Monday, March 04, 2013

I'm only thinking of him

In the musical Man of La Mancha, the hero's niece Antonia piously, but insincerely, sings the song "I'm only thinking of him."

I'm only thinking of him,
I'm only thinking of him,
Whatever I may do or say;
I'm only thinking of him!
In my body; it's well known,
There is not one selfish bone...
I'm only thinking end worrying about him!

A reprise is being sung in Albuquerque, New Mexico.  For years, the University of New Mexico Hospital has served as the safety net hospital for the region's poor and uninsured, supported in part by $90 million per year from a dedicated tax levy.  Now comes the Lovelace Health System, owned by Tennessee's Ardent Health Services, offering to share beds with UNMH as an alternative to UNMH building a new $146 million hospital.

I am moved by the generosity of this for-profit chain.  I'm sure they are only thinking of the needs of the public and the burden facing UNMH.

Oh wait, a story in Albuquerque Business First eventually mentions something of interest:

[Lovelace CEO Ron] Stern’s letter also said the Lovelace Medical Center in the Downtown area has an occupancy rate of 61 percent and could easily take overflow patients from UNMH.

Oh, 61 percent.

By the way, was Lovelace proposing to take all kinds of patients, or only ones with insurance?

Let's turn back to the song.  (Click here if you can't see the video).


David Joyce MD said...

Come Paul, Obamacare promises to have everyone insured. If you were strategic planning health care for that area and you were promised that everyone will have health insurance by 2014 what would be the smart move. Spend a fortune to build a new non-profit health center or use your existing capacity. If it were GE or Ford, I think they would make use of existing capacity. Docs need to think more like business people from the get go.

Anonymous said...

Im with Paul on this one. As a native New Mexican, I have seen all sorts of wild scheming by the Lovelace operation dating back to the 80's when it alligned almost exclusivley with Cigna and went down in flames, financially. There are several physician investors now--good luck guys. NM has a huge indigent-generational welfare recipient and Medicaid population with little ACO or free market penetration due to the overall persistently lousy NM economy. Lovelace used to partner with the adjacent VA and UNM Hospital as a teaching facility for the Med School, but since the late 70's, Lovelace has been on life support--not competing well with the statewide Presbyterian Hospital chain- Armada.

Anonymous said...

Its a nice idea David, but in practice the need for beds at the state's only tertiary care facility isn't going away, and can't be replaced by boarding patients at a community hospital. Simply, the patients are too sick, or too socio-economically complex to be treated in a community bed. It they weren't, they presumably would have voted with their feet and walked the mile to the front doors of the Lovelace facility themselves. And, look at the statistics for "universal coverage" in New Mexico: not likely in 2014 despite Medicaid expansion. High copays for the above-Medicaid income crowd, and a large number of undocumented residents means that the need for a safety-net/tertiary facility isn't going anywhere soon.

e-Patient Dave said...


Unlike other commenters I don't know the local market. But I was deep into writing a post about yours here, and what I kept coming down to was:

A for-profit chain with idle capacity offers to sell some to another one with excess demand.

Did I miss some other cue that this isn't actually what's happening?

I have no idea whether motives in Albuquerque are pure; just wondering if I missed some factor.

Anonymous said...

The point is that NM is not affluent enough to risk "cherry picking" of insured patients from its single tertiary care- trauma- university hospital system. In spite of Medicaid expansion many NM residents will continue to be "uninsured" for a host of socio-economic reasons as the commenter above indicated. The legislature, tradionally very tight with funds, has deemed UNM Hospital worthy of funds for facility updates. I'm pretty sure that if a UNM-Lovelace merger was feasible, it would be considered.