For a family in financial crisis, it's almost never a good idea to pay off existing debt by incurring new debt. For Grady Memorial Hospital, which for years has teetered on the edge of insolvency, borrowing another $100 million makes no sense at all.

Unless, of course, the goal of the Fulton-DeKalb Hospital Authority is to delay the step it knows it has to take: Handing management of Grady to a nonprofit, nonpolitical governing board that will have a better chance of curing the hospital's long-term financial ills.

In July, a task force of the Metro Atlanta Chamber of Commerce, which reviewed Grady's plight at the authority's request, recommended such a change in how the hospital is governed. The hospital's foundation paid $2 million for a consulting firm to go over Grady's management practices and the consultants also suggested such a move be considered.

Switching to a nonprofit corporate governing structure — an arrangement adopted by virtually every other major hospital authority in the state over the last 25 years — would allow Grady to shed legal restrictions on money-making ventures that it is barred from launching as a government hospital. Profit from such ventures could help offset Grady's considerable losses, most of them generated by treating patients who lack health insurance or other means of paying for medical care.

Unfortunately, the authority's leadership can't bring itself to embrace that concept.

Pam Stephenson, chairwoman of the authority, plans to ask fellow board members today to seek a $100 million line of credit as part of a short-term "stabilization" plan to pay off Grady's largest debts and help it make payroll well into 2008. The plan would give the authority time to consider other, long-term plans for changing how the hospital is run and financed, she said.

However, that delay comes with a catch. Lending institutions are willing to put up the money only if Fulton and DeKalb county taxpayers back the loans with at least another $20 million in public financing, Stephenson said.

That's not likely to happen. Last week, Fulton County commissioners introduced a resolution that would allow emergency funding for Grady only if the authority turns governance over to a nonprofit corporation. That was a clear signal to Stephenson and members of the authority that Fulton County, which already puts up $84 million a year to subsidize Grady, is tired of business as usual.

Even if the authority somehow managed to borrow $100 million to pay off Grady's long-standing debts, the hospital would still need another $250 million for new medical equipment, information technology and other capital investment the hospital has delayed while lurching from one financial crisis to the next.

Continued stalling would directly affect patient care, and would do nothing to address problems that threaten the institution's very existence.

— Mike King, for the editorial board