Some of the discussion today has centered on the issue of competition, control, and profits.

New York City has been closing down hospitals that once enjoyed a hefty public subsidy but are now expected to pay for themselves or turn a profit. After these hospitals were turned over to private corporations, the pressure to make a profit brought about the closure of several major hospitals.

One of the hospitals slated for closure is Long Island College Hospital. Founded in 1858, the hospital serves several communities in Brooklyn. At some point in the not distant past, it was off-loaded to a for-profit corporation, which them passed it on to a state agency. But, unfortunately, the hospital doesn’t make any money, so its managers want to close it. Local politicians, including Bill de Blasio–who ran first in the Democratic primary for mayor–are fighting the closure of LICH.

Now, all this might seem arcane, but I have one important fact to share about LICH: It saved my life. In 1998, I felt very ill about 7 p.m., when it was impossible to reach a doctor, had a sharp pain in one leg, and walked to LICH. I was quickly diagnosed with deep-vein thrombosis and a pulmonary embolism. If I had not been able to get to the hospital that night, I would not have survived until morning. Both my lungs were rapidly filling up with blood. In a matter of hours, I would have died had I not had a neighborhood hospital. I stayed in the emergency room for a day, and in intensive care for two days, and was hospitalized for a week.

And soon this hospital will close. People will have to travel long distances in a city where traffic is often snarled to find emergency care. During Mayor Bloomberg’s nearly 12 years in office, about a dozen similar hospitals have closed, including the legendary St. Vincent’s in Greenwich Village, where AIDS patients found respite from their suffering at a time when no one wanted to treat them.

Here is the part I don’t understand: Why should hospitals be expected to make money? Doesn’t society have an obligation to keep them accessible to the public? In what sense does competition and the demand for profit improve hospitals? I don’t get it.