Keep our hospital open!"
"They treat us like human beings here."
The spontaneous cries came from 12 elderly patients at the Public Health Service hospital here as they caught sight of the hospital's director.
But the director, Dr. Pat Mattingly, can do little to help them. He got his orders this week from Health and Human Services Secretary Richard S. Schweiker: stop admitting patients and close the hospital by Oct. 31.
In one of the early graphic examples of the Reagan administration's budget-cutting resolve, the federal government is shedding itself of the 183-year-old Public Health Service hospital system, including eight hospitals and 27 clinics across the country. Net savings this year: $144 million.
The administration says the hospitals, built in port cities to protect the new nation from communicable diseases, represent "unwarranted" special treatment for the commercial seamen they were set up to serve. But over the years the hospitals have become valuable health centers for their low-income neighbors and there is concern that these people won't be able to find or pay for care elsewhere.
What angers the hospitals' supporters most now is the way the administration sunk the life raft Congress threw them last July--a plan to give the hospitals that Schweiker determined were "financially viable" a year to find someone to take them over.
The military will take over two of the hospitals, in San Francisco and Norfolk. The state of Louisiana is turning the New Orleans hospital into a juvenile psychiatric unit. A religious order is converting the Nassau Bay, Tex., hospital into a community center and five of the clinics will be taken over by the Army, state and local agencies.
Until Monday, the hospitals and community groups working on the transfers said they had received federal assurances the facilities would remain open until transfers for the others could be arranged.
But Schweiker approved transfers for only four of the hospitals and five of the clinics, blaming Congress for not passing his department's appropriations bill by his Sept. 30 deadline for deciding on the conversions. Critics say that's a flimsy excuse; in fact, Hill aides said, the HHS appropriations bill has not made that deadline for the past 10 years. Schweiker said that without knowing how much money the department would have to help make the transfers, he could approve only those facilities that would not need renovations to meet local building codes for hospitals.
"I think it's a dodge," said Rep. Barbara A. Mikulski (D-Md.), whose district includes the Baltimore hospital. " . . . If the executive branch wanted to close it, this is a shabby way."
Community groups in Baltimore, Boston, Seattle and Staten Island, N.Y., had sought $49.7 million in federal money to keep the hospitals open during the transition. But Dr. Michael Steinberg, whose Wyman Park Health System, a collection of Baltimore community health groups, had sought $20 million for the Baltimore hospital, said its takeover plan included options to borrow money elsewhere. "We weren't given a chance," said Steinberg. "We are shocked and astonished by Schweiker's decision."
"We tried to take the administration in good faith on this transition," said Tom Byers, assistant to the mayor of Seattle. "Now they want the hospitals to close before we make the transfer."
In a sharp letter to Schweiker, Rep. Henry A. Waxman (D-Calif.), author of the rescue plan, said the secretary was directed to keep the hospitals running until September 1982 if he believed the hospitals could make money under their new owners. "The fact the . . . appropriations measure has not passed Congress as of Sept. 30, 1981, does not, and was never intended to" stop Schweiker from approving takeover proposals, he said.
"We just don't have enough money," said Schweiker spokesman Laura Genero, who noted it will cost $25 million--mostly in severance pay--to close the four hospitals.
The hospitals received letters Monday telling them to close by the end of the month. The 536 doctors, nurses, pharmacists and other health professionals at the Baltimore facility will receive telegrams this week offering them reassignments to other federal facilities and giving them 72 hours to decide whether to accept them.
The closings will affect many more people than the merchant marine, who lost their free care at the hospitals Oct. 1. The maritime flavor has all but disappeared over the past 40 years, as Congress opened the hospitals to dozens of other groups, including active and retired military personnel and their dependents, federal employes from the Coast Guard, the National Oceanic and Atmospheric Administration and the Public Health Service, aliens being screened by federal authorities and special community programs.
As a result, the hospitals found a niche providing what other facilities didn't, such as geriatric day-care centers and juvenile alcoholism programs. In Baltimore, for example, the 208-bed hospital houses six nonprofit centers, including a mental health unit and a low-income clinic. The hospital also is popular with military dependents, who complain of the distance and long waits for appointments to other military hospitals, such as Walter Reed Hospital in the District.
"Up until last week everything was go," said Baltimore director Mattingly, as he walked past a lobby sign proclaiming, "This Hospital Is Not Closing. There Is No Need for You to Go Elsewhere for Care."
"Then suddenly, the rug is pulled out from underneath us," he said. "I'm in the position of telling the staff we're going to close and we're going to fight at the same time. People's morale is just about as low as it can be."
Officials of community groups in Seattle and Baltimore say they will file lawsuits to try to halt the closings if Congress doesn't pull through with last-minute appropriations, which is unlikely.
Schweiker spokesman Genero noted that the hospitals have known President Reagan's intentions since his first budget message in February; the administration, she said, is required to give 30 days notice of the closing.
"There are patients scheduled for surgery through November," said Dr. James Gilliam, deputy chief of the anesthesiology department. "This is no way to close a hospital.