OP-ED: Closing SUNY Downstate would be a disaster for Black and low-income kidney transplant candidates
Following decades of financial disinvestment in SUNY Downstate, one of Brooklyn’s largest and most important hospitals, by prior administrations, Governor Hochul has announced that financial assistance for SUNY Downstate is contingent upon its closure. It is unconscionable for her to link financial support to the closure of a vital healthcare institution that serves as a lifeline for our community.
This fast-track approval of the restructuring plan for SUNY Downstate by April 1, 2024, under the guise of “transformation,” is deeply troubling. The State has failed to comply with laws requiring a report on SUNY Downstate’s infrastructure needs yet bases its closure decision on these alleged deficiencies. By doing so, it is endangering the lives and livelihoods of thousands of Brooklyn residents.
SUNY Downstate serves patients like me, Nardel Joseph. I am 34 years old, and I have relied on dialysis to stay alive since 2018 due to end-stage renal disease. Over the past six years, it’s been very difficult to work and live a normal life. For most of this time on dialysis, I believed that I was not eligible for a kidney transplant because of my immigration status and lack of Social Security number. With help from volunteer lawyers working with New York Lawyers for the Public Interest, I was able to qualify for health insurance that will cover my transplant. After being denied appointments at other hospitals in Manhattan, I was welcomed at SUNY Downstate, which houses the city’s only organ transplant program within a safety net hospital, and I am now on a waitlist to receive a transplant. Shuttering SUNY Downstate could leave me and over 100 other people who are currently listed for transplants in a state of limbo and with limited options for necessary medical care that is both as welcoming and as culturally competent as the care we receive at SUNY Downstate.
SUNY Downstate is not just a hospital; it is a cornerstone of the Black, brown, low-income, and immigrant community in central Brooklyn. It has proven to be an essential healthcare service for New Yorkers in a community that has been historically overburdened by high incidences of chronic disease. It provides unparalleled access to transplants for low-income, Black, and immigrant patients who have been systemically excluded from these operations by racially biased medical algorithms and decision-making models. The closure of such a facility would have devastating consequences for the health and well-being of the city.
For those who have received their transplants at SUNY Downstate, the majority of whom are covered by public insurance like Medicaid and the Essential Plan, connecting with the specialized medical care needed to preserve the transplanted organ could prove difficult, if not impossible, given the limited uptake of such insurance at private hospitals.
On top of the terrible toll closing SUNY Downstate would have on current patients, the restructuring relies on the proposed transfer of patients to already overcrowded hospitals. This move disregards the urgent healthcare needs of city residents. It will likely exacerbate the strain on the public health system, further marginalize vulnerable populations, and lead to worse health outcomes for people who rely on our public health system. Furthermore, the lack of transparency and community involvement in this decision-making process is unacceptable and harmful to a large swath of our community who already face barriers to accessing lifesaving care.
Governor Hochul and our state elected officials have the opportunity to reaffirm their commitment to accessible healthcare for all by investing in the modernization and revitalization of SUNY Downstate while engaging with stakeholders including residents, patients, community organizations, and healthcare professionals to ensure their perspectives are central to the decision-making process. These principles are outlined in the Senate’s budget proposal and have been championed by legislators like Senator Zellnor Myrie, who represents the hospital and the surrounding community.
By investing in this critical institution, the state can strengthen our healthcare infrastructure, improve patient outcomes, and uphold our shared values of equity and compassion while continuing to address the harms that prevent the Black community from accessing life-saving kidney transplants. Governor Hochul must walk back the proposed closure of SUNY Downstate and ensure the hospital can remain an integral part of the Brooklyn community for years to come.
Nardel Joseph is a Brooklyn resident and SUNY Downstate patient. Karina Albistegui Adler is co-director of Health Justice at New York Lawyers for the Public Interest.
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