PrintMarch 2, 2009
Michelle Obama's Patient-Dumping Scheme
The First Lady helped create a notorious program that dumped poor patients on community hospitals, yet the national media ignore the story. Imagine if her husband were a Republican.
The University of Chicago Medical Center has received a good deal of justly opprobrious press over its policy of "redirecting" low-income patients to community hospitals while reserving its own beds for well-heeled patients requiring highly profitable procedures. Substantial coverage was given to a recent indictment of the program by the American College of Emergency Physicians. ACEP's president, Dr. Nick Jouriles, released a statement suggesting that the initiative comes "dangerously close to ‘patient dumping,' a practice made illegal by the Emergency Medical Labor and Treatment Act, and reflected an effort to ‘cherry pick' wealthy patients over poor."
Oddly absent from most of the unflattering press coverage of UCMC's patient-dumping scheme is any mention of the role our new First Lady played in devising the program. A laudable exception has been the Chicago Sun-Times, which reported last August that "Michelle Obama -- currently on unpaid leave from her $317,000-a-year job as a vice president of the prestigious hospital -- helped create the program."
On the rare occasions when other "news" media have bothered to connect the Urban Health Initiative to its glamorous creator, they have attempted to whitewash this tawdry program. Typical of such disingenuous coverage was a story in the Washington Post, which described it as "an innovative program to steer the patients to existing neighborhood clinics."
But no amount of journalistic lipstick can hide the reality that Mrs. Obama's initiative is a patient-dumping scheme. Such "cherry-picking," as Dr. Jouriles accurately describes it, was, at one time, fairly common. Prestigious institutions like the University of Chicago Medical Center routinely "dumped" Medicaid, uninsured and other unprofitable patients on less mercenary community hospitals. Many patients suffered needlessly, and more than a few actually died, as the result of this practice. So, in 1986, President Reagan signed the Emergency Medical Labor and Treatment Act (EMTALA) into law. EMTALA made such "redirection" illegal, but many high profile hospitals still chafed at being forced to treat poor patients. Enter Michelle Obama, UCMC's "Vice President for Community and External Affairs."
Mrs. Obama first hatched the UCMC program as the "South Side Health Collaborative," which featured a gang of "counselors" whose job it was to "advise" low-income patients that they would be better off at other hospitals and clinics. The program was so successful in getting rid of unwanted patients that she expanded it, gave it a new name, and hired none other than David Axelrod to sell the program to the public. According to the Sun-Times, "Obama's wife and Valerie Jarrett, an Obama friend and adviser who chairs the medical center's board, backed the Axelrod firm's hiring." Axelrod helped the future First Lady formulate a public relations campaign in which the "Urban Health Initiative" was represented as a boon to the community actuated by the purest of altruistic motives.
The resultant PR campaign was a study in Orwellian audacity. Chicago's inner city residents soon began hearing that UCMC's patient dumping program would "dramatically improve health care for thousands of South Side residents" and that the medical center was generously willing to provide "a ride on a shuttle bus to other centers." Likewise, the people who ran the community hospitals to which these unwanted patients were being shuttled began to read claims in local media to the effect that the Urban Health Initiative was good for them as well. Dr. Eric Whitaker, the Blagojevich crony who succeeded Mrs. Obama as Director of the program, repeatedly assured gullible reporters that the financial impact on these hospitals would be positive: "The initiative actually is improving their bottom lines." The CFOs of those hospitals were no doubt relieved to learn that treating Medicaid and uninsured patients is profitable.
But you just can't please some people. In one of the few frank passages of the Post article, we discover that many members of UCMC's medical staff believe the program is nothing more than an "attempt to ensure that the hospital retains only affluent patients with insurance." And another association of emergency physicians has joined ACEP in denouncing the Urban Health Initiative. The Chicago Tribune reports that Dr. Larry Weiss, president of the American Academy of Emergency Medicine is unhappy about UCMC's failure to consult its own ER physicians before initiating the program: "Not including emergency-room physicians ... would be analogous to changing the way surgery is performed in an operating room without involving any surgeons." Dr. Whitaker assures us, however, that such critics are merely "opposed to change."
Presumably, he would be similarly dismissive of Angela Adams, who brought her son to the medical center's ER after his lip had been partially torn off by a pit bull. As the Tribune puts it, "Instead of rushing Dontae into surgery ... the hospital's staff began pressing her about insurance." Unfortunately for Dontae, he was covered by Medicaid. So, all he got from the UCMC emergency department was a shot, some antibiotics, and instructions to "follow up with Cook County." Angela had to take her son across town to John Stroger Hospital, where he was immediately admitted for reconstructive surgery. Like doctors Jouriles and Weiss, Angela is having trouble seeing the community benefit of the Urban Health Initiative.
Meanwhile, the program's parents, Michelle Obama and David Axelrod, have moved to Washington. As the First Lady and the President's closest advisor, they wield enormous power. Indeed, they may be the most powerful people in the Obama Administration, aside from the President himself. If these two characters were willing to betray their Chicago neighbors -- the South Side's most vulnerable citizens -- with a disgraceful program like the Urban Health Initiative, what sort of mischief will they devise for the hapless denizens of flyover country?
Come to think of it, isn't Obamacare being sold to us in pretty much the same way the Urban Health Initiative was sold to Chicago?
David Catron is a health care finance professional who has spent more than twenty years working for and advising hospitals and medical practices. He blogs at Health Care BS.
