through the paper, trying to find what had upset him. Nothing in the
front pages or Metro, but it jumped out at me from the second page of
the Business section.
I never read the financial pages, but even if I did, I could have
missed it. Small piece, lower bottom corner, next to the foreign
exchange rates.
The headline read HEALTH CARE IN THE PRIVATE SECTOR: THE OPTIMISM
FADES. The gist of the article was that the for-profit hospital
business, once seen by Wall Street as a rich financial lode, had turned
out to be anything but. That premise was backed up by examples of
hospitals and HMOs gone bust, and interviews with financial honchos,
one of them George Plumb, formerly CEO of MGS Healthcare Consultants,
Pittsburgh, and currently CEO of Western Pediatric Medical Center, Los
Angeles.
Pittsburgh . . . The outfit revamping the library with an outmoded
computer system-BIO-DAT was from Pittsburgh too.
One hand feeding the other? I read on.
The honchos’ main complaints centered on government meddling and
“market-restricting” fee schedules but also touched upon difficulties
dealing with insurance companies, the skyrocketing cost of new
technologies, the salary demands of doctors and nurses, and the failure
of sick people to behave like statistics.
“One AIDS patient, alone, can cost us millions,” lamented one East
Coast administrator. And we still haven’t seen the light at the end of
that tunnel. This is a disease no one knew about when any of the plans
were put together. The rules have been changed in the middle of the
game.”
The HIV epidemic was cited repeatedly by executives, as if the plague
were a bit of naughtiness devised to throw the actuaries off track.
Plumb’s special contribution to the gripe-fest had to do with the
difficulties of running inner-city hospitals due to “unfavorable
demographics and social problems that seep into the institution from
the surrounding neighborhoods. Add to that, rapidly deteriorating
physical plants and shrinking revenues, and the paying consumer and his
or her provider is unwilling to contract for care.”
When asked for solutions, Plumb suggested that the wave of the future
might be decentralization-replacing the large urban hospital with
smaller, easily managed health-care units strategically located in
positive-growth suburban areas.
“However,” he cautioned, “careful economic analyses need to be done
before planning anything of that magnitude. And nonpecuniary issues
must also be considered. Many established institutions inspire a high
degree of loyalty in those whose memories are grounded in the good old
days.”
It sounded awfully like a trial balloon-testing public opinion before
proposing radical surgery: putting the “physical plant” up for sale and
heading for suburban pastures. And if cornered, Plumb could always
brush off his comments as detached expert analysis.
Kornblatt’s remark about selling off the hospital’s real estate began
to sound less like paranoia and more like an educated guess.
Of course, Plumb was only a mouthpiece. Speaking for the man I’d just
proposed as a possible murder contractor and accessory to child
abuse.
I remembered what Stephanie had told me about Chuck Jones’s
background.
Before becoming Western Peds’s chairman of the board, he’d managed the
hospital’s investment portfolio. Who’d know more about the precise
value of Western Peds’s assets-including the land-than the man who kept
the books?
I visualized him and Plumb and the gray-twin numbers crunchers, Roberts
and Novak, hunched over a moldy ledger, like predators out of a Thomas
Nast cartoon.
Could the hospital’s dismal financial situation be due to more than
unfortunate demographics and shrinking revenues? Had Jones mismanaged
Western Peds’s money to the point of crisis, and was he now planning to
cover his losses with a flashy real estate sale?
Adding insult to injury by taking a nice fat commission on the deal?
Strategically located in positive-growth suburban areas.
Like the fifty lots Chip Jones owned out in the West Valley?
One hand feeding the other . .
But to pull off that kind of thing, appearances would have to be kept
up, Jones and company exhibiting unwavering loyalty to the urban
dinosaur until it drew its last breath.
Pulling the chairman’s granddaughter out of treatment wouldn’t be part
of that.
In the meantime, though, steps could be taken to hasten the dinosaur’s