ERLANGER’S ‘TRANSITION’ SOUNDS LIKE A NEVER-PUBLIC DONE DEAL

Isn’t it interesting that many of our community leaders say there needs to be more conversation with the public about moving Erlanger from a governmental authority to a private, nonprofit organization.

Yet the only conversations going on appear to be happening not with the public, but among very few. What’s more, those not-so-public conversations seem to already be done, perhaps decided.

Isn’t it interesting, too, that the primary reason always given for why Erlanger can’t make it (although it seems to muddle through year after year, complete with hefty bonuses for its executives) is that its board meetings have to be public and thus it theoretically loses some sort of competitive edge?

Really? Like other hospitals don’t know how many nurses and bed pans and doctors a hospital the size of Erlanger has to pay for?

Of course they do.

Like other hospitals don’t know how much doctors want in their contracts to work at one hospital or another? Of course they do.

So really, is that excuse just an excuse to conduct all of its business behind closed doors? You know the answer to that.

And here’s another observation: In this “conversation” that wasn’t ever really happening in a public setting until Wednesday, we’re told that part of the problem — “the nature of beast” as former board member and chair Russell King told the Times Free Press recently — is Erlanger’s public mission of “providing high levels of uncompensated care.”

Because the 130-year-old Erlanger is a public safety net hospital, it treats more uninsured and underinsured patients who are often sicker and in poorer health than the patients who frequent its competitors. Last year, Erlanger provided roughly $150 million worth of uncompensated care, which ultimately means there’s less money to go around for employees and other investments.

If Erlanger becomes a private, nonprofit hospital, does this mean it wouldn’t have to provide care to those who can’t pay for it?

Except —

Current Erlanger board chair Jim Coleman has told the Times Free Press that Erlanger trustees are committed to maintaining Erlanger’s status as a safety net hospital under the new model.

What part of these two conflicting statements are we supposed to believe?

We mentioned “conversations.”

Coleman says the hospital board, “after nine months of due diligence,” began approaching stakeholders, including Hamilton County Mayor Jim Coppinger, to begin the process of exploring a new governance structure for Erlanger. Although Erlanger must provide notice and hold public board meetings to conduct official business, Tennessee law allows public hospital boards to meet in private to “discuss and develop marketing strategies and strategic plans.” So much for those “public” conversations.

Next up, Coppinger asked the Hamilton County Commission on Wednesday to approve funds to hire a lawyer “representing the county in the transition.”

That was the first public signal that change is likely coming for the health system — which was founded in 1891 after Baron Emile d’Erlanger, a European financier with local railroad holdings, donated $5,000 to establish Chattanooga’s first hospital. Over 130 years, Erlanger has grown to become one of the nation’s largest public hospital systems comprising six hospitals across Southeast Tennessee, including the only children’s hospital in the region.

The hospital board, appointed by Tennessee lawmakers and the county commission, governs the hospital, but the land and buildings are owned by the county. And they are worth a lot of money.

Coppinger told the Times Free Press last week that so far the community is responding well to the county’s effort to transition Erlanger Health System from a governmental authority to a nonprofit organization, a move he believes is important for the system to remain competitive and stable for the long term.

“The comments I’m hearing from the general public and in respected positions have all been positive. I’m sure if you look far enough there’s people who aren’t pleased, but that’s generally the case with any decision,” Coppinger said. “Only time will tell where the criticism may come, but so far it’s been extremely positive.”

So far — like two days? Did we mention that commissioners expect to vote Wednesday to bring on Richard Cowart, chair of Nashville-based Baker Donelson’s Government Relations & Public Policy Department, to assist with “the transition” process?

Kind of sounds as though it’s all a done deal, doesn’t it? Coppinger said it will take a long time to work out details, such as whether the county would continue giving $1.5 million to Erlanger to provide inmate care each year if the hospital is no longer public.

Yeah. Follow the money. And keep asking: What about folks who don’t have insurance?

Here’s one possible answer: Perhaps the hospital executives’ bonuses will just get bigger.