published Tuesday, March 19th, 2013

Let Erlanger move forward: Commission holding hospital back

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    The Erlanger Baroness campus.
    Photo by Staff File Photo.
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Hamilton County commissioners have never been closely engaged stewards of the Erlanger Hospital Authority, nor have they ever squarely dealt with the enormous financial cost of the county's indigent-care burden that falls chiefly on Erlanger Hospital.

Given their long indifference toward the health of this community's mainstay hospital, one would think they would leap to ratify the nonprofit charter legislation crafted by the county's legislative delegation — and recently signed by Gov. Bill Haslam — to clear the way for an autonomous hospital board, and to lock-in a pitiful fraction of the indigent cost the county was originally obliged to help pay.

But no, current county commissioners now seem ready to refuse the charter legislation and to keep a death-grip on Erlanger Hospital, all for the sake of holding onto their ability to meddle in the hospital's affairs.

This isn't the direction county commissioners should take. The pending legislation would trim the board from 12 to nine members. And to escape the chains of appointees selected more for political favors than business acumen, it would allow the new board to become self-perpetuating.

Our county commissioners, however, say they object to giving up their rights to appoint board hospital board members. Some object to the legislation's mandate requiring the county to contribute $1 million annually to help finance indigent care — an amount that would later be linked to a cost-of-living index.

They act as if that's too large an amount to contribute to indigent-care costs. That's baloney. The $1 million figure is a big retreat from the $3 million that county government -- helped until just two years ago by a sales-tax-sharing agreement with the city -- was initially obliged to provide toward Hamilton County's cost of indigent care at Erlanger.

Even the $3 million figure was just a drop in the bucket. When the Erlanger Hospital Authority agreement was originally fixed in 1977, Erlanger's audited indigent care costs — not charges — amounted to less than $20 million. Due to soaring national medical costs since then, Erlanger's indigent-care costs have now soared to $85 million.

Erlanger's top competitor hospitals here provide far less indigent care in favor of more lucrative insured-patient care. And none of Erlanger's competitors provide the costly Level 1 trauma care that Erlanger, as the region's major public hospital, has traditionally provided.

For all its enormous value as the region's lifeline hospital, county officials have failed to keep up with soaring medical costs for the indigent and the uninsured. County officials now wrongly cast blame on city government for ending its sales tax agreement with the county. Yet the sales agreement was never equitable to city residents -- they also pay full county property taxes — and was never a proper basis for countywide support of Erlanger's indigent costs.

Erlanger's string of bad CEOs the past two decades just proves the failure of political stewardship toward Erlanger. It's past time to rewrite the charter for Erlanger's future. County commissioners would serve area residents best by ratifying the new charter agreement outlined in the current legislative proposal. Other governmental agencies here have proven the value of such charters. Erlanger deserves a similar chance.

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Oldfolk said...

Today in the TFP I see that the Commission has vetoed this legislation. Senator Gardenhire, one of the sponsors of the bill, has said that if the Commission didn't accept the bill, he would discontinue any further work on Erlanger's behalf.

So let me get this right, after stirring up so many people at Erlanger (including most of the employees) with the prospect of even more change, everyone is just going to give up now?

So the political influences will continue, right.

And Erlanger can't even depend on a measly $1 million to cover over $80 million of indigent care. Take a look at what Memphis, Nashville, & Knoxville governments "donate" to their public hospitals.

The good-ole-boy system is still working nicely in the Chattanooga area and nobody really cares enough to continue to try to fix the problem. Embarrassing.

March 20, 2013 at 11:20 a.m.
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