Campaign to Save Our Hospitals v. Giuliani is a lawsuit brought by the Center for Constitutional Rights (CCR) on behalf of the prominent public interest organization Campaign to Save Our Hospitals. It charged New York City Mayor Rudy Giuliani with violating the New York State Constitution by selling off public hospitals to for-profit companies. The New York State Constitution clearly requires that the state and its subdivisions provide dignified and comprehensive physical and mental health care to all New York residents, regardless of their ability to pay.

Since its creation in 1969, New York City’s Health and Hospitals Corporation (HHC) has operated the public hospital system to provide care of hundreds of thousands of poor and uninsured New Yorkers who cannot afford the care of private hospitals. HHC has played a disproportionately large role in caring for those who suffer from special access problems due to conditions such as HIV/AIDS, tuberculosis, and psychiatric disorders. Unlike private hospitals, by law, public hospitals may not turn away patients because of their inability to pay.

In 1993, facing a budget deficit and committed generally to the privatization of certain assets of the City as a fiscal solution, Mayor Rudolph Giuliani commenced his plan to dismantle the HHC system though the sale or long-term lease of public hospitals. In 1994, the City, through the Mayor’s Office, began to explore the possibility of privatizing three hospitals: Coney Island Hospital, Elmhurst Hospital Center, and Queens Hospital Center. This plan would have had a profound impact on the residents of Queens, since Queens Hospital Center and Elmhurst Hospital Center were the only public acute care facilities in the borough. Similarly, Coney Island Hospital was the largest such facility in South Brooklyn, serving a population of 75,000 people.

Under the Mayor’s hospital privatization plan, HHC would no longer serve as the primary mechanism by which the City provided health care services to its poorest residents. Instead, private companies would operate and manage the hospitals for their own profit and for that of their shareholders. For many of the City’s poorest residents, the care they received at public hospitals run by HHC was critical and life-sustaining. These residents were the most vulnerable to illness, possessed the fewest resources, and were most in need of the medical protection offered by the public hospital system. It was these residents who would be most affected by the changes contemplated under the hospital privatization plan.

In January 1997, a New York State Supreme Court judge ruled that the Giuliani administration’s plan was ultra vires (beyond its authority), and that since the public hospital system had been created by the state, state legislation was needed to dismantle it.  The court further ruled that City Council approval was needed prior to selling off City property. 

After the initial ruling, the Giuliani administration declared that it was going ahead with its plans regardless, announcing in May 1997 the signing of a 99-year lease of Coney Island Hospital to a private for-profit group. However, under the terms of the proposed transaction, the lease could not become operational until all legal challenges were resolved.

The State Supreme Court ruling was upheld by the Appellate Division on June 9, 1997.  However, the City did not give up. The City’s petition for review by the Court of Appeals was accepted on June 5, 1998. Oral arguments on the case were heard by the Court of Appeals on February 16, 1999. On the day of the argument, members of the Queens and Coney Island coalitions, Hospital Workers Local 420, and the Committee of Interns and Residents filled the entire courthouse. The judges seemed receptive to CCR’s argument, but no one could predict the outcome.

On March 30, 1999, the Court of Appeals ruled unanimously that the Mayor’s privatization plan was not authorized by the governing statute. The Court expressly noted the conflict flagged by CCR between the statutory mission of the Health and Hospitals Corporation and the profit-maximizing goals of a private, for-profit corporation, and held that HHC’s critical public mission of providing comprehensive, quality health care services to the poor and uninsured residents of the City must be fulfilled.