditional brick buildings, it’s easy to greet this as “progress.”

But glass and metal exteriors aren’t guarantees of good design, or of wise investment.

Glass wall construction isn’t actually new, even. The earliest prototype of “modern” glass buildings was San Francisco’s Hallidie Building—opened in 1918. Not exactly state of the art.

If this style is still newer than most Lakewood buildings’, that doesn’t mean it’s an advance. Professionals’ judgment of the glass wall concept is that it’s good for looking shiny and not for much else:

…designers appear to choose all-glass curtain walls or floor-to-ceiling strip windows because they make it easy to create a sleek impression while leaving all the tricky details in the hands of the manufacturers. (buildingscience.com)

One developer calls glass-walled condos “throw-away buildings” because of their short lifespan relative to buildings with walls made of concrete or brick. (Canadian Broadcasting story)

The mundane realities of metal and glass architecture encapsulate the larger deal that’s up for a vote this November: it only resembles “the future” in the sense that it’s something new, and shiny.

Beneath the surface, the proposed health center is just a medical office building. Nothing state of the art about that. Nor is there much progress in sending away jobs and economic strength. The “freestanding emergency room” concept is new-ish; there were “only” 146 of them in the United States 11 years ago. But they aren’t replacing hospitals yet, as the new hospital in Avon reminds anyone paying attention.

Sustaining Lakewood’s progress depends on knowing the difference between real assets and valuable services, and fake progress in a shiny package. We can help clear up which is which by voting against an imitation-progress deal in November.

Forum at Madison Ave Library, Sunday 8/21

Save Lakewood Hospital is sponsoring another free public forum on healthcare and the future of our hospital this Sunday, August 21.

Once again, Lakewoodites are invited to hear an independent doctor’s perspective, as well as that of experts in law and finance. After a brief opening presentation, panelists will open the floor for questions.

The forum starts at 1 p.m. on Sunday, in the auditorium at the Madison branch library (13229 Madison Ave). Registration is free but please call in advance: 216-586-2401.