[Vision2020] Gritman's Community Service

Fri Feb 25 10:26:27 PST 2005

Thank you David Budge. You beat me to a number of the punches I intended to
throw back on this one. Donovan Arnold had a rough time in November. Many of
his candidates lost and he is still dealing with that. His answer is to stir
the pot with his, as David stated, pathetic whining.

I would add just a couple things:

1.	I wish Donovan could have been at the strategic planning session I
attended Wednesday afternoon. Gritman invited many community members in to
comment on how the hospital is doing in fulfilling their mission. There were
no Gritman employees in attendance. The facilitator encouraged us to share
the good and the bad. The close to twenty people in my group had rave
reviews for the hospital. There were some problems/challenges discussed but
we all acknowledged that some were beyond the control of Gritman- or any
hospital for that matter. Example- dealing with HIPAA and how that
complicates being user friendly to patients and family members. It’s
especially tough on clergy.
2.	My business had the privilege of providing support services to the
University of Idaho student health program for a number of years. Several
years ago the University followed national trends and made some major
changes in their program. At that point, they no longer needed my local
services and I stepped aside. However, I was privy to information that, if
anything, we were on the end of the curve wherein other colleges and
universities had long ago made insurance mandatory. I would ask Donovan to
do a little research on this. How many schools still have optional insurance
for their students? As David stated, this is a state policy. Additionally,
if you hadn’t noticed, health care delivery and cost is one of our greatest
issues. Have you not noticed the number of health insurance companies that
have gone bankrupt in recent years? I sell lot’s of health insurance and
encourage UI students to give serious consideration to the plan. When I
started with the program, approximately 500 students voluntarily purchased
it. When I finished up, we were at about 3000. A large group has purchasing
power not found when buying an individual policy. 
3.	And finally, echoing David’s comment- thank God we live in a county
where it is O.K. to make a profit. The last time I checked we have a few
other for profit entities in town- including C J’s.

We are all very fortunate to have Gritman Hospital in Moscow.

Jon Kimberling

-----Original Message-----
From: vision2020-bounces at moscow.com [mailto:vision2020-bounces at moscow.com]
On Behalf Of David M. Budge
Sent: Friday, February 25, 2005 2:10 AM
To: Donovan Arnold
Cc: vision2020 at moscow.com; bjswan at moscow.com
Subject: Re: [Vision2020] Gritman's Community Service

GOD, PLEASE MAKE THE VOICES STOP!!!!!!!!!!!!

Holy mother of pearl!  I feel like I've died and gone to Oliver Stone
conspiracy theory hell.  Have some of you been raised under heavy power
transmission lines or grew up on a diet of lead based paint chips.  
I take what I can stands and I can't stands it no more.  

A)  Accrording to the online U of I Student Health Insurance Program
brochure, the Idaho State Board of Education requires proof of health
insurance for ALL publicly funded institutions of higher education in the
state.  This is not solely a U of I policy.

B) The insurance program is underwritten and administered by the Mega Life
and Health Insurance Company of America.  Ergo, the University makes not one
damn dime form the insurance program.

C) The cost of the insurance is about 25% less than the cost of comparable
individual policies purchased through any other competitive program in the
state.  Pretty good deal ask ANY insurance agent.

D) The $11 million charged off for indigent care cannot be written off on
their taxes.  They don't pay income taxes for cripes sake.  They're a
not-for-profit entity!!!!

E) Who, exactly should pay for indigent care?  What is happening right now
is that everyone else is paying for those who can't through $20 bandaids.
In fact, the people who get screwed the most are those who either have not
the benefit of a collectively bargained health plan (like SHIP) or a
government program (like Medicaid and Medicare) but I'll get to that in a
moment. Write you strinkin' congressman!

Now, as I say, I don't have a dog in this fight (although I was born there
and delivered by the legendary Dr. Wilson for all you townies who may care.)
The current health system in this country is a disaster, but that's little
fault of the hospitals.  It's systemic.  

You want to get down on the heath care system, that's fair game.  But I see
that some here have so little clue as to what in fact are the pressures on
hospitals that their arguments are vacuous hyperbole.  

About 80% of health care is used by 20% of the population.  About 60% in
total dollars is used by the 13% receiving Medicare.  Medicare payments are
highly regulated by the Heath Care Finance Authoritiy (HCFA) and are paid
under a system called Diagnostic Related Groups (DRG's) the sets maximums
for any payment that can be made for any service.  This system has put
horrendous strains on the entire hospital system nationally and I'm sure
that Gritman is no exception.  Hence, pricing needed to make up the
deficiency ($20 bandaids) is a defacto subsidy by all other payers.
Additionally, under the Community Hopsital Charter Bill, no community
hospital is able to turn anyone away for care regardless of their ability to
pay.  This doesn't even include the pricing pressure from Medicaid. (check
out  http://www.enterstageright.com/archive/articles/0601patuncon.htm for
some backgound on insruace and HMO's - libertarian rant.) 

I assume, but I don't know for sure, that Gritman makes its annual reports
available, in one form or another,  to anyone who asks for it.   The
accounting used is called Fund Balance Accounting where there is no equity
per say as there is no ownership.  Anyone with a bone to pick with Gritman
should get that statement before casting ad hominem attacks based on
groundless assumptions and vacuous logic.  My guess is, being familiar with
such things, that Gritaman has a minimal "free funds balance" and just about
all resources are earmarked for specific programs.  If you're really so full
of piss and vinegar on the issue get involved, donate your time to the
hospital, and study the finacials, so no one has to subsidize you ignorance
with spilled ink.

Lastly, is it so wrong that anyone makes a profit on anything?  How
ridiculously obtuse is this proposition?  We live in a market economy and,
although it sometimes lacks in fairness, it seems the best current model in
the egalitarian distribution of goods and services.  (hint to Mr. Arnold -
you've got a University in Moscow - how 'bout econ 101.)

You know what?  Keep up the pressure and good people like B.J. Swanson will
eventually tell you to go piss off, sell Gritman to Health Corporation of
America and shut down all indigent services.  Then pathetic whiners that
think everything in the country relative to commerce is out to get them will
have the opportunity to take their pathetic paranoia and pound sand. You
should be thanking him for doing otherwise thankless work. 

You may have an argument for socialized medicine (regardless of how wrong
heades it may be) but you're making assumptions here that are based on, from
what I can tell ...nothing.

I want to take this opportunity to thank Mr. Swanson and the entire Board of
Directors.  I've been in similar postions and I know the sacrifice to one's
familyies and personal life it takes.  

Dave (Mr. Screed) Budge 

Donovan Arnold wrote:

B.J. Swanson and visioneers, 

You write well. However, I don't think you are being honest with the
community. Let us shine some light on your points. 

"The Board of Directors are all volunteers from the community and receive no
pay."--BJ S. 

That is because they make their money off making decisions that result in
lining their own pockets. Let us take the case of a previous Board of
Directors Chair. He used his position at UI to require  all UI students
purchase health insurance. This saved Gritman millions of dollars in having
to pay the indigent fund. After leaving as Chair of Board of Directors he
now works one day a week as the Director of Student Health, Benefits, and
Welfare at UI for $90,000 a year and he only works ONE day a week,
Wednesday, and I don't think he even shows up until after 9 AM. That is a
cushy job. That is why he doesn't need the token pay of the position. He
made millions for UI and saved millions for Gritman, at the expense of UI
Students, many of which cannot afford the crappy insurance, that costs more
and cut out vision and dental. 

"Gritman is non-profit"-BJS 

Maybe not for the hospital and community but it sure is for some of the
board of directors and some others that work there. At $20 for a band-aid,
money has got to going some where because is not going to the nurses or the
janitors. 

"Gritman is not a tax supported hospital." BJS 

If you believe that I got a bridge in Brooklyn I would like to sell you.
Humm, as I seem to recall, the taxpayers donated an entire street to Gritman
and paid money to build on an entirely new wing to the hospital for private
doctors to make private profits. Not to mention providing all those
utilities. Now just because it doesn't show as a LINE ITEM on a bill doesn't
mean we are not paying for it. I think to suggest that the taxpayers are not
spending millions of their hard earned dollars on Gritman really is
dishonest and akin of the type of behavior and attitude that has been coming
out of the Board of Directors for the last few years. Taxpayers do support
Gritman and you should thank them for it rather than telling them they don't
and insulting them. Its operations are also supported by taxpayers because
the hospital is tax exempt and taxpayers have to pay higher property taxes
as a result. 

" Last year, Gritman expensed over $11 million in charity care in this
community."--BJS 

Correction, Gritman wrote-off on their taxes $11 million in charity care to
the community. Let us not get carried away. And at $20 for a band aid, how
much care was that? How much did Gritman collect and save from not having to
pay for indigent care by forcing UI students to have expensive health
insurance? How much has Gritman made from other tax supported entities? How
much of that charity was paid as a mandate by local, state, and federal law?
And where was most of the money directed? The answers to those question
began to paint a much different picture. 

"Gritman will pay it's fair share of a BID assessment if it is approved."BJS

You mean Gritman won't break the law? Thanks for that agreement. 

"I challenge you to think of Moscow without Gritman and tell me if you would
be better off." BJS 

Oh please! Are you suggesting that Moscow Residents are to ignorant to
figure out how to staff a hospital if it were not for BJ Swanson and the
Board of Directors? That really is disturbing and insulting you people think
that about yourselves. If Gritman was not there, we would have a better
hospital like we did before it was taken over by a tax dodging and
profiteering form of management. We would not have people lining up to be on
the board of directors to make money off the position if it were not for
Gritman. We would not have as high of property taxes because the private
doctors making private profits would be paying taxing rather than being
supported by them if it were not for Gritman. And lastly, I would not be
forced to buy inadequate health insurance from UI at outrageous prices. The
Board of Directors cost me an extra $500 a year and my former quality health
insurance I had before.  I think people in Moscow would have to filled with
a great deal of incompetence not to be better off with a different hospital.

Finally, it ought to tell people in Moscow something when a former members
of the Board of Directors at Gritman would rather be helicoptered to
Lewiston for treatment rather than be treated at Gritman. Maybe they know
something. 

I know that Gritman has good workers and bad workers, just like every place
else. However, I think it gets worse when you have greedy profit driven
management. Greed should never be allowed to rear its ugly head in a place
that is suppose to provide critical quality care. The Gritman Board of
Directors, over the last several years, has placed the welfare of the
community second to huge profits. 

Good Day, 

Donovan J Arnold 
Victim of Gritman 

"How do you tell when a politician is lying? Their lips are moving" 

From: "B. J. Swanson"  <mailto:bjswan at moscow.com> <bjswan at moscow.com> 
To:  <mailto:vision2020 at moscow.com> <vision2020 at moscow.com> 
Subject: Re: [Vision2020] Gritman's Community Service 
Date: Thu, 24 Feb 2005 20:12:29 -0800 

Donovan & Visionaries, 

The cost of healthcare is certainly a concern for everyone.  Instead of a 
Social Security crisis, the nation probably has a worse healthcare crisis. 
It's not just Moscow. 

You may think Gritman is a huge for-profit, corporate hospital, but it is 
not.  Gritman is non-profit.  It is owned by the community.  The Board of 
Directors are all volunteers from the community and receive no pay.  We do 
contract with Quorum Health Resources for management of Gritman.  Jeff 
Martin is the only Quorum employee at Gritman. If you have ever looked at a 
Medicare Cost Report or one of the 300+ contracts Gritman maintains, you 
would clearly see that to stay in business and provide healthcare that the 
community expects, we contract with a company that specializes in hospital 
management.  It's an extremely complicated and costly industry, but it also 
saves lives. 

Gritman does way more than provide hot chocolate, coffee, etc. to the 
community.  Last year, Gritman expensed over $11 million in charity care in 
this community.  We care for everyone regardless of their ability to pay. 

Gritman is also the largest private employer with nearly 400 employees. 

The direct healthcare areas of Gritman are tax exempt.  Properties that are 
leased or not directly related to healthcare are taxed.  Gritman will pay 
it's fair share of a BID assessment if it is approved. 

You will find that many hospitals in Idaho started out like Gritman; owned 
and supported by the community.  Most have gotten into trouble, sold 
themselves to for-profit companies or gave themselves to the Counties and 
became taxing districts.  Pullman Regional Hospital is funded by a taxing 
district.  The residents of Pullman are taxed to support their hospital. 
Gritman is not a tax supported hospital.  You will find no line item on your

tax bill to support Gritman.  It is tax exempt, but you do not pay taxes to 
keep it running either.  Most communities that now have tax supported 
hospitals would much prefer an arrangement like Gritman. 

I challenge you to think of Moscow without Gritman and tell me if you would 
be better off. 

B. J. Swanson 
Chairman of the Board 
Gritman Medical Center 

---------------------------------- 

------ Forwarded Message 
From: "Donovan Arnold"  <mailto:donovanarnold at hotmail.com>
<donovanarnold at hotmail.com> 
Date: Thu, 24 Feb 2005 18:46:57 -0800 
To: edc at moscow.com, CJs at Turbonet.com, editor at lataheagle.com, 
vision2020 at moscow.com 
Subject: [Vision2020] Gritman's Community Service 

 "Gritman provided hot chocolate, coffee, and cookies for participants of 
the 
Holiday Parade.  Gritman also provides hot dogs and drinks for the 
Homecoming Parade." 

Don't forget the lolly pop and a free sticker if you don't cry during a 
hysterectomy. 

Really though, it is so nice for UI students to pay an extra $500 a semester

in addition to other fees so they can get free coffee and cookies at 
downtown events. What a deal! And we wonder why students are leaving UI by 
the hundreds. The logic just doesn't follow :P 

Donovan J Arnold 

--------------------------------- 

>From: Barbara Richardson Crouch  <mailto:edc at moscow.com> <edc at moscow.com> 
>To:  <mailto:CJs at Turbonet.com> <CJs at Turbonet.com>,
<mailto:editor at lataheagle.com> <editor at lataheagle.com>,
vision2020 at moscow.com 
>Subject: Re: [Vision2020] NSA 
>Date: Thu, 24 Feb 2005 18:55:11 GMT 
> 
>Phil, 
> 
>Gritman is a not-for-profit corporation.  The hospital is controlled and 
>operated by a board of directors comprised of community members.  Gritman 
>provides millions of dollars per year in unreimbursed care to our local 
>residents. 
> 
>Gritman provides various services and supports downtown events.  Gritman 
>provided hot chocolate, coffee, and cookies for participants of the 
>Holiday Parade.  Gritman also provides hot dogs and drinks for the 
>Homecoming Parade.  Plus Gritman supports finacially many, many events 
>throughout the community. 
> 
>Barbara Crouch 
> 
>--------------------------------- 
> 
> > Kai - If NSA  and Grittman (since Grittman is  FOR PROFIT) were paying 
> > property taxes there would not need to be  a BID. 
> > 
> > Phil 
> > 
> > -------Original Message------- 
> > 
> > From: Kai Eiselein 
> > Date: 02/24/05 09:06:41 
> > To: vision2020 at moscow.com 
> > Subject: [Vision2020] NSA 
> > 
> > Rose, you may want to take a closer look at the BID. I am rather 
>ambivile> nt 
> > about it, but I did write an article in the December 9 issue of the 
>Latah> 
> > Eagle about the process. 
> > According to the documents I have, a tax exempt entity is not exempt 
>from> 
> > the a BID levy. That would include New St. Andrews College and Gritman 
>to> 
> > name a couple. The BID in Twin Falls includes the administrative office 
>o> f 
> > the school district, as I recall, and they are subject to the BID levy 
>as> 
> > well. 
> > 
> > 
> > Kai T. Eiselein 
> > Editor 
> > Latah Eagle 
> > 521 S. Jackson St. 
> > Moscow, ID 83843 
> > (208) 882-0666 Fax (208) 882-0130 
> > editor at lataheagle.com 
> > 

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