By Maria Saporta
Friday, March 12, 2010
Dr. Arthur Kellermann, one of Atlanta’s top public health professionals, has accepted a key policy position with the RAND Corp. in Arlington, Va. But Kellermann is not leaving Atlanta without some thoughts of the health and fiscal issues facing Georgia and Grady Hospital.
Kellermann, founding chairman of the Department of Emergency Medicine at Emory University, had most recently been working on the community-wide efforts to turn around the financially struggling Grady Hospital.
In the last few years, Kellermann self-proclaimed title was “associate dean to keep Grady from closing.”
Kellermann said he played a supporting role in helping save Grady Hospital, and that the lead actors were the Atlanta business community, philanthropic organizations and the Robert W. Woodruff Foundation.
Despite the progress, Kellermann said Grady’s financial standing is still fragile.
“Grady is out of hospice and back in the intensive care unit,” Kellermann said. “Grady is still struggling. There’s a massive burden of uncompensated care. The public funders are still looking for every opportunity and pretext to reduce support.”
Later Kellermann said: “There are many state leaders around today who don’t realize the incredible resource that Grady represents for all of Georgia.”
Kellermann said the metro area dodged a bullet when it was able to keep Grady from closing its doors and be able to continue serving the poor and the uninsured.
“You could not have imagined the havoc that would have happened in Atlanta and Georgia had Grady become insolvent,” he said.
After years of being immersed in Georgia’s public health-care issues, Kellermann decided to join the RAND Corp. as the senior principal researcher holding the Paul O’Neill-Alcoa Chair in Policy Analysis — drawn to its nonpartisan approach toward issues.
“They’re an island in a town that’s increasingly partisan and increasingly polarized,” Kellermann said in a telephone interview from the Washington, D.C., suburb of Arlington. “That’s why I’m so excited about coming here weighing into the thicket of policy and public integrity.”
But Kellermann said “it really was not an easy decision” to leave Atlanta.
“I love Atlanta. I love Georgia. I love Emory,” he said. “I was sad about leaving Atlanta and Grady. But it really was a call to national service.”
Because he will be focused on public health and policy issues, Kellermann said he expects to come to Atlanta fairly often.
In his new role, Kellermann hopes to be able to influence national health-care policy. Specifically, he would like to see a shift in the industry to reward doctors who are able to keep their patients healthy.
“We have the finest rescue system in the world,” Kellermann said. “But we don’t do a good job keeping people from getting critically ill and from needing rescue.”
One project he would “love to see RAND tackle” is establishing a baseline of health care — defining a minimum essential health benefit.
For example, that would mean people would be guaranteed to be vaccinated against measles. In contrast, people would have to pay a premium for higher level medical services, such as cosmetic surgeries.
Kellermann said the concept of providing a “baseline of care” is in the proposed national health-care bills, but “nobody is thinking what that baseline would be.”
As he sees it, the nation has two choices — the status quo or the current health reform legislation now in Congress.
“Am I thrilled with health-care reform? No? Do I think it’s better than the status quo? Yes,” Kellermann said. “We are losing ground every day. Our health-care system is bleeding this country to death.”
In talking about Georgia, Kellermann said the biggest medical issue is what will happen to Medicaid during the state’s current budget crisis.
Kellermann believes Georgia actually has an obvious choice. Instead of passing a hospital bed tax or gutting Medicaid, Kellermann favors increasing the cost of a pack of cigarettes by $1. That would not only provide funding to help Georgia pay its medical bills, it also would discourage people from smoking and getting lung cancer and other smoking-related diseases.
“I’m dumbfounded that some of the state’s leaders are opposed to it,” Kellermann said.