Hospital Closing Outrages

Commentary by Frosty Wooldridge

BOULDER, CO - Jan 9, 2008

Dear Friends:

You're invited to send a letter to the NY Times on their ridiculous lack of coverage of WHY our hospitals are going bankrupt across the nation. Over 300 hospitals have bankrupted in the past 20 years. The reason explodes daily as millions of non-paying illegal aliens use the EMTALA Act to gain free medical care at a cost to you and me. 

We're going broke and health care costs skyrocket out of reach. 

I reported on Grady three years ago. They suffered $64 million in losses at that time. It's worse today as they are about ready to collapse. 

Please take a few minutes to click the LTE to the NY Times, give them a piece of your mind in 200 words or less and send it to them. 

Thanks, 

Frosty Wooldridge www.frostywooldridge.com

New York Times letters@nytimes.com

http://www.nytimes.com/2008/01/08/us/08grady.html?_r=1&hp&oref=slogin

A Safety-Net Hospital Falls Into Financial Crisis By SHAILA DEWAN and KEVIN SACK

Original Article: http://www.nytimes.com/2008/01/08/us/08grady.html?_r=1&hp&oref=slogin

Published: January 8, 2008

....snip....Once admired for its skill in treating a population afflicted by both social and physical ills, Grady, a teaching hospital, now faces the prospect of losing its accreditation. Only short-term financial transfusions have kept it from closing its doors, as Martin Luther King Jr.-Harbor Hospital in Los Angeles County did last year. That scenario would flood the region’s other hospitals with uninsured patients and eliminate the training ground for one of every four Georgia doctors.

....snip.......Although the hospital is unique in many ways, the code red at Grady is emblematic of the crippling effect America’s health care crisis has had on public hospitals around the nation. Though Grady is among the most distressed of the country’s 1,300 public hospitals, others have faced similar challenges in recent years, including those in Miami, Memphis and Chicago, said Larry S. Gage, president of the National Association of Public Hospitals and Health Systems. There are 300 fewer public hospitals today than 15 years ago, with hospitals having closed in Los Angeles, Washington, St. Louis and Milwaukee, Mr. Gage said ....snip.....Like other public hospitals, Grady is operating on a business model that is no longer sustainable. A third of the hospital’s patients, including those treated as outpatients, are uninsured, among them a rapidly growing group of immigrants.

....snip......As a result, the hospital has faced deficits for 10 of the last 11 years. It can no longer do so. This fiscal year’s budget gap is projected to hit $53 million. Emory University and Morehouse College, whose medical schools supply the hospital’s doctors and are its biggest creditors, are owed an accumulated $71 million and have threatened to bolt. Grady officials estimate it would take $366 million to meet long-ignored capital needs, like replacing quarter-century-old beds, antiquated computers, and the trauma ward X-ray machine, which conked out two years ago. Department chiefs predict a growing difficulty in recruiting physicians and residents.

....snip.....Virtually every aspect of Grady’s operations has come under scrutiny: its nine neighborhood clinics, its subsidized pharmacy, its care for Atlanta’s growing population of illegal immigrants, even its 60-year-old governance structure........Will Grady outsource, or simply downsize? And if it must downsize, which patients should be turned away?

....snip.....The ER did not have a working X-ray machine that night, so doctors had to roll in a portable one to locate the bullet. The X-rays were produced on film rather than digitally, causing a 10-minute delay in diagnosis. There were gurneys without wheels, and a computer system so outdated that doctors had to call up four separate programs to compile records on a single patient........“We’ve gotten really good at MacGyvering,” said Dr. Philip H. Shayne, an emergency room physician. “We use paper clips for a lot of stuff.” That may no longer be good enough.

On any given day, a patient taken to Grady’s storied emergency room, or to any other unit in the hospital, may still receive care as good as any in the city. But the signs of stress are everywhere, in overworked staff, in broken equipment, in outmoded systems.

....snip.....The hospital’s burden is most visible in the emergency room, where the hallways that recent night, as most nights, were chockablock with stretchers — one man, shackled to his gurney, writhing through an acid trip; a woman fighting seizures; asthma patients sucking down oxygen. Their comings and goings — more than 300 a day — are tracked in doctors’ script on a greaseboard, a relic rarely seen in an age of big electronic screens. Because of crowding, it can take 24 hours to move a patient to intensive care, Dr. Haley said.

....snip......The equipment for cardiac catheterization and magnetic resonance imaging breaks with regularity. Because Grady often cannot pay suppliers on time, there have been temporary shortages of essentials like neck braces, electrodes and even saline. A third of the ambulances need to be put out of their misery, said Astria L. Benton, a paramedic supervisor. Every week or so, a vehicle simply gives out while in transit, and Ms. Benton prays that the patient will not die before she can orchestrate a rescue. “No one wants to talk about it,” she said, “but it could happen.”

....snip.....The hospital board has long been reluctant to make money-saving changes that might reduce its traditional mission. Late last year, it rejected the advice of financial consultants and its newly hired chief executive to close an expensive outpatient dialysis clinic for the poor, fearing that many of the clinic’s uninsured patients, including many illegal immigrants, would have nowhere else to go.

....snip.... Hillary Estrella Reyes is one of the newest Grady babies.

Just three days after she was born in late October, she slept in the lee of her mother’s hospital bed. Tucked into a bassinet with a knit cap and blanket, she was an oblivious example of the explosion in Hispanic growth in Georgia and at Grady. A third of the hospital’s newborns are now children of Hispanic parents. Grady’s crisis has not touched

Hillary’s parents, Patricia and Daniel Reyes, who seemed calm as the nurses wheeled the baby away for a checkup. They paid for prenatal care in $100 installments, and Medicaid will cover the cost of the delivery, because the baby is a citizen. But her parents are in the country illegally. Without Grady, families like theirs would face an uncertain future in their new city. Where would they go in case of a serious ailment? And what of Hillary, who was born with an unusually rapid heartbeat? If Grady were to close, her options for care might be severely limited. Grady’s disappearance is a prospect Mr. Reyes, a janitor, and his wife — like many of the hundreds of thousands Grady serves — are unable to visualize. Asked about it, Mr. Reyes could do nothing but shrug. “I haven’t got sick yet,” he said. “Thank God.”

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