Another View: Don’t forget charity care

I don’t think it’s a stretch to say that health care reform is on the minds of many Atlantans these days. It is certainly on my mind as both a taxpayer and as the CEO of the state’s largest provider of charity care, Grady Health System.

Many observers initially believe any plan that promises to provide health insurance to as many as 97 percent of Americans would be a boon to hospitals like Grady. That’s a fair assumption.

We will deliver more than $300 million in uncompensated care this year, and it would take converting only a fraction of that to insured customers in order to make us solvent, thanks in part to financial support from Fulton and DeKalb counties and the U.S. government’s Disproportionate Share Hospital (DSH) program.

DSH payments are special funding for hospitals that treat significant numbers of indigent patients. DSH funding, while imperfect, is a critical part of keeping hospitals like Grady alive.

But there’s the rub. In order to pay for significant health care reform, the president and congressional leaders are considering phasing out DSH. If it is pulled too quickly, Grady will pay for the government’s mistake.

That’s the thing about safety net hospitals. People in need will show up, and we will provide the care, whether they’re insured or not. That is Grady’s mission.

In many ways, Grady is lucky. We have made remarkable progress over the past year, finding $60 million in improvements in how we operate just as this recession took hold. Otherwise, I’d be the former CEO and this space would be used to discuss how area hospitals are absorbing the free care that Grady used to provide.

My own proposal for health care reform offers a much simpler solution than the current plans in Congress. For $10 billion annually (versus the roughly $100 billion per year House plan), the federal government could provide enough support to keep Grady and every other safety net hospital in the country solvent.

We are the experts at providing this care and are working on the best models to provide it in the same cost-effective way that our private hospital brethren do.

While Grady is much larger than most, there are approximately 50 to 100 hospitals in the United States that provide the vast majority of safety net care.

Give these hospitals the money directly, save the taxpayers billions of dollars and these hospitals can continue to provide that care. Nearly 1 million people rely on Grady’s care every year.

Unfortunately, direct support to public hospitals is not the direction reform is headed. As this reform plan works its way through Congress, we at Grady feel strongly that DSH must stay in place long after a government-sponsored health plan is available to all. A substantial cut to DSH in the first five years of a reform plan could undermine the stability of Grady and every other hospital like it in the country.

In the high-flying trapeze act called health care reform, the last thing you want to lose is your safety net.

Michael A. Young is president and CEO of Grady Health System.