The Grady tragedy and what it means

The charity hospitals' plight is a canary-in-the-coal-mine sort of thing, but it's a great big canary, and a great big mine.

Grady Hospital in 1951While candidates are fretting about the plight of the middle class in health care, the safety net of the poor is unraveling.

For decades that net consisted of a string of public "charity" hospitals in major cities around the country, funded by local taxpayers. Many doubled as regional trauma centers and as teaching hospitals.

Now many of those hospitals, such as Philadelphia General, District of Columbia General, and MLK Jr. Hospital in Los Angeles, are closed.

The charity hospital in my own hometown, Grady Memorial, is similarly threatened. (The picture above, from the Georgia State University Library, was taken in 1951.)

Medicare reimbursements no longer cover costs, and the two counties which were paying the bills won't up the ante, citing its use by people from outlying counties.

Louis Sullivan, HHS Secretary under GHW Bush and a "Grady Baby," writes that without Grady the city would lack any Class I trauma center, and that the regional economy could suffer.

He could have added that without Grady the Morehouse Medical School, of which he was founding dean, would have no place to send its graduates for training.

Sullivan wants county officials to approve Grady's transfer to a non-profit board,  but the new board would be mainly white, and the county officials are mainly black.

White Republicans are leading the charge to save Grady, but when black leaders ask "save it for what" the response is often a threat to just take it over.

The practical impact of this is that trauma care nationwide is suffering, emergency rooms are often unavailable for paying patients like Glenn Beck, and, frankly, poor people are dieing.

Conservatives may insist that health care is not a right, and that if you can't pay for care you should just drop dead. But financially that's not how it works.

Preventive care costs a lot less than emergency care, and doctors take an oath to provide care. Ignoring basic needs for the living costs more than emergency care for the dieing.

The charity hospitals' plight is a canary-in-the-coal-mine sort of thing, but it's a great big canary, and a great big mine.

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