Another deadline with death looms

For over 100 years, Grady Hospital, located on the edge of downtown Atlanta, served the medical needs of poor, uninsured and underinsured people while at the same time establishing world-class trauma, burn and neonatal clinics.

Funded by the taxpayers of Fulton and DeKalb counties, it has struggled for years with less money and more patients. As wages and health benefits have been reduced for workers, the population has sharply risen and public policy increasingly is shaped by business interests.

Despite the efforts of a grassroots coalition made up of clergy, elected officials, union members and other community forces, the hospital was privatized in 2008 and is now controlled by a powerful clique of corporate businessmen.

Immediately, the attention of the hospital management became focused on changing the “mix” of patients, meaning attracting people with insurance while raising the co-pays for the uninsured, making access more difficult for the poorest of the elderly and ill.

Declaring that providing outpatient dialysis was too costly, the corporate Board of Directors cut this critical form of health services for over 90 people in the fall of 2009. About half of the patients were eligible for Medicaid, but several do not meet Georgia’s residency requirement of five years and others are undocumented, longtime residents originally from countries ranging from Ethiopia and India to Nigeria and Mexico.

Most people who have a diagnosis of renal failure require dialysis three times a week to keep the toxic waste from poisoning their system. Missing even a few treatments can cause death.

The Grady Coalition, doctors and other health advocates were joined by the patients and their families in rallies outside the hospital demanding the clinic remain open. Patients provided passionate testimony at board meetings, and a lawsuit was filed which resulted in a temporary injunction. The hospital administration initially told people their only options were to return to their home country or go to another state with shorter residency requirements for Medicaid if they couldn’t make arrangements for dialysis at for-profit clinics. Under public pressure, Grady then agreed to pay for private treatment for three months until December; then until January. Now the cutoff of care is Feb. 3.

At least three of the uninsured patients have died while this cruel cat-and-mouse gamesmanship has been going on. Until now, the for-profit centers have refused to provide free care for some 40 men and women who remain in Atlanta. Their level of stress and anxiety undoubtedly impacts their overall health. Their spouses, children and grandchildren are worried and scared that their loved ones will die. Each deadline brings more terror about the future.

In a suspicious move, Emory Health Services is opening three dialysis clinics in early 2010. The extraordinarily wealthy, private Emory University exercises tremendous influence over the operations of Grady Hospital and has ties to the businessmen on the Board who made the decision to end free and accessible dialysis care to the poor.

A spirited protest by Grady Coalition members disrupted the grand opening ceremonies of the South DeKalb Emory Dialysis Clinic on Jan. 21. Chanting, “People before profit! Serve the Grady patients!” and “Health care is a right! Shame on Emory!” the group demanded that life-sustaining dialysis care be provided immediately and at no cost.