Thursday, October 3, 2019

Past advice on Nashville General Hospital earns new Nashville finance director a wary reception

by Rod Williams - I was pleased to see Mayor Cooper had hired Kevin Crumbo as the new finance director.  One thing that makes me especially pleased is the same thing that is resulting in criticism from from some city leaders, especially Black council members.

In 2017 Kevein Crumbo provided his services for free in analyzing the status of General Hospital and developing a new model for the hospital. Essentially, his proposal  called for turning Metro General Hospital into a ambulatory surgery center and outpatient clinic.  Mayor Megan Barry announced the plan in November 2017 referencing the work of Crumbo.  The plan ran into immediate opposition. While I admire Barry for proposing this plan, I criticize her for the way she executed the politics of the proposal.  She just sprung it on people without selling it and building support. When she ran into opposition she backed down.

Maintaining a charity safety-net hospital is not required by state law or the metro charter.  At one time such a hospital may have made sense, but ever since the advent of medicare poor people have had choices. As time has gone on, people have had even more choice.  If metro wants to subsidize charity care, there are much less expensive ways to do it. General is subsidized to the tune of $50M a year and cannot fill its beds.  It is the hospital that uninsured Metro jail inmates are sent to and Metro employees get an incentive for choosing General, yet few people chose it.

Metro General is on the campus of Meharry Medical School and has long been as source of pride in the Black community. 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, however. General Hospital is now less important to Meharry than in the past. A couple years ago Meharry partnered with HCA to train doctors  at TriStar Southern Hills Medical Center, a hospital in HCA's TriStar Health subsidiary.

That General Hospital gives Black members of the community something to look upon with pride seems to me to be the real reason General is kept open.  It is an expensive ego boost. It is my hope that Mayor Cooper will finally close General Hospital; it should have been closed fifty years ago.

For more on General Hospital see link, link, link, link, link.

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