The case for public health hospitals

As the race for local and national elections heat up, politicians are devoting more attention to the steadfast campaign issue of health care. It is an appropriate national concern, and public hospitals such as Grady Memorial are vital to the provision of public health programs and medical services.

The slogan that Atlanta “can’t live” without Grady is no hyperbole.

With President Barack Obama’s visit to Roseburg, Ore. following his views on the recent shooting there as now “ordinary” in America, it is noteworthy and tragic that Georgia has had the most school shootings of any state.

That is an exceptionally sad fact in light of the shootings last week at Northern Arizona University. As citizens, none of us know how or when we might need the emergency services public hospitals such as Grady provides. Many Atlanta residents wouldn’t be here without Grady.

For example, in Georgia, motor vehicle deaths in 2010 accounted for more than $13 million in medical costs and over $1 billion in work loss cost, according to the Centers for Disease Control and Prevention. We can say proudly that Grady is the premier Level 1 trauma center in the region and the only provider of Advanced Life Support Emergency Medical Support in DeKalb County. It’s not just the indigent that need a public hospital – so do all of us.

The work at Grady goes beyond life-saving trauma care and other crucial services. Grady hosts one of the largest emergency medicine training programs in the country in addition to caring for the droves of underserved Georgia residents.

Some might wonder why we need Grady now that we have the Affordable Care Act. Because of our state’s failure to expand Medicaid through the optional provision of the ACA, there are still 282,000 Georgians who fall in the Medicaid coverage gap. Our legislators locally and nationally need to put partisan politics aside and work out a solution to this funding gap.

As recently as 2008, the future of Grady was uncertain as the hospital teetered on the edge of financial collapse. More recently, Grady Health System received a $30 million gift from the Marcus Foundation and as of 2013 was operating in the black.

Public hospitals are landmarks and health care hubs within communities. They don’t qualify for high payer rates like large hospital systems, and they face funding cuts when times get tight. Yet, they are used by the rich and poor alike in any given hour of need. They employ thousands locally and provide a public good that many take for granted.

We can learn lessons from another public hospital to hopefully avoid its demise. Charity Hospital in New Orleans was shut down after Hurricane Katrina. The 2014 film, “Big Charity,” documents the complex web of political interests and natural disaster that resulted in the hospital’s closure.

Atlanta native and film director Alexander Glustrom noted, “Public hospitals play such a critical role in a city’s ability to function in a healthy way. Sometimes the essential services that public hospitals provide can be taken for granted. New Orleans has learned over the past decade how deep the consequences can be when a city loses its major public hospital.”

While we’re not likely to experience a hurricane in Atlanta, the 2008 tornado and 2014 Snowmageddon taught us natural disasters can still strike. We must be prudent to protect the future of Grady.

As campaign rhetoric expands and candidates speak on issues to increase poll numbers, it is time to realize that public health hospitals need our support as much as we need them.

Dabney P. Evans is an assistant professor of global health at Emory University. Anwar Osborne is a assistant professor in the Emory University School of Medicine and a practicing emergency room physician at Grady Memorial Hospital.

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