Even on the streets of Harlem, where residents are all too aware of the very low priority to which they have been consigned, the news that 5,000 echocardiograms went unread registered palpable alarm. From an initial review of the backlog of these critical heart tests – stockpiled since 2005 – one cardiologist said that half were abnormal and that 20 to 30 percent of patients needed immediate medical attention at the time they were performed.
Medicare and private insurers were quick to assert that they were on it, that is, investigating fraud, for while the tests were essentially trashed, charges were surely billed. An estimated 200 patients died, though whether acting on test results may have saved them will never be known. No doubt a cardiac unit in an affluent community would be inundated with tort litigation after just one such case, the incident put before the courts, a steady supply of headlines ensuing and plenty of television reportage.
On the corner of Malcolm X Boulevard and 135th Street, where Harlem Hospital sits, few had anything to add to the grisly details of this latest incarnation of benign neglect. Workers from within the complex indicated they had been instructed to offer no comment.
Around the way, on West 134th Street, half the block sits boarded up. Just two years ago, as unsuspecting patients thought they were receiving cardiac care, developers on this block announced plans to renovate town houses and sell them for $1 million. One unfinished town house belonged to a Harlem family for 90 years, as the new owner today contemplates turning it into a rooming house, his plans for a high-end sale scuttled.
Long-time Harlem residents have scattered, much like those cardiac patients, as new condos and elaborate renovations dot the landscape, many sitting empty now in the enduring and historic mismatch of wages and prices that is the netherworld of free market speculators. Antipathy for speculators is strong here, as underpaid and unemployed Harlem residents make their way home to tenements, walking past these new, vacant apartments, empty but being kept cool — as attested to by the hum of air conditioning — ready to accommodate a visit from a bargain hunter or, more likely, from an officer of the bank’s foreclosure department.
The almighty bond market and the bounty of yields are now center stage, as the days of reaping 40 per cent returns every 60 days — as in the height of subprime mortgage market — are gone, foreclosure rates are galloping, now encompassing commercial real estate, as well, in one city after another.
Panic – of the distinctly non-Depression variety — has set in at the private equity firms, which are sitting on $500 billion in cash, seeking companies to buy, boost and flip, as is their trade. Most private equity funds are required to return investor money after several years if no activity has been initiated, and the clock is ticking. The returns being offered by firms for new investments indicate that over the life of the funds investors can expect a return in the range of low to mid- teens. Most firms require a minimum of $10 million to invest and at, say, a mid-teen of 13 per cent annual return, a participant would receive $1.3 million per year on the investment. “Those are far from the gross returns of the mid to high-teens that we saw a few years ago,” Hugh H. MacArthur, head of global private equity at Bain & Company told the New York Times in June. These are hard times.
With all attention in the financial field focused on repairing deficits, it’s easy to overlook the very basic fact that America is awash in cash. This is a very, very rich country with piles and piles of cash. Private U.S. accounts today contain approximately $10 trillion in cash and liquid assets, including some of those funds assigned to private equity. On the corporate side, non-financial U.S. corporations are holding more than $1.8 trillion, constituting a 26 percent increase as of March from one year earlier— the largest increase on record going back to 1952, according to the Wall Street Journal. America is immersed in an era of aggressive hoarding, an irony that goes unaddressed in the daily fiscal debate, though debate is certainly too strong a term. Illinois teeters on bankruptcy and rich Americans search for yields.
One beneficiary of this grand obfuscation is the Responsibility President, for whom the leakage of oil affecting coasts from Texas to Florida, an impertinent general recalled from a stepped-up war in Afghanistan and a PR dilemma with Israel must come as welcome relief. President Obama never has to explain to those Harlem residents why they cannot live in the empty condos or, for that matter, why no one bothered to read their echocardiograms.
CARL GINSBURG is a journalist in New York City. He can be reached at firstname.lastname@example.org.