JCAHO, Fannie Mae, and the Fallacy of Privatizing Grady Hospital

It has been nearly two months since JCAHO threatened to pull Grady Hospital's accreditation. I have already explained several times that this step is quite drastic. This is only the second time this has happened. The story received some coverage when it was initially reported and then little was said about it. One reason is because the actual contents of the report haven't been released. In the only other case when JCAHO did this, there was an incident in which a woman begged for help for forty five minutes before dropping on the floor and dying. That incident forced JCAHO's hand in the matter. Why then has the actual report not been released so that the folks can see what exactly are the nightmarish situations at Grady Hospital?

The reasons for this are quite complicated. Grady Hospital is a public hospital and they should be the subject of an open records request. I have spoken with several folks that have attempted to get records from Grady and they describe an atmosphere of stonewalling. JCAHO, on the other hand, is a whole different matter. If someone tries to get the report from JCAHO they immediately tell you that JCAHO is a private organization and not subject to document requests. The problem of course is that JCAHO isn't really private, and they aren't really public. They are quasi both.

The recommendations of the Grady Task Force purport to make the Grady board private and thus create a structure at Grady Hospital that is much like the structure at JCAHO. Grady Hospital will also be quasi public quasi private. In my business, mortgages, Fannie Mae enjoys a somewhate similar structure as well. On the one hand, Fannie Mae is a GSE (Government Sponsored Entity) and on the other hand they are a publicly traded company (trading under the symbol FNM on the NYSE). Since the government created Fannie Mae it gets privileges other entities wouldn't. On the other hand, it is a for profit company like any other for profit company. That is one reason why this GSE was the subject of a serious accounting scandal only a few years ago. This GSE allowed its obsession with profits get the best of it much like other for profit companies.

If Grady is allowed to turn its board private, then it will be private whenever it suits the powers that be, and public also whenever it suits them. What that means is that Grady will scream private whenever anyone wants to create scrutiny and oversight, and scream public when it needs a handout. None of this is lost on the corruptors that make up the Grady Task Force that made these recommendations. I don't believe for one second that turning Grady's board private has anything to do with fixing the systemic problems that put it here.

In fact, it is obvious to me that the same corruptors that put Grady in this position have now used this as an opportunity to make its structure even easier to corrupt. If Grady Hospital's board is allowed to go private, then we may as well put all the activities at the hospital into the perverbial lockbox, close it, and throw the key into the Atlantic Ocean because that is how difficult it will be to ever find out what is going on there. By creating a dual private/public structure, you let the very same people that put it into this mess define it whenever they need to define it. They will define it to their benefit if history is any indicator.

That, I believe, is the sad and brazen nature of the powers that be at Grady Hospital. Even at this time of extreme crisis the only thing they are looking for, I believe, is an angle. That angle is the vague and undefined, private/public structure, that makes Grady even more easy to corrupt. Grady is currently a public hospital with no gray area and yet two months after a damning report is revealed we still haven't seen the contents of that report. That's because despite their public nature, the board continues to balk at requests to release that report. They do this despite their being a public hospital begging for half a billion dollars, and they do it despite their being overwhelming public interest and right to know the contents of this report. If Grady is able to withstand scrutiny when they are solely public, how easy will it be for Grady to do it when they can attach the private label to their entity.

Recently, I produced a piece with recommendations for fixing Grady Hospital. The piece was laced with steps to make it more transparent and more open. Transparency is the only way to confront corruption because corruption happens because no one is watching. This plan by the Grady Task Force would do the exact opposite to Grady Hospital. I don't believe it will do anything but make things worse, and I believe that is exactly how the powers that be want it.

Epilogue:

For a full summary on this entire Grady fiasco and how this privatization plan fits in please read this summary