This morning, I was quoted in the Tennessean article on Metro General Hospital. Of course, I said many things to the reporter (Christina Sanchez, who did a good job with the article) but I anticipated that this quote would probably make it into the story:
“Poor people will not get the care they need if this is shut down,” said the Rev. Jay Voorhees, a member of a clergy advocacy group, Nashvillians for Metro General. “It will affect people’s ability to be healthy. Some of these people will die.”
The comments on the story were pretty typical, focusing on liberal bashing, suggesting that the city shouldn’t be in the hospital business, with a few folks pushing back on the draconian nature of the TennCare cuts. But in at least one case, someone pushed on my comment that folks will die, and I was called later in the day by local station asking about the quote.
So am I making a wild, out of control, hyperbolic statement in an attempt to move hearts and minds, or does this quote have a basis in reality?
Go back if you will to the budget hearings of last year when Metro General presented a budget based on a 10% reduction in the Metro Nashville subsidy. At that time, based on the current situation, the hospital identified four areas that would have to be shut down if adequate funding did not appear. One of those, the one I have the most experience with, is known at the Outpatient Infusion Clinic. It’s an innocuous name with an important function — it provides chemotherapy for persons suffering from all sorts of cancer. It has been heralded around the nation as a leader in the treatment it provides, involved in clinical studies on cancer treatments, and is the clinic of last resort if you have cancer and no money. Metro General provides this service regardless of one’s ability to pay, and for many people it is the difference between an extended life as a cancer survivor, or an early death as a cancer victim.
So, let’s assume that budget cuts force Metro General to close this clinic. Where do the patients that this clinic serves go? The assumption is often made that other area hospitals like Baptist or Vanderbilt will pick up the slack. However these institutions have clearly said that they have neither the ability nor the willingness to do so, as they are already providing more indigent care than they would like due to the provisions in the law that require emergent care to all regardless of ability to pay. While chemotherapy is a matter of life and death to most of us, technically it is not considered emergent care, and thus the hospitals are under no obligation to provide these services to persons who are unable to pay for the service. In the end what you see are people who are unable to receive the treatment that has a potential of saving or at least extending their life out of an inability to pay for that treatment. Yes, people will die because the treatment that has been available to them in the past is no longer available.
Do you doubt this? Consider the example of Las Vegas’s University Medical Center, which forced to make similar cuts. CBS 60 Minutes profiled one patient in the area who had been referred to their chemo clinic only to find out it had been closed:
Roy Scales has been calling the private doctors from the list University Medical Center sent with its letter. He has been searching for someone who will accept payment from the county’s medical assistance for the poor program, which he calls insurance. It has been five months since he was diagnosed.
He told Pelley he called at least 25 doctors and oncology practices trying to find care.
Asked what they told him, Scales said, “‘What about that insurance? Well, we don’t accept that insurance.'”
“What are you going to do if you can’t find a doctor to take care of you?” Pelley asked.
“Die peacefully,” Scales said.
At the end of the story, Scales was in hospice care, waiting to die peacefully.
The Infusion Clinic at Metro General is just one area at risk. Also at risk is the cardiac clinic that assists folks with heart disease. And that is only the tip of the iceberg if the TennCare cuts that are proposed are adopted.
Yes, there will be people who could receive treatment who will die if places like Metro General or The MED in Memphis close. It isn’t hyperbole. It’s a simple fact.