There will be an opportunity to sort out whether the company’s collapse was caused by greed and incompetence, as Governor Maura Healey said last week, or whether wrongdoing was also at play, as the governor has also suggested.
But as the Globe’s Joan Vennochi wrote in an op-ed column, “It’s now time for Massachusetts to come up with the morally correct fix for it, strengthened by new laws that make sure it never happens again.’’
“The state has limited powers to address the Steward mess because it has engaged, for decades, in chronic unilateral disarmament,’’ said Sager. Governors and lawmakers over multiple administrations have failed to create the tools needed to protect the public health system from the financial meltdown of one or more hospitals.
Steward’s future is in the hands of a bankruptcy judge in Texas — a judge who previously worked at the law firm representing Steward. The Healey administration won’t have a lot of say in what happens to the company’s eight hospitals in Massachusetts.
“But it’s premature to accept’’ that some Steward hospitals might close, Sager said. The state needs to move fast.
Fulfill the requirements in a 2012 law that the state catalog all health resources — such as health care professionals and facilities — and recommend how they should be deployed. Because there is no adequate inventory of hospitals and services, Sager said, the Healey administration doesn’t have a complete understanding of which Steward hospitals are essential to caring for the public and shouldn’t close under any circumstances.
Enact a receivership law that would allow the state, during public health emergencies, to take over essential hospitals by eminent domain or similar means. The state already has similar powers for nursing homes.
Create a hospital stabilization trust fund that would support ailing but critical hospitals. Sager proposes financing the fund with annual assessments of 0.25 percent on all hospitals’ patient care revenues and 1 percent on non-operating revenue such as investment income. The assessments would raise $100 million a year based on current hospital spending of about $45 billion annually.
“Why has state government failed to put its arms around health care and [not] developed a capacity to act, to intervene — to cease standing on the sidelines?’’ asks Sager. “Because influential hospitals have long preferred that it not act. And probably some payers, also,’’ he said, referring to health insurers.
Although Steward’s action was anticipated for weeks, neither Healey nor her secretary of health and human services, Kate Walsh, discussed what steps the administration is considering.
The state can’t afford to make the same mistakes again.