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Tue Nov 27 18:04:35 GMT 2007

Roy,

Re: years of mismanagement. No doubt. Ditto for the big hospital in Chicago.
I think the creation of a "non-political" governing agency could be an
important first step. It's a model that's recommended by virtually every
"blue ribbon" commission that looks at problems of public hospitals. I hope
it helps. Obviously I think these hospitals do a lot of good for people
whose access to quality care is limited.

Rob

-----Original Message-----
From: trauma-list-bounces at trauma.org [mailto:trauma-list-bounces at trauma.org]
On Behalf Of Roy Danks
Sent: Tuesday, November 27, 2007 12:56 PM
To: Trauma &amp; Critical Care mailing list
Subject: RE: Grady

Rob,

I don't have a solution for Iraq, but what little I understand of war (and,
it's complex), if we just up and pull out, we're going to leave a few troops
behind...we can't possibly get every one out, en masse.  Do I think we are
in Iraq for solid reasons?  No.  But, hindsight is 20/20, to abuse a cliche
and we have to support the current troops, that's all I'm saying.  Would I
go to Iraq and be a surgeon there?  Absolutely. 

Public hospitals:  First, Rob, I didn't use the term low life's...that's
yours buddy.  Not disagreeing, but I don't need that one charged to me.
Ah....I don't know the answer to this.  I mean, here I am, for all intents,
a "rural" trauma surgeon.  Sure, we're Level I...we have about 10%
penetrating trauma.  I can't imagine how they do it at Grady, LAC, Ben
Taub...all of those.  We know this is an expensive business, but we can't
expect the feds to bail everyone out all of the time.  Grady is where it is,
presumably, because of years of poor management and neglect.  Give them more
money and they'll find a way to blow it.  We have proven that time and again
in medicine.  Businessmen we ain't.

It goes back to the Biblical reference of giving versus teaching a man to
fish for food....

Sincerely,

Roy

> From: rfsmithmd at comcast.net> To: trauma-list at trauma.org> Date: Tue, 27 Nov
2007 10:53:31 -0500> Subject: RE: Grady> > Ron and Roy,> > So we should
close the few remaining public hospitals in the US because of> the low lifes
that seek care there?> > And the compelling reason to have our soldiers
continue to get killed in> Iraq is because if we brought them all home some
of them would get killed in> the process? > > Rob Smith> > PS Please tell me
you're not saying Iraq was involved in 9/11. And I also> think drug pricing
here is an outrageous boondoggle and all solutions should> start with
getting rid of the lawyers.> > -----Original Message-----> From:
trauma-list-bounces at trauma.org [mailto:trauma-list-bounces at trauma.org]> On
Behalf Of Ronald Gross> Sent: Tuesday, November 27, 2007 10:31 AM> To:
Trauma &amp; Critical Care mailing list> Subject: RE: Grady> > Roy,> > You
actually said what I was thinking but didn't have to stomach to put it> out
there.> > Ron> > >>> Roy Danks <roydanks at hotmail.com> 11/27/2007 10:12 AM
>>>> Yes, by all means. Let's continue to fund those who won't go out and
work> for a living, who are too lazy to flip burgers at McD's, who would
rather> peddle drugs than legal wares, who use violence to solve problems,
who have> children but no way to pay for them...let me pay more taxes so
that others> can live the high life and never lift a finger.> > And, let's
take funding away from the soldiers in Iraq so they don't have> the means to
defend themselves. Let's forget 9/11, it was probably a> once-in-a-lifetime
occurrence. > > Pret, how would you pull out of Iraq? Have you contacted
your Congressman> or the President with a grand plan? How do you pull out
thousands of> soldiers without leaving a few behind to be massacered?And,
the answer isn't> "we should never have gone there". Because, we are there
and without a plan> to get out, we'll be there a long time.> > Hey! Maybe
the physicians at Grady could work for less money! Yeah! Cut> their earnings
so that others may continue to suck off the government tit!> > Get real,
Pret. You're not part of the solution.> > > > > Date: Tue, 27 Nov 2007
09:24:21 -0500> From: pbjorn at emh.org> To:> trauma-list at trauma.org> Subject:
RE: Grady> > Sad that all this red ink> comes to a small fraction of one per
cent of> Georgia's share of federal> healthcare reimbursement slashed by
the> current administration.> > Fifty> million dollar budget shortfall? End
the Iraq war six hours early> and let> Grady keep the change.> > Pret Bjorn>
Bangor, ME USA> > > > > -----Original> Message-----> From:
trauma-list-bounces at trauma.org>> [mailto:trauma-list-bounces at trauma.org] On
Behalf Of Robert F. Smith> Sent:> Tuesday, November 27, 2007 7:52 AM> To:
rockmd at aol.com; 'faran bokhari'> Cc:> 'Trauma &amp; Critical Care mailing
list'> Subject: Grady> > > > Atlanta> Hospital Moves to Unburden Itself of
Debt > > > By KEVIN SACK>>
<http://topics.nytimes.com/top/reference/timestopics/people/s/kevin_sack>>
/ind> ex.html?inline=nyt-per> and SHAILA DEWAN>>
<http://topics.nytimes.com/top/reference/timestopics/people/d/shaila_dew>>
an/i> ndex.html?inline=nyt-per> > > ATLANTA, Nov. 26 - The politically>
appointed board of Atlanta's troubled> charity hospital effectively voted>
itself out of business Monday, the> first> step in at least a short-term>
escape from the insolvency that had> threatened> the region's only
top-level> trauma center.> > Without the financial bailout made possible by
the vote,> the hospital,> Grady> Memorial, was at risk of not meeting its
payroll,> perhaps by the end of> the> year, hospital officials had warned.
Though> Grady, like most public> hospitals>>
<http://topics.nytimes.com/top/news/health/diseasesconditionsandhealthto>>
pics> /hospitals/index.html?inline=nyt-classifier> , has faced
intermittent>> financial crises in the past, this one has generated real
anxiety>>
<http://health.nytimes.com/health/guides/symptoms/stress-and-anxiety/ove>>
rvie> w.html?inline=nyt-classifier> because of its roots in a collision of>>
national forces, including the unchecked growth of uncompensated care> and>>
deep cuts in government reimbursements. > > Political leaders and medical>
officials have worried that Grady, woven> into> Atlanta's social fabric>
since 1892, might follow Martin Luther King> Jr.-Harbor Hospital in Los>
Angeles County as a casualty in 2007. If so,> the> consequence would be a>
"patient tsunami" at other area hospitals, the> Metropolitan Atlanta
Chamber> of Commerce said in a report earlier this> year.> > Grady - which
supplies> the region with its only 24-hour trauma center as> well as poison
control> and burn units and large clinics for AIDS>>
<http://health.nytimes.com/health/guides/disease/aids/overview.html?inli>>
ne=n> yt-classifier> and sickle>>
<http://health.nytimes.com/health/guides/disease/sickle-cell-anemia/over>>
view> .html?inline=nyt-classifier> cell anemia - has operated in the red>
for> 10> of the last 11 years. It is expected to run a deficit of $50>
million to> $55> million in this year's $730 million budget. > > The>
hospital owes an accumulated $63 million to its biggest creditors,> the>>
medical school at Emory University>>
<http://topics.nytimes.com/top/reference/timestopics/organizations/e/emo>>
ry_u> niversity/index.html?inline=nyt-org> and the Morehouse School of>>
Medicine,> which provide its doctors and have threatened to train
residents>> elsewhere.> Republican state legislators had threatened a state
takeover if> local> officials did not reconstitute the hospital's governance
structure.>> > Following a raucous meeting marked by chants and protest, the
10-member>> Fulton-DeKalb Hospital Authority voted unanimously to hand daily
control>> of> Grady and its affiliated clinics and services to a nonprofit>
corporation> to> be formed for that purpose.> > A Chamber of Commerce task>
force had advised earlier this year that a> governance change was needed to>
remove the hospital from the control of> the> elected commissioners of>
Fulton and DeKalb Counties and to restore the> confidence of lenders,>
foundations and Georgia's Republican leaders. > > Advocates for patients>
have warned that the hospital would become less> responsive to community>
needs if it was operated by a less political> board.> But with few other>
options and Grady's fiscal condition worsening, the> authority felt it had>
little choice.> > "In three weeks, our cash position would have been zero,">
the> authority's> vice chairman, Dr. Chris Edwards, said at the meeting>
Monday.> > In its resolution, the hospital authority, which would continue>
to own> Grady's buildings and land, made explicit that its willingness to>
hand> over> control depended on substantial financial commitments from both>
the> public> and private sectors.> > Before the lease, to be executed by>
Dec. 31, becomes effective, the> hospital> must receive written commitments>
for a capital infusion of $200 million> from> businesses and>
philanthropies.> > In addition, the resolution demands that state leaders>
provide written> support for $30 million in new state aid.> > A. D.
Correll,> a former chairman of the Georgia-Pacific Corporation and> the>
co-chairman> of the task force, said he considered the vote a critical>
first> step,> though with provisos attached. "They were a surprise, a lot
of> them,"> Mr.> Correll said of the conditions, "and they require action on
a whole> lot> of> people's parts." > > Mr. Correll said a single anonymous
donor had agreed to> give the> hospital> $200 million if the donor approved
of the governance> system changes. He> said> he was confident that the
private sector could> raise an additional $100> million in two or three
years.> > The fate of the> hospital has become a keenly watched civic
drama,> overlaid> with issues of> race and class. > > Some black activists
and elected officials had warned> that the> governance> change would shift
control of the hospital from black> political leaders> to> white business
leaders. The hospital's problems, they> said, are> financial> and not
political.> > Chamber of Commerce officials,> white and black, have
responded that the> only> color that matters in the> campaign to save Grady
is green. And> justifiably> or not, they say,> business leaders and state
officials were willing to> participate in a> rescue only if they saw a real
departure from past> practice, when the> hospital's board was perceived to
lack technical> expertise and the will to> block corruption and cronyism.> >
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