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Sunday, December 2, 2007
Grady ‘ransom’ merits healthy dose of scorn
The Atlanta Journal-Constitution
Any doubt that those who run Grady Memorial Hospital exist in la-la land was erased this week with a most astounding document agreeing to avoid suffocating its hostage — itself — if the business community and those who run Georgia pay a recurring ransom.
The governor reacted badly. “I have no intention of signing an unenforceable document that seeks to bind the state to a specific, annual appropriation,” said he.
The Speaker of the House — the state official farthest out on the Grady limb — received the news unsympathetically. “Today’s attempt by the board of Grady Hospital to control the Legislature is simply unacceptable.”
The lieutenant governor looked askance, too, declaring that state government’s Big Three “are not going to be bound by a governmental authority.”
The President Pro Tem of the Georgia State Senate, Eric Johnson of Savannah, upon receiving news of the hostage-holders’ demand that state leaders agree to fork over $30 million annually or it would hold its breath until it flat-out expired, inquired thoughtfully: “They didn’t require us to fund an ice cream cone for every patient?”
Picture this: Except for the brief three-year tenure of Dr. Andrew Agwunobi, who left this year for a private-sector job in California, Grady has been adrift for decades, always on the brink of financial disaster whether providing charity care, Medicare, PeachCare, Medicaid or private-paid.
Its problems, as the board resolution passed this week sees it, are the “result of decreasing public funds, adverse reimbursement policies and other factors beyond the control of the [Fulton-DeKalb Hospital] Authority.” As a consequence, “the Authority has suffered severe financial hardships and deficits in recent years that have threatened the system’s ability to continue to provide high-quality medical services …” to “increasing indigent and charity populations” in Fulton, DeKalb “and surrounding areas” in the face of “decreasing public funds.”
That is really quite an astounding declaration, replete with a heretofore unasserted responsibility to be the “primary provider of health care for the indigent and uninsured” in areas outside Fulton and DeKalb.
Please note that Georgia has not yet approved the medical use of marijuana — and, consequently, nobody in a health care environment should be in fantasyland, as this board clearly was as it resolved that:
• “No later than, and as a condition precedent to [turning day-to-day operations over to a management company], representatives of the business, charitable and philanthropic communities shall provide a written commitment for funds in the amount of not less than $200 million.”
• Before acting to save itself, “certain business and philanthropic leaders of the Atlanta community” will commit in writing to conduct a campaign “on a good faith, best effort basis” to raise an additional $100 million.
• Before this creation of the state agrees to do anything responsible to save itself — i.e., hire management help — “the Governor, Lieutenant Governor, and Speaker of the Georgia House of Representatives each shall have provided written confirmation of their intent to support, in addition to amounts currently received from the State of Georgia for the benefit of the System,” not less than $30 million annually plus “necessary budgetary measures for the implementation and funding of the Statewide Trauma Network, which would provide additional financial support for the System,” and higher appropriated sums for medical education.
Now, keep in mind the top dog on the Grady board is State Rep. Pam Stephenson (D-Atlanta). Before coming to the General Assembly, she headed the state’s health planning division. In each capacity, as legislator and as agency head, she knows politics and process.
To allow her board to make blindly stupid demands on the top three officials of Georgia government — demands, incidentally, that would require them to usurp the authority of the entire General Assembly — is breathtaking. In more than 30 years of reading public documents, this is the most bizarre.
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