Sen. Bernie Sanders (I., Vt.) rallied Monday with Philadelphia hospital workers, residents, and political supporters against the closure of Hahnemann University Hospital, seizing on the situation to tout a signature issue in his presidential campaign.

"We should not be talking about shutting down a major hospital and converting that property into hotels or condos,” Sanders told about 1,500 people outside the hospital. “This is not a complicated issue. It is a question of getting our priorities right.”

The candidate was the draw for the third protest in a week outside Hahnemann, with demonstrators calling on local and federal officials to keep open the hospital on North Broad Street, which serves many lower-income residents. For his part, Sanders said he would introduce legislation to reserve $20 billion in emergency funds to help states buy hospitals in financial distress.

Hahnemann’s emergency department, already closed to critical cases, remains open for less serious cases, but this week will start to send ER patients who need inpatient care to other facilities. A complete closure is expected in September at the hospital, whose creditors say has lost millions each month.

For Sanders, the closure presented an opportunity to localize his biggest issue — Medicare for All — in a state critical to Democrats in 2020. Sanders also decried the hospital’s closure last week in an Inquirer opinion piece coauthored with Councilmember Helen Gym, who also spoke at the rally.

Sanders told the crowd Monday the planned closure is "not just a Philadelphia issue, it is not a Vermont issue, it is a national issue.” If developers can turn the hospital into luxury condos, he said, “it will send a signal to every vulture fund on Wall Street that they can do the same thing in community after community.”

He used the podium to argue that if every American had Medicare, for-profit hospital closures would be less frequent because there would be fewer coverage gaps between the rich and poor. Hospitals in low-income city neighborhoods and rural areas would have more stable cash flow. Sanders has also stressed that with better coverage, patients would be healthier, driving down costly emergency room visits.

“This is not a question of economics, it’s a question of basic human morality,” he said, citing rising infant and maternal mortality rates. “How many people will in fact die if this hospital is shut down?

The crowd of health-care workers and Sanders supporters cheered enthusiastically in the afternoon heat.

Dawn Andonian, a veteran operating room nurse, said she didn’t have a surgery all day since the hospital has curbed admissions. Her coworkers are depressed, she said, and at 60, she’ll soon be out of a job and looking for work. “I don’t care if Mickey Mouse got up there," she said gesturing toward the podium, “as long as it gets us national attention.”

While not uniformly defined or explained, the concept of Medicare for All has been one of the dominant topics among Democrats running for president.

It’s also a key dividing point between former Vice President Joe Biden and the other top polling candidates. While Biden opposes the policy, several Democratic candidates, including Sen. Elizabeth Warren, Sen. Kamala Harris, Sen. Cory Booker, and Sen. Kirsten Gillibrand, cosponsored Sanders’ 2017 Medicare for All bill and have endorsed the policy.

Hospital workers listen as Democratic presidential candidate Sen. Bernie Sanders speaks at a rally July 15, 2019 at Hahnemann University Hospital, railing against its closure and citing it as an example of why the country needs his ÒMedicare for AllÓ plan.
TOM GRALISH / Staff Photographer
Hospital workers listen as Democratic presidential candidate Sen. Bernie Sanders speaks at a rally July 15, 2019 at Hahnemann University Hospital, railing against its closure and citing it as an example of why the country needs his ÒMedicare for AllÓ plan.

Would Medicare for All have saved Hahnemann?

As Sanders extolled his plan, some critics doubted whether it would save Hahnemann, at least given the current levels of money paid hospitals through the massive Medicare and Medicaid programs.

Currently, experts point out, hospitals make up for relatively low payments from the two programs by shifting the cost onto private payers, notably onto large private insurance firms. “Commercial health plans’ reimbursement levels are certainly going to be higher than Medicaid and Medicare,’ said Daniel Grauman, chief executive of Veralon, a Philadelphia health-care consulting firm.

With 36 percent of its revenue last year coming from Medicare and 29 percent from Medicaid, Hahnemann was unusually dependent on government money among Philadelphia hospitals, according to the latest figures from the Pennsylvania Health Care Cost Containment Council.

Stuart Fine, a professor in Temple’s College of Public Health, said that, by design, Sander’s proposal would put all Americans into one plan. This would newly provide hospitals with revenue from patients who previously had no coverage whatsoever, Fine said, “but it would substitute lower rates of reimbursement than companies get from regular insurers.”

Hours before Sanders arrived in Philadelphia, Biden released a video explaining how he’d expand the Affordable Care Act, rather than abolish private insurance. In it, he took aim at candidates such as Sanders and Warren who favor a Medicare-for-all plan.

“I know how hard it is to get that passed," Biden says in the video of Obamacare. "I watched it. Starting over makes no sense to me at all. I knew the Republicans would do everything in their power to repeal Obamacare — they still are — but I’m surprised so many Democrats are running on getting rid of it.”

Biden has also been critical of other Democrats in the field, who he says haven’t been ‘straightforward’ about what Medicare for All means — in many cases, no private option.

In Pennsylvania on Monday, Gov. Tom Wolf and Mayor Jim Kenney said their administrations would put up $15 million to keep hospital services going with another provider if the federal government matches the commitment. Their joint release said Hahnemann’s corporate owners already owe the state and city $40 million.

“At this point, there is no means to provide public funding to bail out the current owners," the statement said. “We are fighting to maintain patient safety, save access to care and employment, protect St. Christopher’s Hospital for Children, and mitigate the damage done by the current owner.

Joel Freedman, head of the American Academic Health System, replied in a statement that the company had sought help from the city and state months ago.

“We had been requesting such support from the State since early 2018,” Freedman said. “Although the new support announced by the Governor and Mayor today did not arise in time to save Hahnemann, the $15 million of funding will aid in the transition of care.”

Staff writers Liz Navratil and Craig McCoy contributed to this article.