- "Opponents of the Wishard plan have been unable to refute the contention that a new hospital is needed."
- "Nor have [the opponents] cast serious doubt upon the financial position that Wishard has laid out."
- "What [opponents] have seized upon, as a last resort, are a technicality and an insinuation: Taxpayers would have to cover the Wishard bonds if worse came to worst, therefore, taxpayers are being led into a trap."
- "Wishard, though, has ample present and prospective money to pay off the bonds."
- "Will changes in health-care law affect those federal payments? Perhaps. Drastically? That is politically improbable."
Gee, where to begin? Ryerson, who has been real prickly on open and transparent processes in his editorial viewpoint on every other matter of public importance hasn't a care about the Wishard referendum process. Let's start with how HHC officials secretly developed plans to build a new hospital at least two years ago, never mentioning it in its recorded board meeting minutes. When the Star's own business reporter discovered in early June that the IU Board of Trustees had an item on its agenda to sign off on a proposed land swap of the Wishard property for land owned by IU west of the campus, HHC CEO Matt Gutwein denied any specific plans to build a new hospital. A little more than two weeks later, Gutwein and his lobbyists secretly inserted a special election referendum into the special session budget bill at the last minute that circumvented the new law requiring referendum for large construction projects. This special election forced a costly special election only five months after the public discovered there was even a plan under consideration for a new hospital. The HHC then drafted murky language for the referendum question that leaves voters begging exactly what are they voting to approve.
From the beginning of their presentation, which had obviously been carefully crafted and molded long before the special election got sprung on us in the state budget, HHC officials have sought to mislead the public on what the referendum will mean. It doesn't tell us HHC is building a new hospital, along with a parking garage, office complex and power plant. It doesn't tell us how much the construction costs will be. It doesn't tell us how much money will be borrowed. It doesn't tell you how the borrowed funds will be repaid. It doesn't tell you that you are voting to approve a new tax levy to back the general obligation bonds that are being issued to finance its construction. It doesn't tell you how much your property taxes would have to be raised to pay for the bonds. Essentially, all of the critical information voters need to make an informed decision is missing from the referendum question. And yet none of that bothers Ryerson in the least bit. So much for openness and transparency in government.
Contrary to Ryerson's assertion, the burden is not on the opponents to prove that a new hospital is not needed. The burden is on the HHC, and they've not been asked to do that in any critical way. More than $1.5 billion has been spent by nonprofit hospitals constructing new hospitals in the Indianapolis area over the last five or six years. Winona Hospital in the central city closed four years ago and remains a vacant eyesore now owned by the City of Indianapolis. St. Francis is closing its Beech Grove Hospital and moving to a new hospital further south. Major expansions and renovations have taken place at Methodist, IU, Riley and Veterans Hospitals all within a stone's throw of Wishard. Marion County is the only major county in Indiana with a county-owned hospital. Why is that? Why can't the funds directed at Wishard instead be redirected to existing hospital to serve the poor and uninsured? Why has Wishard spent tens of millions building new operating rooms, renovating rooms, installing new cafeterias, etc. during the past several years if they planned to tear it down? If the buildings are in such bad shape, why is the hospital fully accredited, and why is it rated so highly for its care as the HHC claims?
The opponents have raised very serious doubts about the financial viability of this plan contrary to Ryerson's assertion. It relies entirely on a source of revenues the HHC didn't even have until it entered the nursing home business statewide over the last several years. Its "ownership" of these nursing homes is merely a legal fiction to allow it to collect upper limit Medicaid payments from the federal government at a rate double what other nursing homes in Indiana are receiving. The HHC's own former CEO Mitch Roob called it a scam that would eventually get them in trouble with the feds. Indeed, the Bush administration tried unsuccessfully to end these payments a couple of years ago, but the Congress intervened to stop them from taking administrative action. The GAO has long complained that these payments are not in keeping with the cost sharing agreement between the federal government and state governments underpinning Medicaid.
As we speak, Congress is considering the most comprehensive overhaul of our health care delivery system in the history of our country. President Obama has stated that he will help pay for his national health insurance plan by cutting more than $600 billion out of Medicare and Medicaid. On the chopping block is Medicaid disproportionate share payments, of which Wishard receives more than $100 million a year. Obama plans to cut those payments by at least one-third, if not eliminate them altogether. If universal health care coverage becomes a reality, people will be able to go to any Medicaid-certified hospital; they won't need to go to hospitals like Wishard. Ryerson might brush off these changes that are on the horizon easily, but it's a real landscape changer. If the HHC officials had allowed the referendum election to take place at the next election, the May 2010 primary instead, we would probably have a clearer picture of what health care reform will mean to the industry and, in particular, its financial impact on Wishard.
Ryerson can call it far-fetched speculation to suggest that Marion Co. property taxpayers will wind up footing the bill for a new hospital, but the odds are actually very high that Wishard's financial picture will change drastically over the next several years. Indianapolis Taxpayers PAC's Carl Moldthan has already pointed out discrepancies in the dollar amounts Gutwein has been providing for the cost of the new hospital to the tune of tens of millions and we've not even broken ground on construction. Inevitably, these projects always wind up costing considerably more than officials originally claim they will cost. HHC officials say trust us because we studied this one better than what other projects like the Central Library and Lucas Oil Stadium were studied before being undertaken. Really? As of June of this year, Matt, you said there wasn't even any plan to build a new hospital.
For all his disinformation, at least Ryerson didn't repeat the false claim that HHC has reduced your property tax bills by tens of millions of dollars through efficiencies as one ill-informed, out-of-state, non-voting radio talk show host/blogger did today. I'm going to explain this to those of you with thick skulls one last time. The 2008 property tax reform and relief law required the rollback of certain levies in Marion County. Yes, that new law reduced your tax levy going to HHC by about $25 million; however, you were required to pay a 1% increase in the state sales tax. The state is using some of those revenues to replace the $25 million or so in lost revenues in the form of property tax replacement revenues. If you want to give credit to someone for reducing those property tax levies, give the credit where it is due: the lawmakers who voted to approve that law. While Mayor Peterson was busy raising your local income tax by 65%, or $90 million a year, two years ago, HHC was hoarding cash to build this new hospital. It now claims to have $150 million for that purpose. And contrary to the ill-informed views of that writer, it is a bit of a stretch to say lawmakers decided to put this question before voters and not the HHC when most of them didn't even know it had been inserted into the state budget until after they had voted on it, just as most of them didn't know they were voting on a property tax exemption for nursing homes. Make no mistake about it, we are voting on this referendum because Matt Gutwein and HHC's lobbyists got Sen. Luke Kenley and Rep. Bill Crawford to sneak it into the budget under radar without a single public hearing.
Speaking of dishonesty, Ryerson allows another big pro-Wishard column penned by Gutwein and Wishard's medical director, Dr. Lisa Harris. Essentially, they're telling us Wishard will be closed if the referendum is not approved on November 3. "On Tuesday, you will decide whether Wishard will continue to exist," they write. That assertion makes both of them big fat liars. When WRTV's Norm Cox pressed Gutwein on this claim, he conceded that the current hospital could operate as is for another ten years. TEN YEARS! That's a lifetime as these things go and assumes they won't spend the kind of money they've spent in recent years to modernize and update its facilities. You know how Gutwein has repeatedly stated during several dozen public appearances over the past several months while on the county payroll making $300,000 a year that state law prohibits him from urging you to vote yes on the referendum question so he won't do that? With a wink and a nod, of course. The two write at the end of their column: "Please vote yes to ensure Wishard remains a part of our community for another 150 years."
As another example of his blatant bias on this subject, Ryerson placed former State Rep. Jon Elrod's well-argued comments in opposition to the Wishard referendum as a run-of-the-mill "letter to the editor", along with letters from people in support of the referendum who don't even live in Marion County. Ryerson has only allowed one guest column during this debate in opposition to the referendum, last week's column by Carl Moldthan. He has run at least eight guest columns in support of the referendum over the past several months, in addition to his own over-editorializing in support of it and the blatantly misleading, pro-Wishard stories that have run on the paper's news pages.
Ryerson's newspaper is paying a big price for the lack of trust he has endeared to the Indianapolis public over the past year. When he's not been pushing a taxpayer bailout of the CIB, he's been pushing for another boondoggle of a public construction project over which he'll be the first to point fingers when things don't go as planned. I'm happy to report that people are following my advice and dropping their Star subscriptions to register their disapproval with the newspaper's content. A former columnist for the Star and fellow blogger Ruth Holladay reports on the Star's plummeting circulation numbers over the past year. Daily circulation dropped by 41,479 subscribers, or 17%. The Sunday edition, the most-read paper of the week, dropped 25,987, or about 8.1%. Gannett-owned newspaper overall fared a little better. Daily circulations are off 13.2%, while Sunday circulations are off 7.6% Holladay notes.