As plugged-in people know, the Chinese Hospital plans to raze their 29,793 square foot building at 835 Jackson and build a 101,545 square foot hospital in its place, a plan which will be presented to San Francisco’s Historic Preservation Commission this week.
Yes, Bruce Lee was born in the building. And no, still no word from the Mayor’s office with respect to any demands for approving the needed project.
I’m not sure why the editor continues to act surprised/shocked/whatever about the concessions CPMC made to get their new hospital built. Palo Alto required over $40 million in concessions from Stanford for their new hospital. It’s nothing unique to SF.
[Editor’s Note: We’re anything but shocked or surprised, nor do we necessarily disagree with the approach. We are, however, waiting to see how the demands measure up.]
Let me make a few comments here that are a bit bold but not intended to be offensive in any way.
Chinese – someone corrected me at a cocktail party this weekend and told me the correct word is Asian – have a reputation, earned or not, for building ugly but practical, utilitarian buildings. This has certainly been the case in China, though it is changing fast as people become more interested in aesthetics and good architecture, especially in places like Shanghai.
Chinese influence is increasing in the city. As one poster once put it, the Chinese should take over this city and run it like Singapore. The only question is why has it taken them so long.
The only negative I can see is that there are going to be more ugly concrete structures. But the positives are huge, in reduced government corruption and greater public safety.
And in real estate – you heard it here first – they are going to take over the hellish housing projects and move those tai-chi grandmas in, with astounding improvement in life in those projects and huge boosts in value and the quality of life for anyone owning property nearby.
I thought the other rendering for this building looked bad. This isn’t even brutalism, it’s just brutal!
I hope this gets approved, for the sake of a new hospital, but I also hope it gets redesigned, for the sake of the sidewalk.
unwarrantedinlaw: I don’t know why Chinese influence in government would result in less corruption. Neither Singapore nor China are known for their political transparency. And the only thing offensive about your comments is the generalization of “the Chinese” as a monolithic “them” — including, apparently, all Chinese (er, “Asian”?) people in China, Singapore, and San Francisco, without differentiation. That’s offensive enough.
I’m quite surprised to find that Singapore is actually around 75% ethnic Chinese…
http://en.wikipedia.org/wiki/Demographics_of_Singapore
Such as shame… I hope a lot of people write letters of protest.
Who’s Bruce Lee?
[Editor’s Note: We don’t know if you’re being sarcastic, but if not, a quick Google search should answer your question faster than a flying fist.]
It seems to me that part of the problem is that the opposition to expanding the use of underused locations is just as strong, or even stronger, than the opposition to demolishing historic structures.
See, for instance, City College’s problems with their Chinatown campus.
Of course I was being sarcastic; only to emphasize my personal distaste of using any person’s status, famous or not, to garner support to make a building, such as this hospital “historic”.
I’m sure some of the historic preservationists would use this information about Lee as a way to gain historic status for the hospital and prevent the new one from being built.
Would an anonymous baby born there, say on the same day, have the same sort of status? Should they?
I’m sure if the majority of Asian/Chinese residents in the area, who use the facility, are asked “how historic do you think the old hospital is, based on the fact that one Bruce Lee was born there..?”; I suspect most of these good citizens desperately want a new, state of the art health care facility. They probably don’t care who was born in the old building.
This projects demands quick approval and construction.
Any building of architectural beauty and Chinese cultural significance should be preserved, celebrity status or not. Bruce Lee? An amazing, awesome artist is what he was.
Would you say the same if it were George Washington rather than Bruce Lee?
lyqwyd: no I would not. And thank you for showing the difference between famous people and historically important people.
George Washington never destroyed Chuck Norris in the Colloseum in Rome while a kitten watched, and his birthplace is a National Monument.
http://www.nps.gov/gewa/index.htm
So unfair.
“Would an anonymous baby born there, say on the same day, have the same sort of status? Should they?”
From your response to me you have answered your own question. Some people are of more historical note than others. We may disagree on where that cutoff is.
One person’s famous person is another person’s hero, and I would say Bruce Lee is far more than just famous. He drastically changed the acceptance of Chinese culture in this country, and inspired an entire genre of film. An entertainer can be of historic importance. Charlie Chaplain, Miles Davis, Charlie Parker are just a few who come to mind.
Bruce Lee being born in the hospital isn’t the only reason to consider it as historic, and even if it’s not an historic building, the sheer ugliness of the proposed replacement is reason enough for many to oppose it.
Yes, some people may be of more “historical note” than others. That’s true and real.
But I feel that one doesn’t attempt to save an old, out of date, dysfunctional, severely seismically deficient building because some person of historical note was “born” there. That does not make the building more valuable, or more functional, or safer. It’s just simply a fact that someone of note was born there. Nothing more, nothing less.
Historic preservation has its’ place in our city; however often used as a tool to stop responsible progress, change and growth. Witness the boarded up Pagoda Theatre in North Beach, now vacant and crumbling after 15 years of being empty. It’s a blight on the neighborhood. You can blame that on the preservationists.
There has been much discussion on the pro/con of the design of the new proposed hospital. I have offered some of my thoughts. They remain the same:
The existing building should be demolished and a new state of the art hospital be built to serve the needs of this particular community. They deserve it.
putting “historical note” in quotes doesn’t make it less true. Bruce Lee is probably one of the most historically important people to be born in SF.
From Wikipedia:
“He is widely considered by many commentators, critics, media and other martial artists to be the most influential martial artist of the 20th century, and one of the biggest pop culture icons.He is often credited with changing the way Asians were presented in American films”
Not the most important historical figure by any means, but he’s definitely an important person in American history.
The building itself has at least one site dedicated to it’s history, which to me would qualify it for consideration as an historic building. I think there are much less worthy structures that have been granted historic standing.
I personally think historic preservation is often used poorly in this city, but as I stated before, this building is one that actually warrants it. Throw in the fact that the replacement is terrible and I’m all for preservation.
As I stated in the previous thread, there are ways to preserve structures without encasing them in amber. Keep the facade and allow an extension of the building upwards (with a setback) and to the rear. Thus the historic value can be preserved and the hospital expanded and updated to meet modern needs. There is a middle ground between frozen in time and destroying it all and replacing it with a pile of garbage.
OJ Simpson, Jerry Garcia, Clint Eastwood, Robert Frost, Ansel Adams, not to mention Alicia Silverstone, were all born in the City. Pick your poison. Glad you’re a Bruce Lee fan, but portrayal of Asians as kung-fu fighters in mainstream films is a dubious honor, and pop culture recognition is not actual impact. Besides, if he was born in the building, what’s the point of preserving the facade? You’d want to preseve the room, or maybe the bed if you could find it.
I’m reeling over the notion that this building be preserved because of one pop culture kung-fu movie star was born there. Seriously? you feel that very minor fact is enough to preserve this building?
Wow. Additionally, Brillo adds a good comment to this discussion, and well articulated.
Well, at least we know we are still in San Francisco, and the “hysteric” preservationists are deep at work. Keeping the facade of an old building is not a generally accepted practice of true historic preservation, nor is it widely supported by the National Trust. However, there are some hideous examples of this practice right in Washington, DC.
Not to mention the incredible cost of retaining a old concrete framed facade would cut into the badly needed funds to building an outstanding functional hospital. Whether or not you support the design of the “proposed” new building is an entirely different discussion.
Bruce Lee returned to Hong Kong at 3 months and lived there until his early teens. When he returned to the U.S., he lived in San Francisco for a few months, before moving on to Seattle, where he opened his first martial arts studio. Upon returning to the Bay Area, Lee chose Oakland as the site for his second martial arts studio. He is buried in Seattle.
http://en.wikipedia.org/wiki/Bruce_Lee
Historically, preserving the Seattle and Oakland studios makes far more sense than a hospital in a city to which his ties are otherwise tenuous.
Whoah! Now when viewed from the opposite direction of the street I take back my negative comments. It is soooo much more beautiful from this angle and as a plus it blocks the view of that ugly Transamerica Pyramid.
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This initial plan is probably just an opening volley in the negotiations with the city. “You want concessions? How about we make it a little less ugly?”
The new building is to the old as Ed is to Bruce. Just sayin’
Reducing Bruce Lee to a “pop culture” figure is like calling Bob Marley a “reggae singer,” or something. Some of you posters need to do more deleting and less saving. You are not culturally literate enough to engage, and it’s comical. Just sit out now and then and let others talk, fuddy duddys. Bruce Lee is a global icon who changed perceptions worldwide. (But hospitals are not made to last, but rather to change with the times. So a child’s birth in one, no matter culturally important is not an argument for preservation.)
It’s an old run down hospital – who cares? Tear it down.
Wish the new building was a little more interesting though.
@Brillo
I said “one of”, not the most. I would say Bruce Lee is more historically significant than most of the people on your list.
@futurist
I don’t recall anybody saying the building is historic due solely due to Bruce Lee, I certainly didn’t. I have pointed out in this thread and the previous that the building has historic value on it’s own merit.
I agree with anon1 that if Bruce Lee having been born in the hospital was the only thing of note for the structure, then it would have little significant historic merit, but that’s not the case.
You don’t like the facade idea? Feel free to propose something better than the ugly proposal that is on deck, I’m open minded. The current proposal is why historic preservation has the power it does, trying to replace something of importance with something so bad makes people want to fight it with whatever options they have.
Cost arguments for this situation have no weight for me, I think the people who are swayed by that type of argument are already in agreement with you. San Francisco has certain rules about aesthetics, and I don’t feel any need to waive them in this situation.
There’s examples of poorly done expansions that preserve the original facade, but there are also excellent examples. And even the worst work would still be better than the existing proposal.
If they can’t afford the make a decent building, then make the existing one earthquake safe and keep fundraising for the time when they can build a replacement that is not so hideous… Or sell the building and build a new hospital where the building doesn’t have any appeal… Or just move to a new building that is already up to modern standards.
To tell you the truth, I’m not even clear why it’s so important there be a hospital in Chinatown at all. Even if this small hospital went away completely, there are lots of areas in SF with far less access to hospitals. Many of those areas also have poor and/or old people. Please explain why it’s so important that this hospital remain exactly where it is, and be built at the absolute minimum cost (except for that whole “new state of the art” part).
There are many options better than the current proposal.
@debtpocalypse
Even for the most important historical figures, people usually are generally interested in where they died, where they were born, and maybe where they did their most important work.
You want concessions?
I’d give ’em several extra floors if they’d push back the facade.
I know in London they do a lovely job of preserving facades while making the interiors modern and flexible (Ex. Apple store). We saw several examples under construction while tooling around, nothing left but the facades propped up. Kept the flavor of certain neighborhoods while keeping the energy and flow of the city going. I don’t think it is that much more expensive. Cheaper than retaining the interior as well (Ex. Los Angeles City Hall which was remodeled at twice the price of just putting in a brand new building).
Couldn’t that be done here? Why does it have to be all or nothing? Nice interior details could be sold or repurposed in the new building. Has anyone been IN the building? Is it anything special inside at all, architecturally (like LA City Hall, admittedly, was)?
How twee that we get to debate the merits and architecture of a building that will save peoples lives!
I’m not sure what “twee” means, but it sounds like you are saying hospitals should have carte blanche do do whatever they like, is that correct?
I’m pretty sure that’s not what Joe said.
Perhaps the hospital can be compelled to establish a separate ward to treat local victimized strawmen?
Most of this is addressed to lyqwyd, but not entirely:
The cost issues of retrofitting an out of date building such as this one are enormous, and they impact greatly the client’s budget in providing a state of the art facility.
There really is an urgent need to replace this dangerous, seismically deficient building. Sadly, much of Chinatown is unreinforced masonry as well as unreinforced concrete; presenting a tremendous collapse hazard WHEN the big quake comes. Not if. When.
Yes, the initial digital renderings of the building are probably schematic in design only and a placeholder for much much more design development.
It’s extremely important for this hospital,largely serving Chinese families and the elderly to be located IN their neighborhood. The ease of accessibility and literal location of the building are very important to those users.
Calling the new design “something so bad” needs more discussion and detailed commentary.
For the benefit of the neighborhood and local community, I believe the new hospital will go forward and will be a much needed and welcome addition to Chinatown.
I went ahead and looked up twee, from urban dictionary:
“Something that is sweet, almost to the point of being sickeningly so.”
So I think my interpretation of his statement is fairly accurate.
@futurist
“There really is an urgent need to replace this dangerous, seismically deficient building. Sadly, much of Chinatown is unreinforced masonry as well as unreinforced concrete; presenting a tremendous collapse hazard WHEN the big quake comes.”
It survived Loma Prieta. It’s condition has been the same for decades, why is it suddenly so urgent? SF GH is being upgraded and it’s not being allowed to be the cheapest of all possible options. Other hospitals are being upgraded / replaced and are being held to certain minimum standards. Why should this place be given special treatment?
“Yes, the initial digital renderings of the building are probably schematic in design only and a placeholder for much much more design development.”
This is the cheapest part of a project, it wouldn’t have cost much at all to do a decent initial design. What normally happens is that the design gets valued engineered to look even worse than the initial design.
“It’s extremely important for this hospital,largely serving Chinese families and the elderly to be located IN their neighborhood.”
Why is this neighborhood (which, as I pointed out, already has easy access to many nearby hospitals and medical offices) more important than other neighborhoods that don’t have any nearby hospitals at all.
Why not just move to another nearby building if it’s so important and urgent? Then the hospital wouldn’t have to be closed during demolition and construction.
“Calling the new design “something so bad” needs more discussion and detailed commentary.”
Read the previous thread, there’s plenty of explanation as to what’s wrong with the design.
“I believe the new hospital will go forward”
I have no problem with the hospital being upgraded, just not as currently designed.
“and will be a much needed and welcome addition to Chinatown.”
It’s already not welcome to many people.
why all the fuss?
It’s not like Chuck Norris was born there……
“If they can’t afford the make a decent building, then make the existing one earthquake safe and keep fundraising for the time when they can build a replacement that is not so hideous… Or sell the building and build a new hospital where the building doesn’t have any appeal… Or just move to a new building that is already up to modern standards.”
Aren’t we in the midst of a health care crisis affecting both access to care and cost of care? This is the type of argument that only someone with access to great health insurance and plenty of liquid assets would make.
How does preventing hospitals from being built or fighting to raise the cost of construction which will raise the cost of care make any sense? There are only going to be a small number of hospitals in any town or even a big city like SF. If it really hurts you that much to look at an ugly building full of professionals trying to help out sick people at a reasonable price, walk down a different street and admire the bay windows. And shame on cities for extracting huge concessions that only increase the need for Healthy SF type programs.
“why all the fuss?
It’s not like Chuck Norris was born there……
Good comments @ M.
I can say confidently, as an architect, who has been part of a large design team on several major California hospitals, that the client and the client’s leaders are extremely aware of the high cost of building a new facility.
We work with them, often with tight budgets (relatively speaking) to bring them the best facility their budget will allow; that means extremely functional spaces, designing the huge complex of hundreds of rooms and spaces that all must relate carefully to particular needs, complex mechanical, structural, and electrical systems, and of course full compliance to the state code for seismic safety.
Think about it. In an earthquake, the one facility (among others) we need to remain standing and fully functional is a hospital.
Architects work very hard to bring all of these components together, along with appropriate materials and aesthetic decisions, working on a tight urban site, AND respecting the client’s budget.
This particular project has all of those constraints. I’m pretty sure that among the Chinese Hospital leaders and board of directors, they do not place a high priority on saving the so called “historic” facade.
You guys are just throwing everything you can at the wall and hoping something sticks.
So now rising health-care costs are why this hospital should be allowed to get away with sub par design. I wonder what the next irrelevance you will use, global warming? meteor strikes?
Now you suggest that those that don’t like it should not be allowed to walk on the street because the hospital board doesn’t want to spend anything less than the absolute minimum.
Nobody here is preventing the hospital from being build, we are just trying to prevent it from having a terrible design.
San Francisco, and many cities, have certain rules about what is allowed. And given that other hospitals have made significant efforts to create a decent design, and some of them serve poor and/or old and/or Chinese people.
If you are an architect I would expect you to understand why so many people are so unhappy with this plan.
The building has potential historic value, the design sucks, and people are going to fight it. Best approach to for the hospital board is to come up with a better design/ proposal. You may not like it, but you aren’t going to convince the opposition with the type of arguments and personal attacks you’ve used so far.
Personal attacks? no, I don’t think so.
I’ve been giving simply my opinion and thoughts, as an architect, who has worked on projects very similar to this one, and with considerable experience regarding the long design process and entitlements necessary to design and build an urban hospital such as this one.
“Should not be allowed to walk on the street..”..huh?
Yes, we have “certain rules” that define what is allowed and not allowed. That’s called the Planning Code, and this building adheres to the code, from what I can see.
Sure, we can discuss endlessly the pro/con issues of the exterior design. Fact is, we have not seen very much in the way of resolved design solutions other than a couple of digital perspectives. Tell us why the design “sucks”, to use your words. I’d enjoy hearing your comments about the design, and what would make you “approve” the design.
And yes, it’s true: I am an architect, but to date, I have not seen a lot of comments as to why “so many people” are unhappy with the design.
Good grief, I’m just one voice here.
Lyqwyd –
I don’t know. I’m lobbing only one ball at this wall and it’s pretty sticky.
I thought that stating that requiring more expensive (including concessions) hospital buildings will contribute to the health care crisis should have been a major part of this conversation and is worth discussing. There is a clear connection here; throwing in some nonsense about global warming or meteor strikes is clearly an attempt to distract from a real issue here.
Do we not have a health care crisis affecting access to care and cost of care? Will increasing the cost of construction of vital medical facilities and/or throwing road blocks in the way of approval increase health care costs? How much does aesthetic design of a very small number of buildings matter in light of those very real issues? I think this should have been a part of the conversation at least.
I am not an architect, a health care professional, or even Chinese; just someone terrified of what it would be like to visit a hospital without health insurance. I’m only speaking out here because it seems crazy to me that we can have over fifty comments on the two threads demanding expensive re-designs, retrofits to an inferior building, and impractical moves to another nearby miraculous empty modern hospital building, without any consideration that health care costs is THE critical issue facing this nation. Have you seen projected Medicare costs or the percentage of personal bankruptcies caused by health care bills?
Are SocketSite readers that out of touch that this can’t even be part of the conversation and is instead a tinfoil issue to mock like meteor strikes?
Again @ M:
Well said.
“Think about it. In an earthquake, the one facility (among others) we need to remain standing and fully functional is a hospital.”
Just a reminder that despite its name this old building is NOT a hospital. It is an administrative office building. Its ability to withstand an earthquake is an issue though not as important as a public safety building (hospital, police station, fire station, etc.) being able to withstand a quake.
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“And shame on cities for extracting huge concessions that only increase the need for Healthy SF type programs.”
And even greater shame for applying different standards to similar projects. That would smack of cronyism. We’re still waiting to hear the city’s response to this project.
I kinda agree with those who think that Bruce Lee’s birthplace isn’t enough to seek historical preservation, but like lyqwyd said, you have to use the tools that are at hand. I personally think that the proposal is not only ugly, it insults the rest of the neighborhood. jenofla wrote:
Here’s the thing: the precious members of the architectural order of the illuminati don’t want to do this.
They want to ram modernism down the throats of people everywhere, even if they don’t want it. What they might actually say out loud when pressed is, “this represents the future of architecture, not the past.”
Witness Stanley Saitowitz practically going out of his way to build stark brutalist multifamily buildings in the middle of a block of Victorians or other traditional style single family homes that deliberately stick out like a sore thumb so that fanny caressers like John King, who has also drunk the Kool Aid, can come along and call it “bold”.
Employing rhetoric like saying the existing building style must be demolished/replaced due to seismic concerns, as if it somehow follows that seismic concerns somehow force the adoption of a modernist design for replacement.
Implying that “appropriate materials” and “efficient design” somehow mandate modernism. As if the architect couldn’t, if they wanted to, choose appropriate materials for a style of building that harmonized with the rest of the neighborhood, or at least what’s on the rest of the block.
While they’re at it, they make sure to call everything that isn’t in their preferred modernist style “fake”, “passe” or “Disney-fied” or some other insider agreed-upon epithet.
It’s épater le bourgeois for the built environment. We shouldn’t fall for it.
Well, yea, but…
Yes, being an admin building currently, it is largely full of human beings who work for and with the actual hospital, and those people need to be alive and safe when (not if) the big one strikes.
@M
I just group you with futurist et al. Your side seems to be using every argument you can think of, and none of them seem legit to me. First Bruce Lee is a nobody, then it’s Bruce Lee is not important enough, then when the building has historic merit on it’s own it’s earthquake safety, now it’s healthcare costs, I’m sure it’ll be something else equally invalid soon. Basically your side doesn’t think this place should be held to a minimum standard of aesthetics even though other similar projects are.
Healthcare costs are certainly rising, but it’s not because people expect a certain minimum aesthetic appeal, and allowing this design is not going to stop costs from rising. At best you are mistakenly associating two separate issues, at worst you are trying to take advantage of a real issue to push your agenda.
Add on the fact that, as MoD points out, this isn’t even a hospital today, yet somehow it’s an urgent matter that it become one now, and people of the community can’t survive without it, even though they have for decades.
It basically comes down to a small group of people who want to do whatever they want with no regard for the rest of the people living in, and visiting, San Francisco.
@futurist
Most buildings are largely full of human beings, yet we still expect a minimum of aesthetic appeal when a new building is built… why is this situation any different?
It’s funny how you all flame up about a decision that Ed Lee has already made (well, was made for him, but either way).
there are only two questions left here:
the one that the editor raises re: extraction of favorable terms or no extraction – the implicit assumption being the latter – which will raise the currently implicit question, why & so forth.
the other question of course is whether the building will be brought down by a demolition crew or will Chuck Norris just roundkick it.
Did you miss the part where the plan is being presented to the historic preservation committee?
If the deal were done there would also be no question of whether the mayor will extract favorable terms. And since the deal is not done, there is the question, and one of those terms might be a better design.
the project sponsors are also asking for some rather interesting zoning variances. That’s also an entry point for extracting concessions, whether or not they are equivalent in dollar value to those demanded of CPMC.
yes, I’m sorry if not being clear – the decision re: this being torn up, the feeling is, has already been made, and, therefore, again, the assumption is that the preservation commission will, pro forma, “approve” it;
only q is whether they (or really the mayor) will “try” to “extract”, at least for appearances, something or whether this will sail through w/out concessions;
@lyqwyd
All you want to do is dismiss my single point by grouping me with other arguments. This is an important point! If we extract or cause building a hospital to be more expensive, our health care will be more expensive. I am only pushing this issue because I am shocked that no one else is.
The design “sucks.” Sure, but do we care that it may lower health care costs for sick people? I guess no one here does. Like I said earlier, this focus on fighting a hospital’s construction over design and historic concerns and total dismissal of the effects of raising hospital building costs could only be made by those lucky to have great access to health insurance and liquid assets.
I think it is telling that SF and SocketSite readers have NO issue with forcing health care costs in SF to go higher and it is not even worth discussing. Yet there is plenty of hand-wringing on other threads about how SF is pricing out the middle and lower classes. Maybe there is a connection here?
@M
I dismissed your point because it is irrelevant to this discussion, just like the other arguments that have been presented thus far. Go look up the factors in rising healthcare costs. Hint: it’s not construction costs.
I’ll go ahead and save you time here are the top 5 factors in rising healthcare costs:
Both via the lawsuits, and the additional bureaucracy involved in trying to prevent it
Even if it were a factor of importance (but it isn’t) I’ve still seen no explanation as to why this situation should be given an exception to the rules that are applied to all other similar projects.
It’s good you are concerned about rising healthcare costs, but you should be focusing your efforts where they can possibly have an impact.
Lyqwyd –
Hospital costs were not a top five factor in your unattributed list of factors, ergo, it is no factor and my attempt to open some discussion can be completely ignored and dismissed by you.
My google searches:
http://www.unitedhealthgroup.com/hrm/UNH-Health-Care-Costs.pdf
http://aharesourcecenter.wordpress.com/tag/hospital-construction-cost-per-bed/
United Health Group (an insurer, so grain of salt) quotes the HHS stating that 8% of health care cost increases come from construction and equipment and 33% from Hospitals. Those two categories seem relevant to the discussion.
On page 3 of the same PDF, the Urban Institute pull quote cites the growing market power of hospitals and physicians to charge whatever they want as a major driver of health care costs.
The second link states estimates that hospitals cost $1.5 to $2 million on average per bed. I would guess this is higher for SF like everything else, especially once extractions and costlier designs are taken into account. That’s a lot of health care billing just to break even on your hospital construction. I’m sure the sick will be happy to pay those higher costs.
Combine the cost of a hospital with the above opinion that hospitals use their market power to charge more for health care and it would seem to me that encouraging more hospitals to be built at lower prices might lower health care costs. I’m not a health care policy worker either and my googling could be off, of course, but this is my contribution to the “irrelevant” discussion.
Once again, I think there is a case to be made that throwing up expensive road blocks that limit the number of hospitals built and raise the price at which they can be built, might increase health care costs, something that most people care about. That’s not to say design and other considerations aren’t irrelevant either. I’m just saying life is full of tradeoffs and we should be aware of them and discuss them. If someone else wants to chime in, I would love to hear what people have to say.
But this is all irrelevant, of course. The design “sucks.” Let’s get back to that.
@M: I agree with you that rising health care costs are an important issue. I may have not linked it directly to my earlier comments, architecturally speaking, but I can tell everyone this: The client is very concerned with costs for this new building; they have a budget; They are working VERY carefully to use that budget in the wisest possible way to provide a well functioning health care facility to their patients and staff. Providing an efficient building is of utmost importance. Providing a “beautiful” building with an unlimited budget is NOT.
Construction costs and operating costs are a very real part of rising health care costs, along with staffing, technology and equipment.
@ lyqwyd: Your comments are welcome here, as all others are. However, your replies are becoming quite “dismissive” as you say, because you find all other comments “irrelevant” to the discussion.
That’s becoming rather offensive, and one that the editors of SS frown upon. Please refrain from being dismissive.
I don’t agree with every comment here, but they are all welcome as part of this discussion.
M and futurist – If you are so concerned with the effect of construction costs on retail healthcare expenses then where was your outrage when the city extracted an extra $115M from CPMC? It wasn’t that long ago.
@ MOD: No, you have that rather wrong and completely changed what I have been saying:
+ Never said I was “so concerned” about construction costs. I stated that health care construction costs are HIGH due to the type of facility, codes, materials that are required. I said that construction costs are a “very real” part of health care costs. Just to clarify.
+ I support the Mayor’s request for so called “concessions” including affordable housing, transit and street improvements with regard to CPMC. I have no outrage because I was not outraged.
OK, then you’ll have no problem if the city asks for changes to improve the look that increase this project’s cost then, right ?
Milkshake –
I ran across that CPMC thread when it was too old for me to start this complaint but I think the CPMC example and my argument are even better suited. I have been making this case in a general sense for a reason. It is definitely applicable in many other cases.
IF…the City truly asks for changes to “improve the look”, that may or may not increase the cost..You don’t know that…
Then, yes, I support it. here’s the fallacy:
+ “improving the look”, or shall we say re-designing the facade, is a very subjective set of decisions. Some people may like the “new look”. Some may not. Many may not. Many might. Some will never like anything.
+ “improving the look” does not necessarily mean more expensive materials, OR costly changes. But, it could.
+, I personally think the client “Chinese Hospital” will have strong support from the City to spending the dollars AVAILABLE wisely, and not on wasting money to “improve a look”.
http://www.meplaninc.com/uploads/Meplan_-_Medical_Equipment_Planning.pdf (10-50%) of total costs
http://www.healthcaredesignmagazine.com/article/equipment-budget-wizardry-planning-new-technology (10-40%) “and the complexity of current technology and equipment can increase that percentage significantly.”
@M
Interesting, I was actually going to use your first link to support my argument, but felt it was difficult to explain, but since you linked to it I’ll go ahead and do it.
First, the “33% from Hospitals” is from operations, not construction, so has no relevance to this discussion, and in fact supports the idea that construction costs are insignificant.
Next the “8% of health care cost increases come from construction and equipment”. That and equipment part is very important. These two links suggest the cost of medical equipment accounts for 10-40 or 50% of the cost, and added “and the complexity of current technology and equipment can increase that percentage significantly.”
so now we’re looking at construction being somewhere between 7-4% according to that link, which puts it at or near the smallest contributing factor according to the chart. At 4% I would already say it’s an irrelevant factor, but that’s for the entire hospital’s construction costs. What we are talking about here is the facade of the building which generally costs less than 10% of the overall construction cost. So now we are talking 0.7-0.4% (or even less) of the overall costs. So yes, it’s irrelevant to the growth of healthcare costs.
I’ll refer to a couple select quotes from the first document you provided:
“Hospitals, physicians and prescription drugs cause 75% of the increase in spending.”
“67% of the increase in national health spending is accounted for by rising prices charged by providers, not increased use of health care.
“treatment volumes are increasing too – partly because of the rise of chronic conditions and obesity”
In the whole 15 page document the word construction is mentioned only once. The document supports my position, not yours.
Here’s a document from kaiser discussing rising health care costs, with suggestions on how to control them.
http://www.kaiseredu.org/issue-modules/us-health-care-costs/background-brief.aspx
Construction is not mentioned a single time.
Healthcare costs are an important subject, but has no relevance to this discussion. The solution is very complicated, but basically mean an entire overhaul of how we deliver healthcare. It has nothing to do with allowing this hospital to be ugly or destroy a potentially historic building.
@futurist
Dismissive? pot, meet kettle. Go back and read some of your own posts.
Construction costs were just as real a factor (although probably a more significant factor since other costs have risen much faster than construction costs) when the hospital was originally built almost 100 years ago, yet it was built with some aesthetic appeal.
Once again I’ll point out that what we are talking about is simply holding this project up to the same standards as other projects.
@M
Another thing, the link you provided shows that healthcare costs (at least for medicare) in San Francisco are at the national average, and growing at a slower pace than average (page 6).
What are the standards for other projects? Do we have a set of standards that will state when a building is ugly, or when it’s beautiful?
No, I don’t believe we do.
Some 35+ years ago when the Transamerica Pyramid went up, many citizens were outraged over its’ design and height.
Fast forward: it’s a pretty well liked building on our skyline.
Also forgot to include the links related to medical equipment costs:
http://www.meplaninc.com/uploads/Meplan_-_Medical_Equipment_Planning.pdf
http://www.healthcaredesignmagazine.com/article/equipment-budget-wizardry-planning-new-technology
@futurist
One standard is historic preservation, which you’ve repeatedly tried to dismiss.
As Bahma pointed out, they are also requesting a number of variances, those are also standards.
There are many parts of the planning code that discuss aesthetics, so those are standards as well.
Or perhaps you are questioning the standard that is the process of getting these types of projects built, which includes public discussion on the aesthetic appeal (and other factors) of the building being proposed.
As far as I can tell you don’t think those standards should be applied to this project.
I support the design of the new building, as it is presently shown in digital renderings. Going thru the normal design process of Schematic Design, Design Development and Construction Documents, most likely the facade and other parts will be revised, reviewed, adjusted and “massaged”. I support that.
I support the demolition of the existing older building.
I support the Planning Code sections that deal with height, setback, materials and other urban related issues. The Planning Code, Planners and the Planning Commission, however do not “design”. They make recommendations. The final design will come from a long process between the client, users, and the architect, as it should be.
I support the public discussion and involvement.
Even with all these various processes and governmental bodies in place; even with a sensitive and listening client, even with the most talented (world class, if you wish) architects, there is still no guarantee the new building will please EVERYONE.
And it doesn’t have to.
I support the building being designated as historic as I believe there is sufficient merrit.
I support the building being subject to the same processes and standards that are required of other similar projects.
Who said the planning code, planners or commission design?
Who said it has to please everyone?
you previously said “This projects demands quick approval and construction.” which seems to contradict your most recent statements.
Forget it, Jake; it’s Chinatown.
Some interesting information and visuals regarding the proposed new building;
From the Chinese Hospital website: chinesehospital-sf.org as follows:
+ The Community Meeting PDF, 33 pages: On page 33 a richly detailed digital rendering of the new building, showing the facade, materials and other elements at the entry: Modern, clean, inviting, welcoming.
+ The Chinese Hospital Master Plan, PDF, 45 pages:
page 29: per the board of directors: “…the remodel (of the existing 1925 building) would disrupt services to our community for more than 2 years. It was determined a new hospital would be the best choice for the future of Chinese Hospital.”
+ page 36: Policy 1.4: “Preserve the historic and aesthetic resources of Chinatown”. The client response: “Patients expect healthcare to be provided in modern, up to date facilities. The intent of the design of the new building is to ensure the community will feel the Chinese Hospital is a hospital where they will have access to modern equipment, technology and the best practices that will meet all of their health care needs.”
Looks cheap, much worst than the existing.
Keeping the facade, or improving the design, does not preclude them from making the hospital modern on the interior and providing up to date facilities.
I’m not really clear how remodeling the building would disrupt services, but demolishing and building something else wouldn’t.
“It was determined a new hospital would be the best choice for the future of Chinese Hospital.”
but not necessarily the best for anybody else.
Someone earlier quote “outstanding service” of the chinese hospital. Well, I beg to differ, in the chinese community, the insider joke is you go there to die not to get heal as services is not that great. My grandma, great grandma, grandpa died there. There are time nurses will simply ignor you. The Chinese are not known for attentive service, which is in line with other chinese business. (think restaurants) Of course there will be some exceptional nurses and doctors against this grain.
My previous doctor is stationed at the old chinese hospital. It is a bunch of small rooms with low ceilings and simply not suited at all to serve the modern public. As charming it is I SUPPORT TEARING it down but NOT replacing it with a bunker that looks like a PG&E substation.
EIR states architect is Jacob Global Building, who is certainly not well known for good architecture. This building suffers from a design created by an engineering minded firm. Engineers generally create efficient boxes and rarely good architecture.
Now it will match the other bland boxes on the block. What a shame. Why not save the shell and just make it new from the inside?