It looked as though a constructive re-formulation of Grady might be in the works with a new governance system, a new board, and new money. Meetings were happening and even the Speaker of the House was in attendance. But those already in power at Grady saw their livelihoods in danger and so they pulled the race switch. This, of course, has thrown the train off the track. Whether it derails is yet to be seen.
Part of the Grady issue is about race. The people who use Grady is disproportionately minorities. People without health insurance in Georgia are also disproportionately minorities. Grady also has a stigma of race left over from past decades when people referred to the hospital as “The Grady’s”. Morehouse, one of the few African American medical schools has said that if Grady Closes, they too may have to shut their doors.
Still, race here, while legitimate, is only an issue. It’s not The Issue. The issue is that letting Grady close is flat stupid and no one seems to have the courage to step up and say “Grady will not close, it’s too important an asset, we’ll all accept changes to make it happen”. If there were a real disaster and Grady was closed, we’d have lost the best level one trauma center south of DC to handle the emergency. People with real traumas would also lose their access to good care. Without Grady, more people will die.
Yes, there are racial concerns if Morehouse close, but the real issue of Morehouse closing is that we need Doctors. Georgia needs all they can get and keeping Medical schools open is important. Again, if Grady closes and Morehouse closes, there will be fewer Doctors and more people will die.
The Chamber of Commerce recommendations (with which everyone has a complaint, so you know they did something right), suggest keeping the operating authority in place and it’s board in place to address governmental oversight, long term strategic issues, and a link to the communities which Grady primarily serves. Under that board, would the be board of the Non Profit Corporation which was responsible for running the hospital and health system day to day and doing the general strategic and tactical management necessary to keep the enterprise financially stable.
Who should be on the two boards? On the Authority board, there should be elected representatives from the City of Atlanta, Dekalb County, and Fulton County. They should make a bare majority. Then, representatives from the State, Atlanta Regional Commission, and community groups should also be represented. Lastly, members of the Corporation Board should have voting power on the new Authority board. This way, the tax payers who have carried the bulk of the load for Grady will still make a majority of the board and they, via election, would have to be responsive to the people most likely to use the hospital.
The Corporation board will need to be made up of dedicated professionals. Members of Emory University, Morehouse, business leaders, and experts in financial stabilization such as Lisa Cremin must be on this board. A balance of financial experts and medical professionals is needed to keep Grady Running.
Further, the goal of both board must be the same: To financially stabilize and increase the quality of care for all those using the system, regardless of ability to pay.
Grady, perhaps more than any other institution in Georgia calls for a Deming style approach to improve the excellence in the care it provides. To accomplish this, the focus has to be on the customers. To make the customers happy, efforts will be needed to make effective use of staff time, to give them incentives to improve things, and guarantees that the system will still be in place.
So far, one politician seems to get this, and he is Lt. Governor Casey Cagle. Much to the surprise of everyone, he has been out front and recognizing Grady’s importance, keeping it open to those it currently serves, and suing state resources to help fund the transition to a more stable structure that wastes less money. Working with Senator David Shaeffer, there will be enabling legislation for the changes envisioned by the Chamber Report in the coming session of the Legislature.
As for those who still harp about the loss of ‘Black Power’, this is worth pointing out. Power, in and of itself, is pointless. Unchecked, it merely leads to inefficiency… witness the current system at Grady. The key is not power, but actually doing something to help the people who the hospital serves: those in great medical need and those without insurance. A majority of the people using Grady are minorities and so if the system is fixed, the majority who will actually benefit, will also be minorities.
On the outside, the color that matters here is green. On the inside, the color that matters is red. If all you can see is Black or White, you’ll never capture enough green to stop the red from hemorrhaging.