Profits, but Not For the Chil’ren

The AJC covered the pediatric giant, Children’s Healthcare of Atlanta, recently. If you haven’t read the piece, you really should. It’s a rare day when I see this level of in-depth reporting in Georgia-God save the free press! The focus was not only the massive amount of wealth on which CHOA sits, but the meager amount of public aid to Georgia’s socioeconomically depressed children it provides while being its, well, job, as a not for profit healthcare provider. This is a story I know fairly well, albeit in degrees over my own life, which I’ll talk about here. The more important question I hope legislators and the electorate ask themselves is, why do we continue in this way? Who does this benefit and why are we willing to be complacent in it?

I’ve written before here about my own experiences growing up in Walton County as a child with juvenile onset diabetes. I was diagnosed at age six, and entered into then Scottish Rite Hospital a month and a day before I turned seven. Instead of handing out Valentine’s Day cards in first grade, I was checking in for a week-long stay with my parents (who slept in my room btw, not in a nearby hotel) to learn how to manage the disease, receive four shots daily, and check my blood glucose levels. This was a big change for a kid from the metropolis of Social Circle, GA, and I credit all those long drives to the subsequent doctors’ appointments with sparking my adoration of the steel and glass I found in Atlanta. To be fair, I also realized at an earlier age than most that if I wanted reliable healthcare in Georgia, I needed to move into an urban center. Later maturity informed me that job prospects for politics were also more prolific among the city folk as well. My teenage years gifted me with juvenile onset rheumatoid arthritis, so, lucky me, I not only was a patient of Scottish Rite, but also Egleston Hospital. Both of these merged to establish what we now refer to simply as CHOA. While my situation was not half as dire as some of those mentioned in the article, the long car trips were a well worn path in my own life and the crushing bills of pre-ACA PPO health insurance were my raison d’être for entry into the political game. 

In my adult life I had the great fortune of meeting past Fulton County Housing Authority Commissioner, Roger Wise, who spent much of his spare time at the Capitol advocating for a variety of causes, one of which was as National Ambassador for the Shriners Hospitals of North America. You see, the Shriners provide free hospital services for patients AND THEIR FAMILIES and will even fly them from various parts of the nation back and forth between their hospital appointments. Ever wonder where all those donations collected by the men in the weird hats go? Now you know! I have a long line of Shriners- men and Lady Shriners on both sides, including my great-aunt Nell, who was crowned the Grand High Priestess of the Atlanta Lady Shriners in the Temple off of Ponce in the 70s. GA FL Rosalyn Carter even spoke at her coronation. It’s kind of a thing in my family. 

Why doesn’t Georgia have a Shriners’ Hospital? Wouldn’t that be ideal for all needy families in our state to receive abundant care? 

Not so fast! In Georgia, we like poorly regulated monopolies, not actual marketplace competition, silly reader. Let’s thank Georgia Power’s Vogtle for our template, shall we?

Dividing up all those Peachcare for Kids dollars? What are YOU thinking??

And let’s be honest, the Georgia General Assembly doesn’t support actual community based hospitals. The omnipresence of Certificate of Need nips that in the bud, for sure. 

Legislators really like to discuss their rural roots while getting their boots shined at the Capitol, but the reality of allowing the marketplace to meet the needs of their people in actual rural communities is far too progressive. What?!? 

You act as if we actually value life in this state vs. just birth. 

Let’s also please keep in mind that the largest reliable employers of ‘good jobs’ in any rural economy is your school, your prison, and your hospital. With Judicial Reform (which I support) Governor Deal undid a LOT of rural economic health. Governor Kemp hasn’t quite had the time to figure out its replacement. Rivian is great, and directly benefits my hometown area, but what about the rest of the state? Georgia had a 45% teacher retention rate, per our Dept of Education survey in 2015, and that was BEFORE COVID. So I feel like schools may not be the harbinger of reliable rural employment they once were. I sincerely hope I’m wrong.

A few years ago, I found myself in the unique position of sitting on a board of an organization called InCommunity, formerly two entities, called EnAble of Georgia and Georgia Support & Solutions. Incommunity is the largest provider of developmental disability services in the state. Their offices were located in Decatur, close to Executive Park, the behemoth that is CHOA’s executive offices. Incommunity had an existing lease and parking within the building that they were unwilling to concede (have you seen real estate prices in metro Atlanta?) Unfortunately, CHOA had purchased the office building and was pretty adamant about InCommunity relinquishing that land. I received a call from a well placed individual at CHOA in hopes of avoiding litigation. That was not to be, but it was really interesting to find that the court valued the Manifest Destiny of CHOA more than the existing service delivery of folks on the spectrum. 

That’s why I’m not really surprised to find this information out about CHOA’s massive wealth and pittance for the poor. 

I mean, what did folks think would happen? Do we assume that people and corporations self-regulate? I feel like that really goes against the market principles Republican leaders seem to cling to in campaign slogans. 

There’s another layer of this that I haven’t quite pieced together but I think is probably significant. If I were an investigative reporter, I’d try to follow this thread. Governor Kemp’s right hand lady, Candice Broce, who has been put in charge of DFCS following the unexpected departure of Tom Rawlings is also married to Jason Broce, who has oscillated between CHOA and the Georgia Healthcare Association as a lobbyist prior to going out on his own with another CHOA alum. I know from my volunteer experience in the Junior League of Atlanta, Inc. that many of the victims of human trafficking, sexual assault, etc. were examined by a particular doctor (who has now retired) at CHOA, sort of cementing the link between trauma evaluation and the hospital. My strong hunch is, someone is making money in some manner here in the tie between DFCS, the FLOGA’s human trafficking initiative, and CHOA. I’m not saying it’s illegal, I’m just too cynical to think it’s all altruistic either. Call me a cynic, but I’ve just seen too many get fat off of government contracts to not question this connection. 

The important question of all of this is: what is Georgia going to do about it? Investigative reporting is valuable only in that it uncovers something that is acted upon. We have a Governor that supposedly really values rural over urban spaces. Cool! Can we get some healthcare out there?? That’d be really great. Just think, if that had been done a generation ago this farmer’s daughter might have chosen to stay in Walton County rather than moving into Atlanta to meet her healthcare needs. Maybe the families in the article about Children’s wouldn’t have had to make the crazy drives they’ve made. And maybe, just maybe, we would see that inviting more hospitals into our state is not only not a bad thing, but it’s also going to help our most vulnerable, meeting them where they are rather than having to drive all the way into Atlanta. 

Edit: I was notified by the Georgia Hospital Association that Jason Broce has never in fact worked for them, but instead the Georgia Healthcare Association, which is an association of nursing homes. Please note the correction and my apologies for the previous error.

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