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Thursday, June 12, 2003

TOM WALSH: DMC needs aid sooner as well as later

Excerpts: Her [Granholm's]reluctance to seek Band-Aid cash infusions for DMC has some political appeal. Outstate legislators always resent doling out subsidies to southeastern Michigan institutions, be they Detroit museums or the Pontiac Silverdome.
Therefore, Granholm wins points from the anti-Detroit crowd with her suggestion -- echoed in recent days by state health director Janet Olszewski and even by Detroit Mayor Kwame Kilpatrick -- that DMC needs to resolve its own "structural issues" and not expect a blank check.
OK, I get it, I understand the political need to stress fiscal discipline as you try to herd Republicans, Democrats and competing health care systems together to forge a solution to the hospital crisis.
But the vague reference to "structural issues" at DMC is a smoke screen. Or worse, this implication that DMC is inefficient or mismanaged becomes the first step in a blame game, where key players start to duck responsibility for a public policy failure that becomes almost pre-ordained.

But there's enough evidence to conclude that DMC President Arthur Porter and his management team aren't idiots. They have cut employment from 15,500 to 12,000 since 1999, cut accounts receivable in half, and reduced the cost per discharged patient three years in a row. DMC is well below the national average in the cost of supplies per patient and ranks above national hospital firms HCA and Tenet in revenue generated per employee from paying customers, says Nick Vitale, DMC's chief operating officer.

Some DMC doctors have suggested a total shutdown of Receiving to spark a full-blown crisis if the city's only top-level trauma center closes and its 87,000 patients a year are diverted to other hospitals. Granholm said Wednesday that she will not allow Detroit to be without a Level One trauma center, but she didn't elaborate.

If there's confusion about DMC's structure because some Detroit City Council members are ranting about promises made -- or not -- in 1978 when the city's public hospital was closing, forget about it. It's silly. DMC's current financial structure has been in place since 1985 and has been no big secret.

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