As a physician, medical educator and former U.S. Secretary of Health and Human Services, I have become increasingly concerned about the disappearance of a number of public hospitals around the nation. Once-proud and important institutions such as the Philadelphia General Hospital in Pennsylvania, the District of Columbia General Hospital in Washington, the Martin Luther King Hospital in Los Angeles and others no longer exist because of inadequate finances and the lack of support from the civic and business communities in those cities.

The crisis at Grady Memorial Hospital does not have to end with the same catastrophe. Atlanta has a number of committed individuals from our civic and business communities who are willing to support Grady in its time of special need.

In 1975, when I returned from Boston to Atlanta, my hometown, to accept the position of founding dean of Morehouse School of Medicine, I was particularly proud of Atlanta's often-cited motto, "The City Too Busy to Hate." We are an increasingly diverse metropolitan area, racially, culturally, scientifically, educationally and economically. At this time all Atlantans, whether born here or having moved from other cities, need to support one another and our community, as we all work to keep Grady alive and to restore it to optimum health.

Because I am a "Grady baby," I was pleased to accept the invitation to serve on Grady's planned new governance board. This board will have a number of successful, committed civic and business leaders (black and white) from our city who will be contributing their time, their expertise and their influence to saving Grady and making it stronger.

It will not be an easy task. The reasons for the Grady financial crisis include: a steady increase over the past decade in the number of persons without health insurance; continuing increases in the cost of health care and in the percentage of the nation's gross national product consumed by health care; and multiple fiscal restraints by federal and state governments and by private insurers in efforts to control costs. While these factors affect the entire health care system, the greatest impact is on the nation's poor and the public hospital systems upon which they depend.

In my informal discussions with members of the proposed new board, I have been impressed by their commitment and by their realization that, if Grady disappears, our city's health-care system will be thrown into crisis. Our low-income citizens will have a much more difficult time obtaining the care they need and deserve. The special services Grady has available for all of us, such as trauma care, the poison center, the cancer center and others, will no longer be available. The other hospitals and clinics in Atlanta will not be able to fill the void in health services that would be created if Grady closes.

Without Grady, should Atlanta have the misfortune to experience a terrorist attack or a major passenger airline crash, we would be woefully unprepared to care for the many injured persons. Without Grady, Atlanta would be at a disadvantage in competing with other cities for organizations and businesses located elsewhere contemplating a move to a new metropolitan area. Atlanta's convention business, a major part of our economy, would also suffer significantly. We must act to minimize and even avoid these scenarios, if at all possible.

Therefore, I am asking all Atlantans to support the new board and Grady Hospital in addressing the challenges we face. We will be an even greater city because of it.

Any other outcome is not the Atlanta way, and is unthinkable.

> Dr. Louis Sullivan served as the secretary of the U.S. Department of Health and Human Services from 1989 to '93. He is president emeritus of Morehouse School of Medicine.