Issue link: https://nnumagazine.uberflip.com/i/198096
Grady:FINAL 7/3/08 1:25 PM Page 17 "These forces…represent a new class interest that takes historically public institutions, places them under their control, and displaces and abandons the very people…that these institutions were intended to serve." property acquisitions. The mastermind of this expansion was Carl Patton, former dean of Georgia State University and now the newest appointee to the Fulton Dekalb Hospital Authority. Quasi-public entities also sided with private corporate interests. Renee Glover, the chair of the Atlanta Housing Authority, was also a member of the Greater Grady Task Force. Under her watch, the city of Atlanta has bulldozed almost all of its public housing, including Grady Homes, a complex that once stood in the shadow of the hospital. The vacant fields where public housing used to be located now display huge signs announcing the construction of "luxury apartments and condominiums starting at $250,000 and up!" The Atlanta Journal-Constitution newspaper, owned and operated by Cox Enterprises, became the unrelenting voice of the Chamber's task force. Hospital officers had long pleaded with the state of Georgia to provide more financial support since Grady cared for such a high proportion of the state's trauma patients. The Legislature, now dominated by Republicans, refused to contribute any funds to the existing board, only to a new privatized board. From prime real estate, to biogenetic research, from money owed to money to be made, from public (and regressive) taxes to private investment, from the "Grady" way to the "Atlanta" way, the region's corporate, government, educational, and media interests are closely interwoven. One thing was clear: Atlanta's elite viewed the public governance of Grady as an obstacle to its vision for an upscale and gentrified city and region. These forces that are both white and African American, public and private, represent a new class interest that takes historically public institutions, places them under their control, and displaces and abandons the very people—disproportionately people of color and those permanently separated from the work force by electronic production or global outsourcing—that these institutions were intended to serve. The plans of metro Atlanta's elite did not unfold without resistance. A very small but dedicated force of Grady union members, community activists, religious figures, and a few elected officials in a loosely knit group known as the Grady Coalition challenged the plan to privatize Grady. The two sides skirmished at many town hall meetings, county commission hearings, hospital authority boardrooms, public meetings, pickets, and rallies. Indeed, without that fight, few would have been aware of the transfer of public wealth that was about to occur. But unlike the strong union presence of registered nurses in Chicago's Cook County, which was able to stave off total collapse, Georgia law prohibits collective bargaining of public employees. Those who join unions become members, but don't receive the protection or advantages of a contract. Without strong organization, registered nurses lacked a forum to discuss and respond effectively to the implications of privatization for the hospital and its workers. The potential of the new private corporation to cut services to the indigent is very real. As patient advocates, RNs will JUNE 2008 need to examine future proposals closely and weigh in heavily against cuts in care or to an already strapped workforce. Ultimately, the Grady Coalition was not able to stop the corporate interests' relentless drive to shift control of the hospital to the Grady Memorial Hospital Corporation. The two counties voted in February to approve the transfer. On May 20, the corporation began a 40-year lease to run Grady. Though the Fulton-DeKalb Hospital Authority still owns the land and is supposed to continue broad oversight of Grady, for all practical purposes the corporation is in charge. he new corporate board of Grady has promised to raise private funds to bail out the hospital. It is unlikely that this will provide a long-range solution. Interestingly, an October 2007 article published in the Atlanta Journal-Constitution comparing the outcome of four southeastern hospitals that recently privatized as nonprofits found that the change did little to improve their financial health. These hospitals still face major annual deficits due to treating high numbers of uninsured and reduced federal funding and reimbursements. What privatization of Grady does set the stage for is the potential subcontracting out and outright closure of many services, and the resulting losses in jobs and benefits. As just one small example, the lease now reads that Grady employees' defined-benefit pension plan will be discontinued. The primary care neighborhood clinics, which Emory medical school a few years earlier had already refused to staff and which are among the few places where undocumented workers can receive healthcare, are also likely on the chopping block. And the insurance funding situation probably will not improve. The Georgia State Legislature has passed legislation that undermines any regulatory role for government in healthcare. Other bills promote the individual purchasing of high-deductible private health insurance policies or so-called "health savings accounts" that are invested in the stock market. Instead of healthcare being cemented as a necessary part of a society's infrastructure, these neoliberal policies only serve to shift the burden of healthcare costs onto individuals and increase our healthcare insecurities. The demise of Grady Health System as a public hospital is the result of a collapsed system of healthcare financing. To strategically sustain Grady as a public institution would have required equal, quality public health insurance for all. Single-payer national health insurance would do it. Grady and a handful of other public hospitals existed because of an inequitable system of healthcare. Now their future depends on a transformation of the healthcare system. The struggle to save Grady is not just about one institution having adequate funding; it is about a vision of what healthcare could be for everyone. Time is running out. I T Rita Valenti is an RN working at Grady Memorial Hospital for more than 20 years. W W W. C A L N U R S E S . O R G REGISTERED NURSE 17