The Atlanta Journal-Constitution
Saturday, September 06, 2008
New Grady hospital CEO Michael Young fired a shot across the bows of metro Atlanta hospitals Friday, saying they should stop sending their uninsured patients to Grady.
“I think the other hospitals need to do a gut check on their missions, and see if they’re doing their fair share,” he said during a news conference Friday.
“They need to step up and treat every patient the same, rich or poor, insured or not,” Young said.
The practice of sending these nonpaying patients to Grady has gone on for years, Young said, and is a major problem contributing to Grady’s multimillion-dollar deficit.
If it continues, he said, the hospital may not survive.
Having taken office on Tuesday, Young showed his willingness to attack a charged topic right off the bat.
“These other hospitals are [nonprofit] tax-exempt organizations, and both the state and federal government are giving them tens of millions of dollars in tax breaks,” he said. He declined to identify any hospital.
Officials from several area hospitals denied that they dump patients on Grady.
“We don’t dump patients. We don’t send patients to Grady,” said Lynn Peterson, spokeswoman for St. Joseph’s Hospital in Atlanta. “If a patient arrives at St. Joseph’s, they are taken care of here.”
Grady is considered the largest, busiest and most financially troubled public hospital in the state. The hospital treats many uninsured people and loses upward of $40 million a year providing this uncompensated care, Grady officials said. The hospital was close to closing last year when it ran a deficit of $43 million.
Young opened a can of worms that has created debate for years in metro Atlanta. The dumping of patients to another hospital raises concerns about ethics and potentially violates a federal law against the practice. Beyond that, a patient who does not receive proper treatment at a hospital that also tells them to go elsewhere could be the basis of a malpractice lawsuit.
Young said he believes some of these patients sent to Grady are not receiving proper treatment elsewhere, before being sent to Grady. He said he spent 20 hours in the Grady emergency room this week, and was struck by the “high number of those patients who started elsewhere.”
He spoke of one patient from Stone Mountain. He said the patient had been at another hospital, and the treatment was not complete. “They were uninsured,” he said.
Nettie Klein, administrative director of emergency services at Piedmont Hospital, said, “We are required to provide urgent care when they present at the door.”
Sometimes a patient is transferred to Grady for a specialty service, such as Grady’s burn clinic, she said.
Officials at Emory Crawford Long Hospital and Emory University Hospital also said they do not dump patients on Grady. But it is possible for a patient to end up at Grady for follow-up care, if that is more convenient for the patient, said Dr. Kate Heilpern, the Emory official who oversees the emergency rooms at Crawford Long, Emory and Grady.
She noted that if the patient lives in Fulton or DeKalb, they may pay less, or even nothing, by attending a Grady clinic versus one elsewhere.
The Rev. Tim McDonald, a leader of the advocacy group called the Grady Coalition, said he has spoken to uninsured patients who told him they had been sent to Grady from another hospital. He praised Young’s “courageousness” in raising the topic.
But McDonald said such debate has surfaced in the past, with little results. He believes nothing short of state intervention will stop the dumping.
“If Grady is going to be fixed, you need to be honest about this,” McDonald said.
There you have it folks - the confluence between economic reality and the demand for health care services.
The entire argument is the keystone of the activist's claim that "poverty is a SHARED EXPENSE across society. This is a backways perversion of their real argument - WEALTH is a SHARED BENEFIT across society.
Let us back up a bit and look at the key issues - POLITICAL BOUNDARIES. It comes as no surprise that race and class are key underlying issues here. Grady Hospital resides in the core city - Atlanta. Surrounding Grady are poor neighborhoods. Piedmont and others reside in more affluent parts of Atlanta or in different cities/counties all together. During the past 40 years the big struggle in Atlanta was to control the POLITICAL SEATS in a given political container (city of Atlanta, Dekalb County, Fulton County, City of Riverdale, etc). All the while that these battles were going on in the political domain - there was not enough brain waves focused on the underlying economic "boundrification" that was present as various people sought their control.
Fast forward to today and what we see is that upon winning the political contests these same forces now want to eliminate the boundaries of MONEY FLOWS. The problem is that their political adversaries left the core districts and thus the powers that be today were able to take control......but they also TOOK THEIR MONEY WITH THEM!
Thus for these political operatives who are in control - sitting in elective seats or pounding the pavement like Rev McDonald - to actually express the benefits of their political booty - they must now DISINTEGRATE the very boundaries that allowed them to be a MAJORITY in the small context of the metro area that is bounded up.
So now we get to the meat of the case. The truth is there is a strong undercurrent in this movement which says "SEND US YOUR MONEY because it is our right as equal citizens AND MIND YOUR DAMNED BUSINESS ON HOW WE RUN OUR BUSINESS.....with your money!!!".
This leads me to my question - DID YOU NOT REALIZE THE ECONOMIC REALITIES and the need for you to PRODUCE when you were vying for these local offices?
Also - WHAT GOOD IS YOUR SEAT NOW when you are a net DEPENDENT on the people who have vacated......allowing YOU TO RUN THINGS the way that you saw fit? Since you all couldn't get along and the conflict was a source of great angst - ONE SIDE MOVED AWAY and allowed you to have at it. (No these are not just WHITE FOLKS who have moved out. Atlanta has a rich set of Black suburban areas as well.)
All of this begs the question - What is the ultimate goal of the Black Political Agenda if the growth of political power within a district is not accompanied with a RATIONAL (logistical) attempt at maintaining and developing the ECONOMIC foundations of these same districts so that they will remain viable?
If people aren't seeing my arguments - let me clear it up for you:
In so many political struggles where MY PEOPLE obtain power and control over a political boundary one key argument that ensues is that of the CULTURE and TEMPERAMENT of the boundary. What behavior is allowed? What standards are enforced? What is the balance between the perceived interests of the individual versus the corporation? It comes as no surprise that in the case of the Black community the - PROGRESSIVE BIAS always wins out. For most people this sounds most logical and just. This allows them to walk home from a protest march where they chanted "PEOPLE OVER PROFITS!!!", feeling good that they worked for the good of the common man.
All the while the eschewed financial realities. Those who realize that such a movement is NOT ORGANIC but instead is an endless stomach have temporarily separated themselves from the gastric juices via an imaginary line that is painted on a political map. They don't realize how wrong there were to assume that they are now safe. What they have is a temporary deferment. SOCIETY always looks at the actions of "those who have escaped", leaving their "poor brothern" behind to find their own way. It is this same society who needs to LOOK THE OTHER WAY!!! Look at the OFFENDING ACTIONS of those who are "left behind" and seek to HAVE THEM to own up to a certain system of practices that would allow them to live up to the standard that is said to be guaranteed to all Americans.