For a few decades, in large part as a result of state fiscal policies, the City of New York has spent far more than average on the health care industry (not all on health care) and far less than average on the public school system (and even less than that on education). With the possibility of at least somewhat more fair school funding from Albany, and the release of the report of the Commission on Health Care Facilities in the 21st Century, there is an opportunity to alter that pattern. As other forms of transportation developed, much of the nation’s rail capacity became redundant, and eventually had to be abandoned to save the rest of the rail system financially. Since rights-of-way are uniquely valuable and hard to replicate, many places preserved them as trails. Similarly, in a densely populated city space is scarce and expensive, and one of the city’s educational problems is the lack of it. The hospitals and wings to be closed have been exempted from local property taxes for decades, an exemption the value of which likely exceeded their current value many times over. They should be purchased by or given to the city, gutted, and turned into high schools (if large enough) or other schools. If purchased, the money received should only be used for a purpose consistent with the purpose of the tax breaks had been received, not bonuses for departing executives. At least the schools would have decent labs and, if a high school were located in the former wing of a still-working hospital, perhaps some of the students would be inspired to health care careers. For despite the “jobs lost” in the short run due to the proposed closings, the long-term situation in health care is a labor shortage.
Moreover, according a quote in the Times, additional closings are called for but would be “massively destabilizing.” I take that to mean even more hospitals and wings ought to close as soon as the labor from the first round of closings is absorbed in other health care facilities. The data discussed below certainly supports that idea. Those buildings ought to be converted to high schools and other educational facilities as well. The only competing use I can see with equal value to the city is as mothballed facilities, to be temporarily reactivated in the event of an epidemic or attack with mass casualties operated by health care workers brought in from elsewhere.
Sorry to repeat myself, but if you missed it a spreadsheet of comparative public employment from the Census Bureau and related private employment from the Department of Labor is attached. In 2005, New York City had 487 full time equivalent public hospital employees and 1,924 private hospital employees per 100,000 residents, 50 percent higher relative to population than the national averages of 176 and 1,446. At the national averages relative to its population, the city would have had 64,412 fewer people working in hospitals. Now some of these were providing care for those outside the city, from the suburbs or across the country, as New York’s premier hospitals serve more than just the population of the city itself. But clearly there is an excess. The rest of the city’s health care industry was at the national average relative to population in 2005, the data shows.
Meanwhile, New York City’s number of public school instructional employees was slightly below the national average relative to population, and slightly above the national average relative to the number of students, something that made the city’s large class sizes confusing to me. Looking at both the student-teacher ratio and average class size in the city’s recent data release, however, it appears that general education teachers are only teaching or otherwise supervising children on average for 67% of their day. If those teachers were doing so for five of six hours of the school day (83 percent of the time) and were sick for an average of 10 of 180 days per year (5.5% of the time) then teachers would be with the children 78% of the time. No wonder that in schools where teachers agree to waive certain provisions of the teacher contract have much smaller classes.
The Census Bureau data, moreover, shows that NYC teachers, adjusted for the typically higher private sector salaries in New York, were 18% underpaid in 2005 compared with the national average (instructional staff in the rest of the state are overpaid by that standard, and overstaffed). So, if space were available, it would be possible to use some of the Campaign for Fiscal Equity money to pay teachers more to spend more time teaching smaller classes. No additional instructional staff would be required, just higher pay, which would probably help attract better quality teachers. Hence, hospitals to high schools.
Rather than resist the closings, rather than preserve existing jobs for the few (most of us do not have our existing jobs guaranteed), I hope our elected officials will move the people to and reuse the buildings for services of real value to the public at large. Otherwise, they ought to at least change how they describe where our taxes go, to the health care industry rather than to health care, and to the school system (and retirees) rather than to education. It would be scandalous to miss this opportunity.