The NY Times Prints Gibberish Regarding Grady Hospital (Updated)

Prologue: After originally publishing this piece, I thought about it and updated it appropriately. If you have recently been here, read the piece again and see if it is any better. If you haven't, you are getting my best work right away.

Introduction: The role of the media in the Grady scandal cannot be understated. I have already pointed out how the Emory Wheel acts no different than any mouthpiece for any corrupt, totalitarian regime with regards to Grady Hospital. The Wheel plays a vital role in hiding the administration's role in the crisis. I have also pointed out several instances of shotty reporting on the part of the AJC that has effectively failed to add the proper context to this story. This contributes to an Atlanta population that is confused and uninformed when it comes to Grady Hospital.

The media's incompetence, corruption, and willful ignorance have contributed to muddying the waters and keeping the truth from reaching the mainstream. This latest piece from the NY Times is another example of the media's of will in reporting this story accurately. I will explore the consequences of the media's ceding of the first amendment in future diaries. For now, I want to focus on how this particular piece distorts the issue and leaves the reader confused and uninformed.

Here is the piece...

Immediately, the authors attempt to identify the forces that they believe have caused one of the largest hospitals in the country to be on the brink of collapse. These two paragraphs are both found within the first 20% of the piece.

Although the hospital is unique in many ways, the code red at Grady is emblematic of the crippling effect America’s health care crisis has had on public hospitals around the nation. Though Grady is among the most distressed of the country’s 1,300 public hospitals, others have faced similar challenges in recent years, including those in Miami, Memphis and Chicago, said Larry S. Gage, president of the National Association of Public Hospitals and Health Systems. There are 300 fewer public hospitals today than 15 years ago, with hospitals having closed in Los Angeles, Washington, St. Louis and Milwaukee, Mr. Gage said
....

Like other public hospitals, Grady is operating on a business model that is no longer sustainable. A third of the hospital’s patients, including those treated as outpatients, are uninsured, among them a rapidly growing group of immigrants.

As the article later points out, Grady Hospital is in need of funds in the neighborhood of $360 million and the supposition of the authors is some sort of mysterious and nefarious pseudo socioloeconomic forces. (I believe that corruption was the primary factor, however that is beside the point now) No studies, evidence or facts were given to back up this supposition, and furthermore, it was never explained how mere market forces could cause such a huge cash shortfall.

The issue of corruption is addressed though way in the back 30% of the piece and with a passing mention.

There have been charges of corruption and cronyism, most notably in 2005,
when a powerful state senator was convicted of using his influence to secure
overpriced Grady contracts for his temporary services business.

The State Senator (Charles Walker) is not identified by name. The specifics of the case aren't detailed...127 felony convictions. Clearly, the authors don't believe that corruption plays any sort of a major role in their current crisis.

This sort of absurd socioeconomic arguement is only apparent to someone with as much knowledge of the situation as me. To others, they may very well believe that one of the biggest hospitals in the country is failing due to socioeconomic forces outside its control.

Here's what makes this so absurd. One of my favorite quotes throughout this came from an Atlantan friend of mine...

they can't close Grady the rest of the hospitals don't want their patients

The idea that providing health care to the poor is fading due to market pressures is faulty because providing health care to the poor is no market. They aren't competing for those patients. Those patients go there because they have nowhere else to go.

Costs may in fact be going up, however if they are they can be documented. If they are being documented and the funds still aren't getting to the hospital, then someone is responsible for that. Since the article never goes beyond mere assertion, none of this vital information is explained.

The article is clearly trying to create a certain theme. First, it uses Pamela Vaughn as the symbol of Grady. Pamela Vaughn is not only a nurse at Grady, an infallable profession, but she herself was born there. Vaughn is referenced multiple times throughout the piece.

The first paragraph goes like this...

Like tens of thousands of Atlantans over the last 115 years — like Gladys Knight, the soul singer, and Vernon Jordan Jr., the presidential confidante; like more than one in three babies born here in the last decade — Ms. Vaughn entered the world at Grady Memorial Hospital, one of the nation’s largest safety-net hospitals.

Then it painstakingly recites a resume of good deeds performed at Grady Hospital. You find passages such as this sprinkled throughout the piece...

The hospital, sandwiched between downtown and the neighborhood where Martin
Luther King Jr. was born, was the place where victims of the 1996 Olympics bombings and countless other disasters have been treated. It is so intrinsic to the city’s identity that Maynard H. Jackson Jr., the first black mayor, liked to say that Grady babies should be allowed to vote twice.

The bearded, middle-aged man was bleeding from a self-inflicted gunshot wound to the left side of his chest. “Don’t let me go out in pain,” he moaned in a drawl to the doctors and nurses treating his injury. “I was born at this hospital.”

The patient in Trauma 3 was a Grady baby, though no one could have guessed it when the ambulance pulled in at 1 a.m. that Saturday.

This sort of fawning praise is actually quite a bit obscene. It is the first time I have read a puff piece where the target of the puff was an inanimate object like a hospital. The praise is also beside the point. Whether or not good work is being done in the hospital is not the issue. The issue is that the hospital is so deep in debt that it is estimate that up to half a billion dollars maybe necessary. At the same time, its patient care has become so suspect that JCAHO has been moved to act as it has only done once prior in history. Of course, this is something that is barely touched upon in the article.

Last month, the Joint Commission (JCAHO), the country’s leading health care accrediting agency, raised serious concerns about Grady’s status after observing numerous significant shortcomings during a five-day inspection. Although the commission has not yet released a public report, hospital officials, speaking anonymously, said the commission’s concerns included broken equipment, sanitation and the adequacy of staff supervision

Here the article fails in what it doesn't mention and then put together. This move by JCAHO is only the second time in the history of hospitals. The other was King Drew and here is the story that forced JCAHO's hand...

It might have gone down as the death of a "quasi-transient" woman with a history of abusing drugs. That's how the May 9 death of Edith Isabel Rodriguez was initially reported to the Los Angeles County coroner's office.But five weeks later, her demise has become a cause celebre, a symbol of bureaucratic indifference. It is fraught with significance not just for one struggling inner-city hospital but for political and health leaders in the Los Angeles area and perhaps beyond. The county Sheriff's Department, health officials and the Board of Supervisors all are feverishly trying to determine who was to blame and how to prevent a recurrence...

This means the level of patient care is so bad at Grady Hospital that it is on the level of a hospital that stood by and watched while a patient begged for help for forty five minutes and then died. They do what every media does when it refers to the JCAHO action. They mention it in passing and then move on.

The piece of course, then, doesn't put two and two together. The situation at Grady Hospital is so critical that it is simultaneously need of somewhere in the neighborhood of half a billion dollars and its patient care is so bad that it rivals a hospital that sat by while a patient begged for help for forty five minutes before dying.

Of course, again, the layman is not going to process that. Instead, they will feel that shutting this hospital down is a travesty because of all the good work they are doing.

Then, the article makes two rather interesting observations...

Over the years, the cost of caring for the uninsured and underinsured has grown while taxpayer support has stagnated. Suburban counties have declined to pay a share of those costs, though their residents regularly wind up in Grady’s emergency room and its highly regarded centers for burn and poison treatment. Management problems within the hospital have played a role, and community pressure has kept Grady’s politically appointed board from making deep cuts. As a result, the hospital has faced deficits for 10 of the last 11 years.

...

Only the state can force other counties to pony up money for Grady. And the state legislature and the governor’s office are controlled by white Republicans, whose core constituents have historically not viewed themselves has having a direct stake in the hospital’s future.

Those are rather startling accusations. If I read the article correctly, there was a clear increase in costs and at the same time the budget from the legislators became tighter, and it may even have been racially motivated.

First, had the authors researched the case they alluded to they would have known just how absurd and inflammatory those statements are. State Senator Charles Walker was convicted for a number of crimes...127 felonies total. He routinely used the power of the purse strings to curry favor. He himself was black and he was doing all of this within the last decade. This case paints a completely different root for the purse string problems in the Georgia legislature.

Thus, it is unclear how they came to believe for instance that,

the cost of caring for the uninsured and underinsured has grown while taxpayer support has stagnated

These are measurable things however nothing is measured to back up the theory. It is frankly gibberish and worse than that, intelligent sounding gibberish. Unfortunately, it is found throughout the piece. Even worse than that, much of public is likely to fall for much of this gibberish.

CONCLUSION: The conclusion they would get is that this sympathetic hospital is failing due to some sort of pseudo socioeconomic factors outside their control. If they don't get money quick, this staple of the community will close down. Meanwhile, politicians with tight belts refuse to increase funding even though costs are clearly going up.

Epilogue: This scandal has lots of twists and turns. If this article has been confusing, I suggest you read this updated summary of the entire fiasco...