Friday, January 12, 2018

Barry buckles to pressure. Backs down on closing General

Mayor Megan Barry has buckled to pressure and delayed until the end of 2018 her decision to close General Hospital. As expected, members of the Black community had denounced and resisted her decision but in recent days one of the members of the Council who is considered a conservative came out in opposition.

General Hospital is a failure and cannot fill its beds and serves very little purpose, yet the Black community see Meharry General Hospital as a source of pride. Nashville General is the teaching hospital of Meharry Medical College. Meharry is the second largest educator of African-American medical doctors and dentists in the United States and has the highest percentage of African Americans graduating with Ph.Ds in the biomedical sciences in the country.  Should General close, the mission of Meharry Medical College would not be jeopardized. Meharry recently partnered with HCA to train at TriStar Southern Hills Medical Center, a hospital in HCA's TriStar Health subsidiary.

General Hospital has long been a money pit. In the last two years the Hospital has sought $26 million in emergency funding  in addition to a $35 million annual subsidy from the Metro Council.  As reported in The Tennessean recently, a recent audit found that the hospital, "failed at basic bookkeeping, unable to keep track of patient payments and major expenses."

While poor management is obviously a problem, the real problem with Nashville General is that  no one wants to go there.  Metro jail inmates without insurance needing hospitalization have no choice and are sent to General and there is a financial incentive for Metro employees to use General but it still cannot fill its beds. The facility is  licensed for 150 beds, staffed for 114 and has an average of 44 beds filled a day. Metro General should have been closed fifty years ago.  Ever since the advent of Medicaid there has been no need for a city charity hospital and the reason it has been kept open is purely political. There is no federal or state law or metro charter provision requiring the city to operate a charity hospital.

I thought it took courage for Megan Barry to propose closing General. It did, but unfortunately Barry did not have the backbone to follow through and rally support. Facing other issues, such as pushing her transit plan, I doubt the mayor will invest political capital in trying to build support for an end of year decision to close General.  We are probably stuck poring more money down this rat hole for many more years to come.

For more on General see the following:
Mayor Megan Barry delays closure of inpatient care at Nashville General Hospital
Why is Steve Glover fighting to keep General Hospital open? Very disappointing. 
The Tennessean, December 17, 2017: Future uncertain for Nashville General CEO amid mayor's plans to end inpatient care.
The Tennessean, December 15, 2017:  Hospital landscape in limbo as questions swirl over Nashville General's fate
The Tennessean, December 14, 2017: Audit: Nashville General plagued by financial mismanagement despite progress. 
For previous reporting on Metro Nashville General issues covered in this blog, follow this link.   

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