July 2009

From the Editor

If you’re healthy and lucky enough not to need hospitals, or rich or insured enough to afford one of your choice, then all you might know of Grady is how it’s described in the Journal-Constitution—as metro Atlanta’s “safety net” (twelve times so far this year); “cash-strapped” (seven times in the past year); “financially troubled” or “financially ailing” or “financially stressed” (many, many, many times over the years). You might hear about how it wants more money from state taxpayers, a request that sends rural lawmakers into a tizzy as they ask why their tax dollars should go to support a metro Atlanta hospital. (Never mind that their argument is a specious one: A Georgia State University study found that the ten metro area counties contributed 51 percent of the state’s tax revenues but got in return only 37 percent of the state’s largesse. You’re welcome, Valdosta.)

Amid the endless arguments over who’s paying for what and how much, it’s easy to lose sight of what Grady means. First, let’s consider the doctors. One out of every four physicians in Georgia got at least part of their training at Grady. (Turn to page 72 to see one of those—a twenty-six-year-old Emory surgery resident who spends every waking hour, and a few unconscious ones, at Grady.) If our state’s medical infrastructure is a body, then Grady is its heart. Second, consider the patients. The hospital hosts about a million patient visits in a year. Nine out of ten of them lack any commercial insurance. They come not just from Fulton or DeKalb counties, but from Cobb and Clayton and Forsyth and Douglas. They come from all over. If Grady weren’t there, what would happen to the hospitals that are left, when they’re forced to provide care for those who can’t afford it? But that’s not a concern, at least not now, because we have Grady, which will likely lose around $50 million this year because it’s not reimbursed sufficiently—from the feds, from the state, from county governments—for the care it provides.

Local bureaucrats and business leaders often talk about Atlanta as a world-class city. One important measure of a world-class city is the value it places on the lives and welfare of its most disadvantaged citizens. Is caring for them important? Whose responsibility is it to see that the least fortunate among us don’t die of neglect? Is it the hospital’s? Is it the government’s? Is it ours? Or is it the responsibility of no one?

Steve Fennessy