First Lady helped create a notorious program that dumped poor patients
on community hospitals, yet the national media ignore the story. Imagine
if her husband were a Republican.
The University of Chicago
Medical Center has received a good deal of justly opprobrious press over
its policy of "redirecting" low-income patients to community hospitals
while reserving its own beds for well-heeled patients requiring highly
profitable procedures. Substantial coverage was given to a recent
indictment of the program by the American College of Emergency
Physicians. ACEP's president, Dr. Nick Jouriles, released a statement
suggesting that the initiative comes "dangerously close to ‘patient
dumping,' a practice made illegal by the Emergency Medical Labor and
Treatment Act, and reflected an effort to ‘cherry pick' wealthy patients
absent from most of the unflattering press coverage of UCMC's
patient-dumping scheme is any mention of the role our new First Lady
played in devising the program. A laudable exception has been the Chicago Sun-Times, whichreported
last August that "Michelle Obama -- currently on unpaid leave from her
$317,000-a-year job as a vice president of the prestigious hospital --
helped create the program."
the rare occasions when other "news" media have bothered to connect the
Urban Health Initiative to its glamorous creator, they have attempted
to whitewash this tawdry program. Typical of such disingenuous coverage
was a story in the Washington Post, which described it as "an innovative program to steer the patients to existing neighborhood clinics."
no amount of journalistic lipstick can hide the reality that Mrs.
Obama's initiative is a patient-dumping scheme. Such "cherry-picking,"
as Dr. Jouriles accurately describes it, was, at one time, fairly
common. Prestigious institutions like the University of Chicago Medical
Center routinely "dumped" Medicaid, uninsured and other unprofitable
patients on less mercenary community hospitals. Many patients suffered
needlessly, and more than a few actually died, as the result of this
practice. So, in 1986, President Reagan signed the Emergency Medical
Labor and Treatment Act (EMTALA) into law. EMTALA made such
"redirection" illegal, but many high profile hospitals still chafed at
being forced to treat poor patients. Enter Michelle Obama, UCMC's "Vice
President for Community and External Affairs."
Obama first hatched the UCMC program as the "South Side Health
Collaborative," which featured a gang of "counselors" whose job it was
to "advise" low-income patients that they would be better off at other
hospitals and clinics. The program was so successful in getting rid of
unwanted patients that she expanded it, gave it a new name, and hired
none other than David Axelrod to sell the program to the public.
According to the Sun-Times, "Obama's wife and Valerie Jarrett,
an Obama friend and adviser who chairs the medical center's board,
backed the Axelrod firm's hiring." Axelrod helped the future First Lady
formulate a public relations campaign in which the "Urban Health
Initiative" was represented as a boon to the community actuated by the
purest of altruistic motives.
resultant PR campaign was a study in Orwellian audacity. Chicago's
inner city residents soon began hearing that UCMC's patient dumping
program would "dramatically improve health care for thousands of South
Side residents" and that the medical center was generously willing to
provide "a ride on a shuttle bus to other centers." Likewise, the people
who ran the community hospitals to which these unwanted patients were
being shuttled began to read claims in local media to the effect that
the Urban Health Initiative was good for them as well. Dr. Eric
Whitaker, the Blagojevich crony who succeeded Mrs. Obama as Director of
the program, repeatedly assured gullible reporters that the financial
impact on these hospitals would be positive: "The initiative actually is
improving their bottom lines." The CFOs of those hospitals were no
doubt relieved to learn that treating Medicaid and uninsured patients is
But you just can't please some people. In one of the few frank passages of the Post
article, we discover that many members of UCMC's medical staff believe
the program is nothing more than an "attempt to ensure that the hospital
retains only affluent patients with insurance." And another association
of emergency physicians has joined ACEP in denouncing the Urban Health
Initiative. The Chicago Tribune reports
that Dr. Larry Weiss, president of the American Academy of Emergency
Medicine is unhappy about UCMC's failure to consult its own ER
physicians before initiating the program: "Not including emergency-room
physicians ... would be analogous to changing the way surgery is
performed in an operating room without involving any surgeons." Dr.
Whitaker assures us, however, that such critics are merely "opposed to
he would be similarly dismissive of Angela Adams, who brought her son
to the medical center's ER after his lip had been partially torn off by a
pit bull. As the Tribune puts it,
"Instead of rushing Dontae into surgery ... the hospital's staff began
pressing her about insurance." Unfortunately for Dontae, he was covered
by Medicaid. So, all he got from the UCMC emergency department was a
shot, some antibiotics, and instructions to "follow up with Cook
County." Angela had to take her son across town to John Stroger
Hospital, where he was immediately admitted for reconstructive surgery.
Like doctors Jouriles and Weiss, Angela is having trouble seeing the
community benefit of the Urban Health Initiative.
the program's parents, Michelle Obama and David Axelrod, have moved to
Washington. As the First Lady and the President's closest advisor, they
wield enormous power. Indeed, they may be the most powerful people in
the Obama Administration, aside from the President himself. If these two
characters were willing to betray their Chicago neighbors -- the South
Side's most vulnerable citizens -- with a disgraceful program like the
Urban Health Initiative, what sort of mischief will they devise for the
hapless denizens of flyover country?
to think of it, isn't Obamacare being sold to us in pretty much the
same way the Urban Health Initiative was sold to Chicago?
Catron is a health care finance professional who has spent more than
twenty years working for and advising hospitals and medical practices.
He blogs at Health Care BS.
on "Michelle Obama's Patient-Dumping Scheme"