Must Grady close to win health care reform?

A column in the New England Journal of Medicine today notes there are not two health care systems in the U.S., but three.

The teetering, tottering "safety net" of "public and voluntary hospitals, community health centers, public health clinics, free clinics, and services donated by private physicians" means "'Americans who lack coverage can "still get care,' as President Bush recently declared," draining urgency from health care reform efforts.

So presumably if hospitals like Grady Memorial here in Atlanta were to close, it would spur national health care reform.

That may yet happen. The former government hospital has been given over to a private non-profit board. It wants to cut staff and renegotiate its agreement with local medical schools which provide it doctors.

All sorts of "tax that man behind the tree" proposals are being considered to raise money, but patient care is already suffering. Cuts in the pharmacy and dialysis would mean poor people die.

I doubt Glenn Beck would care about that, frankly. Not to pick on one man, but Beck is like most of us. He cares when the crisis hits him, as it did recently. Comedy is when you break your face, tragedy is when I get a hangnail.

So let me note here that any one of us could be put in Beck's situation, at any moment. Safety net hospitals, like Grady, are often their regions' top trauma centers. Grady is the only such center in the state of Georgia.

When the safety net breaks it's not just the poor falling through to the floor. It could easily be you, too. Everyone in Atlanta is just one car crash away from Grady.

Does that increase your sense of urgency?