Now, if the Health & Hospital Corporation desired to accurately inform voters of the question they are voting upon, the wording of the referendum would be something like this: "Shall the Health & Hospital Corporation of Marion County, Indiana be permitted to issue up to $750 million of (insert whatever type of bonds will be issued) 30-year, fixed rate bonds payable from (insert what revenue source is being tapped to pay the debt obligation and the approximate annual amount required to service that debt) to construct a new 300-room hospital to replace the existing Wishard Hospital, which will be demolished and the land upon which it is situated will be transferred to Indiana University in consideration of a transfer of land owned by Indiana University to the Health & Hospital Corporation for construction of the new hospital."
Now take a look at the referendum question Paul Ogden learned today has been certified for the November special election:
"Shall the Health and Hospital Corporation of Marion County, Indiana, issue bonds or enter into a lease to finance safe, efficient and functional facilities for the Wishard Hospital project:First of all, the very first sentence is a total deviation from what HHC officials have told us to date. We have been told that HHC will issue bonds to construct the new hospital, and that it will rely exclusively on its existing revenue stream to pay the debt service and operating and maintenance costs for the new hospital. Note that the language of the question reads "issue bonds or enter into a lease." A lease from whom? Is the HHC going to own this building or not? Secondly, the wording of the referendum nowhere suggests the size of the project being undertaken. Instead, what we get is nothing more than a propaganda piece that makes it appear that you would have to be against the poor, seniors, burn victims and traumatic brain injured persons to oppose the referendum. And just for good measure, they throw in the names of several colleges, including IU, Ivy Tech and Purdue, as if they are integral to the question. This isn't a referendum ballot question; it's a press release for the proponents of a new hospital.
1.to allow Wishard to provide access to care for all residents of Marion County, including people who are seniors, poor uninsured or vulnerable regardless of their ability to pay; and
2.to allow Wishard to provide specialized care, including to victims usffering from traumatic injuries or severe burns; and
3.to allow Wishard to work with colleges and universities including Indiana University School of Medicine, Ivy Tech Community College, and the Purdue School of Pharmacy, to teach future doctors, nurses and other healthcare professionals in Indiana?"
I've never seen anything like the way our so-called Indianapolis community leaders will go to mislead the general public, whether it's the purchase of the Indianapolis Water Company, the construction of Lucas Oil Stadium or the construction of a new hospital, to get them to go along with their schemes to put money in their own pockets at your expense. God forbid the true facts be allowed to get in the way of their good ideas.
As is always the case, we're given only two choices: build this new hospital; or Wishard will have to be closed and there will be no place for the uninsured and the indigent to turn for life or death health care treatment needs. Remember, we have to buy the Indianapolis Water Company to keep it from falling into the hands of a foreign-owned company. We bought it for twice its value and then turned it over to a French-owned company to run at an enormous cost to ratepayers. We were told the Colts would pack up and leave town if we didn't build a new $750 million stadium. We were told we could have that new stadium if we only raised a regional tax on food and beverages. It turns out there wasn't enough money to run the stadium, and we're now told we have to raise more taxes, and the Colts' owner, amidst all this debate, announced that he had never asked for a new stadium in the first place so don't blame him. And now they tell us LOS will be closed if we don't go along with their latest tax, borrow and spend bailout scheme.
Let's get one fact clear. Indianapolis has no shortage when it comes to hospital capacity. In 2006, USA Today mentioned the hospital construction boom underway in Indianapolis. "Indianapolis has gained four heart-surgery centers, two general hospitals and an orthopedic hospital since 2004 — and an additional $1 billion in hospital construction is underway," USA Today wrote. In the last five years, we've seen two relatively new hospitals closed, including Winona on the City's near northside and St. Frances in Beech Grove. There are no plans for the vacant St. Frances Hospital, and the City plans to convert Winona into a living community for senior citizens and give some of the property to the Children's Museum for yet another expansion project.
In the wake of the financial meltdown, Clarian has stopped planned expansions at Riley Children's Hospital and construction of a new hospital in Fishers. Clarian and Community Hospitals each lost about one-third of their investment portfolios in the last year. Clarian's losses totalled over $660 million. Clarian lost $350 million in interest rate swaps alone according to the Indianapolis Business Journal. Clarian had used interest-rate swaps to lower their interest rate payments on their debt and hedge against changes in interest rates. Some financial experts questioned Clarian's reckless investment decisions according to the IBJ.
Unlike Clarian and Community Hospitals, HHC officials tell us they have been investing their money more wisely. HHC has acquired more than two dozen nursing homes across the state. HHC claims these nursing homes are very profitable, throwing off more than $40 million a year in cash to HHC, which it plans to use to finance the debt on the new hospital. Wishard Hospital, although it cares for the indigent, also does well when you consider how much it receives in government funding. Medicare and Medicaid cover the majority of patient costs. Unlike most other hospitals in Indiana, Wishard also gets tens of millions annually in disproportionate share payments to cover patient costs not covered by private pay, insurance, Medicaid or Medicare. Clarian's Methodist Hospital is the only other hospital in Marion County that receives these additional funds from the government. Clarian was so flush with money a few years ago that it spent hundreds of millions of dollars on the monorail that connects Methodist Hospital with the IU/Wishard Hospital campus.
Completely missing in this debate is the impact Obama's proposed health care plan could have on HHC's financial situation. The disproportionate share payments Wishard currently receives would be ended altogether under one version of that health care plan; Wishard instead would be subject to the same reimbursement rules that other hospitals are required to live within. That could leave a big hole in the budget that Marion County taxpayers, who already pay more than $25 million annually to HHC in property taxes, would have to pick up. Construction cost overruns, such as experienced with Lucas Oil Stadium, could also add considerably to the cost of this project. Don't be surprised if this turns into a $1 billion project.
I'm still waiting for an explanation as to why we have to build and maintain a completely separate hospital for the indigent. Every other hospital in Marion County is a nonprofit hospital. Is there any reason why these hospitals can't share responsibility for taking care of the indigent population? If you study the demographic trends of Marion County, you will quickly realize the indigent population once concentrated in Center Township near the center of the City has migrated outward and become dispersed among most of the townships. The policy of maintaining a single, taxpayer-financed hospital for the poor in the central city strikes me as blatant segregation of the "undesirables" from the rest of the population and at a much higher cost than if the cost of caring for this population was spread around to all hospitals, along with additional funding to match what private pay, insurance or government health care plans fails to cover.
It would be nice if we could have an honest public debate on this issue, but after the water company deal, LOS and the CIB bailout debate, I've just about given up hope on that prospect.