Talking Politics: Support is growing for the big R.I. hospital merger

By Ian Donnis
Posted 2/16/22

STORY OF THE WEEK: Support is growing for the proposed merger of Lifespan and Care New England, Rhode Island’s two largest hospital groups. It remains unclear, though, if state and federal …

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Talking Politics: Support is growing for the big R.I. hospital merger

Posted

STORY OF THE WEEK: Support is growing for the proposed merger of Lifespan and Care New England, Rhode Island’s two largest hospital groups. It remains unclear, though, if state and federal regulators will sign off on a plan that would leave one entity in control of about 80 percent of Rhode Island’s healthcare spending. And concern about the potential next step, if regulators reject the proposed merger, has started to percolate (see the subsequent item).

Brown University, with a commitment to contribute $125 million, was an early supporter of the vision of creating an academic health system with Lifespan and CNE. Now, the four major unions representing workers at the two hospital groups have come out in support of the deal, along with Rhode Island’s two top legislative leaders.

Patrick Quinn, executive vice president of SEIU, District 1199 New England, which represents workers at CNE, had been a sharp skeptic on the proposal. Following talks with management, he describes the merger as a win-win that would address top union concerns and offer the promise of improving healthcare in the state.

“We take the leaders of that organization at their word, that they want to do something transformational and not just do a larger version of what they’re doing,” Quinn said during an interview on Political Roundtable. “And they want to shift their focus to population health, to disparities, towards trying to make Rhode Island’s population a healthier population, and build our infrastructure to do that.”

What happens next could come into sharper view with upcoming decisions by state and federal regulators.

SMITH HILL BACKS THE MERGER: House Speaker Joe Shekarchi and Senate President Dominick Ruggerio sent a letter this week to the Federal Trade Commission and the Attorney General’s office in support of the Lifespan-Care New England merger. Excerpt:

“Rhode Islanders deserve the development of a truly local health system …. This investment and expansion will also immensely help Rhode Island's economy.

“We, as the leaders of the State's General Assembly, are not worried about competition for healthcare services in Rhode Island and the surrounding area after the merger. Our constituents already need both health systems as they currently exist, because they each already offer core services that Rhode Islanders cannot live without (for example, childbirths and neonatal care at CNE, pediatric care and complex tertiary care at Lifespan). Further, Rhode Island's Office of the Health Insurance Commissioner acts to cap rates for hospital services, and its successes in that regard have been well documented. We have no concern that OHIC will be repealed ….

“We are also not worried about competition for the employment of nurses or other healthcare professionals or staff. We understand that the merger enjoys unanimous support from the leadership of all unions with collective bargaining units embedded at either Lifespan or CNE ….

“Finally, we share the concerns expressed by the United Nurses & Allied Professionals, Local 5098 (UNAP) in its letter dated Feb. 1, 2022, to the Rhode Island Office of Attorney General (RIAG) and to the Rhode Island Department of Health (RIDOH). In particular, UNAP expressed heightened concern in its letter that the failure of this merger to close would result in the significant deterioration of healthcare in Rhode Island, and likely require the ultimate buy-out of CNE by a for-profit entity. We share UNAP's concerns wholeheartedly, and would prefer the Rhode Island based, non-profit solution to this matter, which is offered by the merger that is before you.”

TURNAOUND: In explaining why the four major unions have emerged as supporters of the Lifespan-Care New England merger, SEIU 1199NE’s Patrick Quinn describes labor as a potent check against the possible excesses of monopoly power. Agreements against diminishing union employment and representation take “the worst edges off the one-buyer problem,” Quinn said on Roundtable. “That gives workers the power to advocate for themselves and for their patients.”

Another big reason for why the unions back the merger, he said, is to maintain local control under the aegis of a nonprofit entity. “There’s tremendous amounts of public dollars in the healthcare system. And using those to enrich a few people in Los Angeles is not the way we want to go,” Quinn said, referring to Prospect Medical Holdings, owner of Roger Williams Medical Center in Providence and Our Lady of Fatima in North Providence, and how its management and investors have taken hundreds of millions out of the company; Prospect is now mulling a sale of the Rhode Island hospitals.

“We understand there are problems with one dominant player in the market, but it’s better and preferable that they be a Rhode Island-based company that’s a nonprofit that at least we have some control over in terms of our laws, our regulations and our bargaining power.”

ENTER FUNG: Former Cranston Mayor Allan Fung has ended the uncertainty about his next political race by announcing a run for the CD2 seat being vacated by Democratic U.S. Rep. Jim Langevin. Fung’s geographical base in Cranston and his moderate profile make him a potentially formidable contender in the general election. (Democrat Seth Magaziner’s campaign quickly responded to Fung’s announcement.) Regardless, Fung first faces a GOP primary with state Sen. Jessica de la Cruz (R-North Smithfield) and former Cranston Rep. Bob Lancia.

THE LONG VIEW: Robert A. Walsh Jr., who has announced his plan to retire in August after 30 years as executive director of the National Education Association Rhode Island, is among the state’s savviest political observers. I asked for his thoughts on some of the top under-appreciated trends in Ocean State politics over the last decades. Here’s his report.

Party politics/outside money: While the Democratic Party in Rhode Island remains a big tent, and the Republicans are more of a club, the ability of issue-based groups, [which] may have worked through political parties 30 years ago, to spend independently has had a significant impact on both primary and general elections. Whether dark money or its more transparent cousin, direct external expenditures outside of party involvement, have changed Rhode Island political outcomes.

Red/Blue shift: Thirty years ago, Barrington and East Greenwich would not rank near the top for Democratic presidential candidate performance — nor would you have predicted a loss in Johnston. But that happened in 2020. Whether Donald Trump can be singled out as accelerating a trend that was already existing or can be considered a correctable aberration is worth watching. Each party must ponder the shift.

The Trump Effect: The former president has also contributed to an increase in nastiness and the vitriolic, vindictive, and sometimes threatening behavior carried out by his acolytes and imitators. At the State House, at school committee and town council meetings, and on talk radio and social media, spewing hatred while ignoring facts ultimately makes it harder to attract good people to run for office or even speak out at public meetings — as is their goal.

Advances in technology: I still recall using voting lists and multicolored highlighters to laboriously examine local records to capture voter history and ensuring extra land lines were ordered for phone banks. Now, election data can be gathered easily, and a box of cell phones constitutes a mobile phone bank. Political messaging can be micro-targeted almost on an individual level. Candidates can record messages and broadcast them instantaneously.

A few things remain the same: Money may be the mother’s milk of politics, but retail politics — knocking on doors, talking directly to voters — can still win elections, especially at the local level. I once noted my job description should simply state ‘build and maintain relationships by talking to people, listening to what they have to say and then trying to be helpful and add value.’ That same rule still applies to our successful office holders, both as candidates and then as elected officials. And finally, the most effective ‘lobbyist’ is an elected official who is passionate about an issue. That hasn’t changed either.”

SHORELINE ACCESS: This dispatch from my colleague Alex Nunes: “Advocates for more beach access in the Ocean State are encouraged by the direction of a House commission currently working on proposed legislation to clarify where the public can be along the shoreline. At a meeting of the group Thursday, commission member and former state Sen. Mark McKenney suggested allowing access walking within a reasonable distance inland of the seaweed line. The current standard is below a multi-year mean high tideline, a hard to distinguish barrier that advocates say is becoming less relevant with sea level rise.

“McKenney is seen as a voice on the shoreline commission more sympathetic to property owners, so his proposal is being read as a breakthrough by some. But other activists want to see the commission recommend 10 feet beyond the high tideline or even more, and some worry about the possibility of additional restrictions being placed in a bill to limit what’s allowable along the water. The commission’s next meeting is early next month.”

THE GOP CAUSE: Chas Calenda, GOP candidate for attorney general, said he’s running because he wants to make the office more accessible and transparent. While Ashley Kalus has filed a notice of organization to run for governor as a Republican, Calenda has to this point been the most visible of any GOP members running for one of the five state general offices this year.

“I certainly can’t speak on behalf of any other potential candidates,” Calenda said during an interview on Political Roundtable, “but I can tell you that the ones that are either in process of announcing or have announced in some way, they’re looking to make sure that this is the right thing for them. I know that there are some good potential candidates that are likely to announce in the near future.”

ART MARTONE: We were saddened by the death this week of former ProJo sports editor Art Martone, at age 66, from a rare illness. Our sports columnist, Mike Szostak, offers this appreciation: “Art was one of those rare individuals whom everybody liked. I never heard a derogatory comment about him, a compliment itself given the many constituencies he had to please while directing the largest sports department in the state during a time of turmoil in the newspaper business. He had an even disposition, a ready smile and a hearty laugh. He could mingle easily with professional stars in Boston and high-school bench warmers in his hometown of Cranston. And he loved a good story, whether of a game, a personality or an issue.”

Ian Donnis can be reached at idonnis@ripr.org. You can follow him on Twitter @IanDon. For a longer version of this column or to sign up for email delivery, visit thepublicsradio.org

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