Monday, December 18, 2017

Mayor Barry's bold and courageous proposal to close General Hospital. I hope she will stay the course.

I am normally pretty stingy with my praise for Mayor Megan Barry and I often disagree with her policy proposals, but I applaud her bold and courageous move to close General Hospital.  She is not completely doing away with the facility  but is proposing to convert it to an outpatient care facility.

During the 2014 mayoral campaign all of the candidates for mayor pledged their support for General Hospital (link). Of all of the candidates, I perceived Barry as the most liberal and the one lease likely to make any changes to General.  With Barry's election I just assumed Nashville General would have a blank check to continue losing money.  Barry has pleasantly surprised me. As General continued to need more and more subsidy, Barry's frustration with General became more and more pronounced.

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 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.  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. It is a symbol of pride for the Black Community and no previous mayor has dared to antagonize the leadership of the Black community.

Mayor Barry is getting push back for her decision to close General.  I hope she has the backbone to follow through with her correct decision.  While members of the Council have also expressed frustration with General, I would not count on them to stand with her when the going gets tough, I would not be totally surprised if there is not a concerted effort with civil rights marches and grandstanding to "save" General.  Pandering to the Black community is always a wise political move in Nashville. The current director could be thrown under the bus and accused of poor management, some superficial changes could occur, and Metro General's future could be secure for another fifty years.

If you have the opportunity to encourage Mayor Barry to stay strong and not back down or to encourage your councilman to support Barry's decision, please do so.

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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