Errin Haines, AP, November 26, 2007
For generations, Grady Memorial Hospital has treated the poorest of the poor, victims of stabbings and shootings, and motorists grievously injured in Atlanta’s murderous rush-hour traffic.
Now, Grady itself is in grave condition.
Staggering under a deficit projected at $55 million, the city’s only public hospital could close at the end of the year, leaving Atlanta without a major trauma center and foisting thousands of poor people onto emergency rooms at other hospitals for their routine medical care.
On Monday, Grady’s governing board of political appointees discussed turning day-to-day operation of the hospital over to a nonprofit board in hopes the move would attract big corporate donations and enable Grady to stay open.
Dozens of activists, doctors, clergy members, lawmakers and citizens packed an auditorium across from Grady and demanded to be heard before the board voted.
Founded in 1892, Grady has struggled financially for years. But now it has reached a crisis because of rising health care costs, dwindling government aid, a lack of paying customers, and years of neglect—a situation not uncommon among urban hospitals like Grady that primarily serve the needy.
In addition to losing money on patient care, Grady needs an estimated $300 million to repair and modernize its buildings and acquire new equipment such as CT scanners and an up-to-date computer system.
The loss of Grady would be unconscionable to many political and civic leaders in this booming metropolitan area of 5 million people. The overwhelming majority of the 900,000 patients treated at Grady each year are poor and black, and the institution is considered a vital part of Atlanta’s black community.
But the proposed switch to a nonprofit governing board is problematic, too. Some fear that the hospital would be less committed to the poor, and that the board would go from mostly black to mostly white.
[Sen. Vincent] Fort, a black Democrat from Atlanta, said earlier that Grady is “absolutely critical” to the city’s black poor. And he charged that Atlanta’s “white power structure”—including the business leaders and politicians who are pushing for the nonprofit board—is trying to orchestrate a takeover.
“To the extent that you have African American doctors, nurses and other professionals operating a big-city hospital and taking care of black people, that is a source of pride in the black community,” Fort said. “So there is a great deal of skepticism that the Chamber of Commerce is interested in Grady. There are some of us who believe that is a self-interest.”
Besides Atlanta’s poor, Grady’s patients include tourists passing through on their way south to Walt Disney World and victims of auto accidents, since Grady is the only hospital in a 100-mile radius of Atlanta that has a Level 1 trauma center, capable of treating the most serious injuries. (A popular bumper sticker seen on cars along Atlanta-area highways reads: “If I’m in a car crash, take me to Grady.”)
Grady also has the state’s only poison control center, obstetrics intensive care unit and comprehensive sickle cell center. And the city’s emergency command center for handling plane crashes and terrorist attacks is based at Grady.
If Grady were to close, poor people would probably swamp other hospitals’ ERs with everything from ordinary colds to genuine medical emergencies.
Doctors, activists, lawmakers, business leaders and the hospital leadership are scrambling to find a fix for Grady, which gets most of its funding from Medicare, Medicaid and Fulton and Dekalb Counties and is run by a governing board whose members are appointed by the two counties’ politicians.
In July, a 17-member task force of business leaders recommended the shift to a nonprofit board. Some of Atlanta’s major corporations have said they would contribute to Grady if it were run by a nonprofit board because it would manage the hospital more efficiently.