:: to the teeth ::    thoughts on social justice, medicine, race, hope and beats

"Another world is not only possible, she is on her way.
On a quiet day, I can hear her breathing." :: Arundhati Roy ::

"The most common way people give up their power is by thinking they don't have any." :: Alice Walker ::
Friday, February 11, 2005  

can't history ever do anything different?

i got all caught up with intricate math problems in my last post and left out some fascinating power plays happening here in albuquerque. remember that you read it here first when the fan starts spinning shit in all directions.

this week we've had a media blitz by our publc hospital leadership. front page news every day about how poor the hopsital is, going bankrupt, because they serve so many poor people. the president of the university exclaimed that the hospital is like a lifeboat already overwhelmed with poor people and more swimming towards it. "the sky is falling!" "the hordes of barbarians are coming!" the british are coming!" well, all i have to say on this is, why oh why are people aloud to lie so loudly in public and get away with it?

our public hospital may well go bankrupt, but not because of poor people, it's because of poor leadership, really bad decision-making and a cynical political process that allows cynical people to exercise their bigotry by scapegoating the poor and people of color as the problem.

a few points to share:
1. our hospital and medical school are in deficit, $2.5Million.
2. administrators claim they do over $95Million per year in uncompensated care to the poor
3. admin just signed a $233Million mortgage on the existing hospital to build a new WING named after our Governor that will cost us $14Million a year to pay off. this small building project happens to be the single largest public building project happening in New Mexico with contracts for developers and builders. what's in the building? a big ER, a big ICU, a big NICU and about 70 adult medical beds. all types of medical care paid for by MEDICAID and insurance. and here's a little known and critical fact about this new wing. it's being built right outside of the county owned land (where the old hospital sits) on privately owned land...
4. the hospital board recently passed a new STRATEGIC PLAN that specifically and systematically alters the payor mix (insured to uninsured) effectively pushing out uninsured patients onto the already overburdened safety-net clinics who are resisting this move. (this by the way is the reason i opened my own clinic in albuquerque.) this is the first OFFICIAL step in creating a two tiered medical system - those with and those without insurance. prior to this, we've already known that insured patients get seen sooner in faculty clinics.
5. the legislature is in session now and our hospital has hired the best lobbyists in New Mexico (with public money) to get as much extra cash as they can from this SUDDEN CRISIS... front page news... money... cynicism... nothing new.

a few points of reality to share:
1. our hospital, a public hospital, gets $56Million a year from the county to cover uncompensated care costs.
2. our hospital, a public hospital, gets over $120Million a year from the state for various programs and support so that it can fulfill it's mission.
3. the claim of $95Million in uncompensated care is being challenged. imagine this. you are uninsured and need to be seen for a terrible sore throat. you cannot get in to any clinics, there is no urgent care so you go to the ER. if that patient doesn't pay their bill, then what should have been calculated as $50 in uncompensated care is now being calculated as $400 or more for the ER visit. so take that $95Million and subtract at least $30Million... and guess who cut out the urgent care and guess who underfunds primary care? that's right, hosiptal administrators who are scapegoating poor people.
4. the new STRATEGIC PLAN is being opposed by many providers and staff in the hospital. whether the admin realizes it or not, they are going to be facing the battle of their lives. doctors are writing scathing letters to elected officials about the deteriorating care in the ER and in primary care and rightly blaming administrators, not patients, for this horrible and deadly state of affairs.

in the meantime, the hospital is threatening to charge patients 100% up front in punishment for being poor.

history will alter it's course as and when enough of us decide that enough is enough. no matter what it takes. cynicism cannot lead us to a better place. each of us must find our voice and our role to build the story of love and compassion and break the grip of systemic violence permeating our world.

peace in struggle,


posted by andru | 2/11/2005 04:43:00 PM | |


I admire your idealism and it is a ray of sunshine in this cynical world. Only time will tell what will happen with this mess that's brewing with the public hospital, and thank god for clinics like yours. However, math equations aside, wouldn't it be prudent to have malpractice insurance at least, if it will cost you about $8-20,000 out of your projected $60,000 a year? After all, we're in a very cynical world, and you never know...

# posted by Anonymous Naia : 2/12/2005 6:50 PM  

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