Let St. Vincent's Build

The blocks around St. Vincent's Hospital in Manhattan's Greenwich Village are full of the eclectic diversity that makes New York's street life second to none. There is celebrated Israeli food at Taim on Waverly Place. There is the Village Vanguard on Seventh Avenue, a temple of the jazz music created by the city's African-American and Jewish cultures. There's a nod to gay culture and sexual promiscuity in a store called "Fantasy World," steps away from multimillion-dollar, elegant, tree-shaded brick townhouses lived in by actresses and private equity financiers. That's all in the shadow of a Catholic medical center that doesn't perform abortions or tubal ligations but has made a specialty of serving patients with the virus that causes AIDS.

The neighborhood is now at a turning point, as the hospital, emerging from bankruptcy, is proposing to sell its building to a private developer, the Rudin family, as a site for new residential housing. The proceeds would be used to build a new hospital building on the west side of Seventh Avenue, across the street from the existing hospital on the site of an existing medical office building.

Hospital executives, architects, and members of the Rudin family briefed The New York Sun on the project yesterday, and they make a strong case for a speedy and enthusiastic approval of the plans by city and state officials. While the construction of a new, $2 million-a-bed hospital by a health care organization still paying off its creditors from bankruptcy might seem a stretch in a state that is trying to stem the growth of taxpayer-supported health care costs, hospital officials note that at 366 beds, the new hospital would be smaller than the 750 beds for which St. Vincent's is licensed and smaller than the 460 beds currently in operation at the existing Manhattan hospital.

St. Vincent's, notwithstanding its bankruptcy, stands for the proposition that the Catholics of this city have something to contribute to the health care marketplace. This is a historical fact: It's hard to forget the memories of preparations at St. Vincent's for a wave of September 11 victims who never arrived because they were buried in the collapse of the twin towers. The hospital's plan is also a statement about the future: the president of St. Vincent's, Henry Amoroso, says his hospital's supporters are prepared to raise $150 million in a capital campaign for the new building. They would keep Catholics as a player in a city whose hospitals include Beth Israel and Mount Sinai, with their Jewish roots, and the NewYork Presbyterian hospital system, with its Presbyterian roots. The plans for the new hospital are crafted by the world-class architects at Pei Cobb Freed & Partners, led by Ian Bader. Every room would be private.

We are also enthusiastic about the Rudin family's plans, by FXFOWLE architects, for housing on the old hospital site. It is a plan for entirely-market rate housing, eschewing "affordable housing" components that developers too often cram into their projects in an effort to chase taxpayer subsidies. The plan would return the site to the property tax rolls, with no abatement. The Rudin family has long been involved in the civic life of New York, and its partnership with St. Vincent's, which serves a significant number of poor patients, on this site is an example of the way that capitalists can be good partners with charities.

So why are the Rudin family and the hospital's leadership girding for a potentially grueling two-year approval process? The hospital is in the Greenwich Village historic district, which, if historic preservation fanatics had their way, would mean it would be preserved unchanged forever as if embedded in amber, with patients still being treated by being bled with leeches. We exaggerate only slightly. There is a danger that the Landmarks Commission will, in its fetish for facades, strangle a vital Manhattan health care institution — the only major trauma center South of 96th Street that isn't run by the City's Health and Hospitals Corporation — that is on the verge of a comeback.

It would be a tragedy to keep St. Vincent's from unlocking the market value of its property and from moving into a more modern building that better suits its needs and that of its patients. If the landmarks commissioners feel the need to assert themselves, they can always extract an agreement that the more charming exterior details of the existing hospital — we think of the reliefs of the nurses that face West 12th Street and the elaborate, though unused, West 12th street entrance pictured alongside — be incorporated somehow into the new hospital or the new housing. It would be a fine idea for the hospital or the Rudins to initiate on their own.

If there's a juncture at which this project deserves to meet government skepticism, it isn't at the city level, but at the state level, where through the Dormitory Authority of the State of New York, the taxpayers of New York will be asked to stand behind tax-exempt financing for the new $750 million hospital to the tune of more than $400 million. Mr. Amoroso makes the case that if the bonds are approved, St. Vincent's debt-to-operating income ratios will be lower than that of other New York institutions. The real answer to the financing issue, though, is in opening New York to for-profit medicine that would allow the health-care industry to tap the capital in the private debt and equity markets. That broad restructuring can't happen soon enough.

Until then, it's hard to see the logic of depriving St. Vincent's and its patients — 55% of whom are covered by either Medicaid or Medicare — of the same state bond financing that is enjoyed by other New York hospitals. The result will be a Greenwich Village enriched by the dynamism that makes New York great, a combination of a faith-based institution and family-business capitalism joining to build new housing and better health care for New York. The alternative is the city-as-dust-covered-museum, hostile to change and new investment, a city that uses landmark historic districts to stifle innovation rather than embracing it as a force that can make the city better.