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.
