:: 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 ::
Sunday, March 20, 2005  

Update on county public hospital finances and politics.

I had the pleasure of attending my first Board of Regents Health Sciences Center sub committee meeting this past week and i learned some interesting truths there.

first off, for those not familiar with power politics, the board of regents is the highest level board at a university. in new mexico, all members are appointed by the governor. this subcommittee has the obligation to oversee all financial and mission aspects of the entire health sciences center, including the hopital and medical school.

after a few weeks of front page news stories about a $2.5 million deficit which was blamed on poor anduninsured people, the truth surfaced in a quiet but profound way. we are only about $100,000 behind budget. the real cause of some of the loss is not uncompensated care rising, it's that our outpatient surgical business is not running at predicted numbers and we lost two GI doctors last year which seriously decreased our specialty income at the hospital.

on top of that, for the first time ever, the hospital administrators finally published their data on how much uncompensated care we really give. let me take a moment to define some terms here. uncompensated care is care given by an institution or provider that has NO REIMBURSEMENT SOURCE. it breaks down into charity care (which is care given away without any effort to try to collect on it) and bad debt (which is care that is charged to patients, sent to collections and then eventually written off as uncollectable).

our hospital administrators were claiming almost $100 Million per year in uncompensated care. no one challenged this figure publicly until the community coalition came along and raised the issue in public meetings and with the board of the hospital. three years later we finally have a partial picture of the truth. out of the $100 Million estimated as uncompensated care about $86 Million has some source of compensation thru county or state taxes, and special reimbursements thru Medicare and Medicaid. The new total of uncompensated care is: $14 Million. not such a horrible number in a $600 Million institution. these are the hospital's figures, made public last week, not mine.

i would also subtract from this estimate all the tax breaks the hospital gets (no property tax, no gross receipts tax, less state and federal taxes for being a nonprofit). subtract the large donations of pharmaceuticals from big companies like pfizer easily totalling over $1Million per year. subtract a few million for having terrible same day access to urgent care forcing uninsured people to use the ER and get much larger bills. subtract all the CEO bonuses. subtract all the money spent on travel, food, vacations of the top execs. subtract all the price breaks the hospital gets on supplies and medicines thru special programs like 340B pricing.

what would the new total be? perhaps a few million? and yet we're made to think that the hospital is going broke because of uninsured people over-using the services. i'm glad that wiser heads than mine, and certainly wiser heads than the CEO are sitting on the board and asking some real questions now. i'll keep y'all updated as things progress.


posted by andru | 3/20/2005 07:02:00 PM | |


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