ANOTHER VIEW: Shortage of 275 beds for hospitals in Atlanta 

 By Jack Bernard, contributing columnist

PEACHTREE CITY, Ga.  |  There is a continuing national trend of hospital mergers and acquisitions. Some of these actions are good for society, but many others are clearly done solely for self-interested purposes.

I know. I  was a vice president of acquisitions for National Medical Enterprises (now Tenet). Per corporate policy, we acquired hospitals with high private pay insurance, low indigent care and minimal Medicaid. Why we were instructed to do so is obvious. Those were the hospitals most likely to make a profit when we attempted a financial turnaround. Eventually, I tired of the shenanigans going on in the for-profit hospital field and left to work with a firm owned by large non-profit healthcare systems.

Well after my departure, Tenet acquired Georgia Baptist Hospital in Atlanta, first started in 1901. Tenet renamed it the Atlanta Medical Center (AMC). At the time of the 1997 acquisition, I questioned the wisdom of that purchase from a business standpoint. 

Improving the bottom line of a facility with a high indigent care and Medicaid mix would be very difficult, probably impossible, even for a “take no prisoners” for-profit.

As I had predicted, Tenet was ultimately unsuccessful. Tenet then sold the hospital to WellStar Health Systems, a large non-profit chain whose main office is in Cobb County. Naively, I thought that Wellstar had the community’s interest at heart and was willing to absorb the facility’s losses. Surely, they realized the financial problems caused by Atlanta Medical Center’s payer mix (Medicaid and indigents). 

But I was wrong. After heavy losses (partially caused by outrageous executive salaries), Wellstar closed the 460 bed AMC, a Level I trauma center. That created a financial opportunity for developers wanting to push gentrification (i.e. pushing out the area’s low-income residents). Working with Wellstar, the for-profit developer Integral Group has now convinced the city to approve a re-development plan which will include mixed uses, retail, commercial and residential. Who gets the substantial profits generated from this agreement is unclear, but the property is now very valuable… and still owned by Wellstar.

Meanwhile, AMC’s closing dumped needy Medicaid and indigent care patients onto already financially strapped Grady Hospital, Atlanta’s only remaining Level I trauma center.  Using American Rescue Plan Act funds created under the Biden Administration, Governor Brian Kemp has provided an additional $130 million to Grady. Fulton County gave $11 million more, enabling Grady to add 185 beds. However, that still leaves a deficit of 275 beds for Atlanta. And, from a healthcare viewpoint, that is where things stand today, a continuing mess and shortage of beds.

Frankly, the AMC closure could have easily been avoided but for the lack of insurance coverage of the residents in the Boulevard area. If all Atlanta Medical Center patients were covered 100 percent, by expanded Medicare for All, this could negate that devastating payer mix issue. You do not see hospitals in Canada or Europe facing these problems

With universal coverage, all healthcare facilities could compete on a level playing field. Instead, we have facilities which serve low-income populations having their hands tied behind their backs by a lack of adequate third-party reimbursement.

With nearly 10 percent of our non-elderly uninsured (14 percent overall in Georgia), we are far behind every developed nation in the world. The best time to enact universal coverage was yesterday. For more healthcare information on single payer healthcare, go to the national web site for Physicians for a National Healthcare Program a https://pnhp.org/ 

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