This is a great day! One of the last Communist dictators in the world has died. I wish I was somewhere celebrating!
A truly evil man has been removed from this earth! I'll celebrate and drink to that.
Metro General Hospital is seeking an additional $10 million dollar subsidy from the city. This would be the second $10 million cash infusion this year on top of the regular $35 million annual subsidy. In 2015 the regular budgeted subsidy was $27.6, increasing to $35 million in 2016. Following the first $10 million additional subsidy this year, Mayor Barry announced a third-party assessment of the hospital's finances and leadership structure. The City has also been holding weekly meetings with the staff to address the financial and management issues. From the response to the request by the city's finance director, the administration is displeased that this request is being made. To read about the request and the city's response as reported by The Tennessean, follow this link.
Metro General is the city's charity hospital. There is no charter requirement that the city fund such a hospital or no state requirement. Metro General is a money pit and is no longer necessary. I suspect the reason no one seriously considers getting out of the hospital business has more to do with the voting power of the Black community and pride of the Black community in having a Meharry Medical College in Nashville, than any real need. Funding Metro General is a way to subsidize Meharry Medical college. In my view, Metro Nashville
needs to get out of the hospital business just as we got out of the
nursing home business a couple years ago when we privatized Bordeaux Long-term
Care and Knowles Home Assisted Living and Adult Day Services, saving the
city $10.5 million a year.
Metro General has been struggling for years. Many years ago there was a need for local governments to provide charity
hospitals and many cities did. As healthcare changed and low income
people no longer had to go to the charity hospitals but could go to the
hospital of their choice, the justification for such safety net
hospitals became less persuasive, but with government slow to change, many cities
continued their funding of charity hospitals as did Nashville.
Over time
other changes occurred which made General even less viable, such as
more people being treated as outpatients rather than being admitted into
hospitals and length of stay in hospitals being shortened. A more recent change has been the impact of the Affordable Care Act (Obamacare). The Obama administration cut subsidies to hospitals that
treat the uninsured. The logic for this was that more people would have
insurance and there would be less need for the subsidy. This policy had
lead to closing of hospitals, especially in rural areas, but has
effected the income of all hospitals.
Metro General Hospital opened as the City Hospital on April 23, 1890 as
Nashville’s first full-service hospital. In 1891 the hospital started a
school of nursing and in 1913 it opened a pediatric ward. The hospital
grew and flourished until after World War II when admissions began
declining. As more hospitals opened in Nashville customers had more
choice. St. Thomas opened in 1898 and then Baptist Hospital, first known
as the Protestant Hospital, opened in 1917. Park View which was the
first in what was to became a chain of hospitals known as HCA opened in
the mid 1960’s. Vanderbilt Hospital opened in the 1970’s and there have
been numerous expansion and additions of other hospitals since then.
Not only did more choice mean less demand for General, but when Medicare
and Medicaid were signed into law in 1965 that meant that low income
people could go to any hospital and not depend on city charity. By the
1990’s General was facing a crisis. Not only did low income people have
choice, but General, dependent on Metro’s level of funding, did not
have the resources to acquire the latest in technology and equipment.
Also the building, by this time a hundred years old, was in need of
rebuilding or major rehabilitation.
Maharry Medical College was also facing a financial crisis in the late
1980’s and early 1990’s. In an effort to help both institutions, in
October 1991 Nashville approved of a plan to merge the Meharry Hospital
with Metro General. The merger phased out services at the Metro General
Hospital site on the bluffs of the Cumberland, now known as “Rolling
Mill Hill,” and relocated services to Meharry-Hubbard hospital. General
Hospital became the teaching hospital for Meharry Medical School and
metro heavily subsidized the 116-bed facility.
General has had a difficult time competing with the many other hospitals
in the area despite Metro’s generous subsidy. Despite Metro’s continued subsidy of the hospital, the hospital
struggles to attract patients. All Metro prisoners are treated at
Mehary-General and Metro employees are given an advantageous deal if
they will use Meharry, and yet still the hospital struggles.
In 2012 the city commissioned a study of Meharry-General conducted by the firm of Alvarez and Marsal.
The study found that as currently operating Meharry General was not
sustainable. One thing plaguing Meharry is that it cannot fill its beds.
They only have an occupancy
rate to about 42%, but even if they operated at full capacity they would
have a per patient loss per day of $1,602. The per patient loss is higher with fewer patients, but the overall loss would be greater with more patients. This study is dated of course and I do not have current occupancy rates, but obviously things have not gotten better.
The consultants offered a range of options for addressing the situation,
ranging from “maintaining the status quo to re-purposing the hospital
as an ambulatory care facility with reduced inpatient services to a full
scale re-design of the business model focused entirely on outpatient
and clinical service.”
A couple years ago, Metro spun off its nursing homes and saved the city $10.5
million a year. A city owned nursing home is as about as archaic as a
city poor farm, yet ending metro’s ownership and operation of a nursing
home was not without its opponents and yet the city did it. Even Megan Barry voted to privatize Boudreaux and Knowles. It is time for Metro to get out of the hospital business.
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| Donald Trump and Betsy DeVos |
Betsy DeVos has been a staunch supporter of more education choices for students and parents, and the school choice movement will have a champion in the Education Department.Senator Lamar Alexander, Chairman of the Senate Education Committee said of the nominations:
The next Secretary should re-evaluate existing federal education programs, work to downsize the agency, promote where appropriate efforts for more choice, and give states more flexibility with existing federal funds to better serve students.
Betsy DeVos is an excellent choice. The Senate’s education committee will move swiftly in January to consider her nomination.
Betsy has worked for years to improve educational opportunities for all children. As secretary, she will be able to implement the new law fixing No Child Left Behind just as Congress wrote it, reversing the trend to a national school board and restoring to states, governors, school boards, teachers, and parents greater responsibility for improving education in their local communities.
I also look forward to working with her on the upcoming re-authorization of the Higher Education Act, giving us an opportunity to clear out the jungle of red tape that makes it more difficult for students to obtain financial aid and for administrators to manage America’s 6,000 colleges and universities.
Betsy is a very gifted and well-respected education leader with a proven track record of advancing excellence and equity for students. She has been a strong champion for parental choice, ensuring that all children, regardless of race or economic status, have access to excellent schools. We have no doubt she will make a great education secretary.Watching the transition team come together and watching Trump moderate some of his positions, I am more and more encouraged and hopeful that Trump will be a good president. As one who was a critic of Trump, I am now hopeful. This nomination was particularly encouraging.
BAEO congratulates Betsy on her nomination.
Another victory is overturning a President Obama action exceeding his authority.
by Dave Flessner, Times Free Press - President-elect Donald Trump, who vowed on the campaign trail to rip
up the Iranian nuclear treaty, should do more to enforce the agreement
rather than discard it right away, U.S. Sen. Bob Corker, R-Tenn., said
Monday.
Corker, chairman of the Senate Foreign Relations Committee and a
critic of the deal that outgoing President Barack Obama negotiated with
Tehran leaders last year, said he expects the incoming Trump
administration should and will do more to police what he said were
ongoing violations of the pact by the Iranian government. But since the
U.S. government and its allies have already returned billions of dollars
of once-frozen assets to Iran, Corker cautioned against reneging on the agreement once Trump is sworn into office in January.
"I don't think that [throwing out the deal) is a very good place to
start," Corker told reporters in his hometown of Chattanooga. "If you
tear the agreement up on the front end, it's almost like cutting your
nose off to spite your face because they already have assess to all of
their dollars." (link)
by Joey Garrison, The Tennessean - Nashville will continue to allow police officers in Davidson County to give civil citations for the possession of small amounts of marijuana despite a new opinion from Tennessee Attorney General Herbert Slatery that contends the local ordinance preempts state law.
In a statement Monday, Metro Law Director Jon Cooper reaffirmed his
position from last week when he told The Tennessean via email that the
Metro Council acted within its authority. (link)
by Michael Collins , USA TODAY NETWORK - Tennessee - WASHINGTON — As President-elect Donald Trump looks for a way to repeal and replace the Affordable Care Act, he should consider calling U.S. Rep. Phil Roe of Tennessee.
Roe, a Johnson City Republican and one of 17 physicians in Congress, wrote a blueprint more than three years ago for repealing Obamacare and replacing it with a system that is more patient centered and market driven.
The bill, which Roe called the American Health Care Reform Act, ...(link)
Brent Leatherwood who is the Executive Director of the Tennessee Republican Party has announced he is running for the Party chairman position. The current chairman, Ryan Haynes, has announce he will not be seeking reelection. The new chairman will be elected by the State Executive Committee at the December SEC meeting. Leatherwood has served as Executive Director since December 2012, serving under both Ryan Hanyes and Ryan's predecessor Chris Devaney.
There is discontent within the TN GOP for several reasons. In October, instead of the Party enthusiastically getting behind Donald Trump's candidacy, Bent Leatherwood issued a statement saying Republican should vote their conscience. While that statement pleased me and other who were disappointed that the party had nominated a person who unnecessarily used vitriolic rhetoric, who lacked the temperament to be president, and who was a Republican in name only, it did not sit well with supporters of Donald Trump. "We’re encouraging people to vote their conscience. We view our job as one to continue the advance of the conservative cause by defeating Democrats. So we encourage Tennesseans to vote consistent with their conservative convictions,” said Leatherwood. (link)
There was also resentment that among the 14 delegates appointed by the Party sent to the Republican National Convention were those who were not Trump loyalist. Most delegates are elected but 14 are appointed by the executive committee. If we would have had a brokered convention, they would have not likely voted for Trump on the third ballot. This became very heated and generated national news coverage that establishment Republican were stealing Trump delegates.
Another recent conflict in the party as been that involving Walther Ferrell and Taylor Ferrell and an allegation that the Party was involving itself in primaries attempting to defeat some incumbent Republicans. Taylor Ferrell was a paid contractor with the TRP who worked to coordinate travel and other logistics for those delegates attending the Republican National Convention. She is also married to Walker Ferrell who is the TRP Political Director. Taylor Ferrell is also sole proprietor of Southland Advantage and Southland Advantage had clients who were running in the primary against incumbent Republican office holders.
Twenty-seven Republican office holders signed a letter calling for Walter Ferrell's resignation due to this conflict. Those who defended Taylor Ferrell said she was not an employee of the Party but was a contractor doing work for the Party and was not violating Party bylaws by having clients seeking to defeat incumbent Republicans. That to me appeared to be a distinction without a difference. Among those leading the effort to get Taylor and Walker Ferrell fired, there were also calls for the termination of Ryan Haynes as Chairman and Brent Leatherwood as Executive Director. For a lot more on this controversy, follow this link.
According to a recent story in the Tennessean, also seeking the position of Chair is Bill Giannini, a deputy commissioner with the Tennessee Department of Commerce and Insurance. Also, a potential candidate for the position is Scott Golden a member of the SEC. Several people who ran in 2015 such as SEC member Rebecca Burke and Vanderbilt professor Carol Swain are not running and neither is former State Senator Jim Tracy who has been mentioned as a candidate.
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