Putting your life in someone's hands is grossly different than buying a hamburger. The April 28 column by D.J. Tice ("Pay up front? Be still my beating heart") -- in which he equated "everyday shakedowns for payment in advance" with payment upon admission to hospitals, presumably Fairview ("AG: Fairview put squeeze on patients," April 25) -- missed the mark.
How far off the mark? Replay history and you will see how some local hospitals have evolved from caring places into money machines. Which in turn explains why we Americans spend 17 percent of gross domestic product on health care and rank 32nd in wellness globally.
While they officially run nonprofit organizations that pay neither property taxes nor corporate taxes, many hospital CEOs in the Twin Cities are paid more than $1 million per year, according to the Star Tribune's nonprofit salary and benefit survey.
Having served for many years on a board of a Minnesota hospital, I can assure you that hospitals hire outside consultants to "coach" doctors how to "code" for as many billable expenses as possible.
Hence the $10 bandage and supplies. And hence the driving of people to the emergency room, with its substantial "overhead" charges.
What is most disturbing is how far hospitals have moved away from their original missions to being financial behemoths today.
At the turn of the 19th century, members of every religious or ethnic group had a hospital to care for their own. Fairview Hospital was organized in the basement of Bethlehem Lutheran Church (44th St. and Lyndale Av. S. in Minneapolis) in 1904 for the expressed purpose: "To care for Norwegians." Quite simply, it was an expression of the religious convictions (values!) to care for the sick.
One anecdote from that genesis says it all: A young child, with indigent parents, was admitted to Fairview for surgery. The anesthetist administered the wrong amount of anesthetics, and the child died on the operating table.
The CEO at the time, Carl N. Platou, was informed of what had occurred. While the attorneys for the hospital counseled complete silence with the parents, Platou went to visit them immediately, and informed them of exactly what had happened.
"Then we cried together."
Days later, Fairview had a memorial service for the family, and the whole leadership team was there, including the anesthetist. In today's language, this is called transparency and integrity. Leadership from the top down.
It's also caring at its best under enormous stress. But the entire organization learned how to be better, by example.
It happened because of the leadership of Fairview in the 1970s.
Where does Fairview go from here? How does it and others like it recover the public trust that patients cling to for healing?
First the board (especially the CEO and former board chair on whose watch the collection effort occurred) need to do more than say "sorry." That would be asking for cheap grace.
Rather they need to articulate the values that guide the organization, and hence affect every employee. Then they need to assure us that the values are being practiced.
Second, the CEO and the executive who owned stock in the collection firm need to come clean about a serious conflict of interest. Address it before the state and federal authorities make it another headline.
Third, they should remind themselves of the Burton Act, which obligates hospitals to provide charitable care in exchange for the public funding received for facilities.
And finally, they must reach their minds back to who founded their organizations and why, and follow the moral leadership of people who went before.
Paul Olson, of St. Paul, is a former president of the Blandin Foundation. He is at firstname.lastname@example.org.
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