Charity’s
Slow Decline: 1960 to 2005
The 1960’s
brought many changes to Tulane and Charity. In 1964 the Civil
Rights Act was passed, and by 1965 Charity and Tulane School
of Medicine were fully integrated, often with some resistance.
Medicare and Medicaid were created in 1965, and many poor
patients were now afforded federal insurance that allowed
them to choose private hospitals over Charity. Charity’s
patient base slowly began to decline, as did its finances.
Tulane also faced
similar financial troubles in the 1960’s. In order to
generate a greater base of teaching hospital beds and gain
income, Tulane’s administration considered three options:
merging with Ochsner Hospital, building a new academic hospital
in downtown New Orleans, or moving the entire medical school
to a new campus on the West Bank. The Tulane-Ochsner merger
never came to fruition and came to be seen mainly as an effort
by Ochsner to stave off competition from a new Tulane hospital.
The conservative board of the University also decided against
moving the school and building a new medical complex on the
West Bank, claiming it would further damage the teaching and
staffing mission at Charity and that Tulane did not have sufficient
funds.
The move to the
West Bank was largely the brainchild of then dean of the medical
school, Charles Sprague. Around the time the University board
declined to allow the move to the West Bank, Sprague was offered
the position of dean and later chancellor of the University
of Texas Southwestern Medical School in Dallas. He resigned
in June 1967, and found the ability to expand he was seeking
in Texas, playing a large role in building the Texas Medical
Center.
The 1970’s
brought more change and politics to Tulane-Charity relations.
In spite of the new Tulane Hospital, the School of Medicine
was still in dire financial condition, due to decreasing federal
grants, a lack of any substantial private endowment, and Charity’s
own financial shortcomings. Physicians who had traditionally
been staunch devotees of Charity Hospital and yet able to
straddle the divide between the hospital and the medical school
became a dying breed. For example the eminent internist George
Burch, at 65, wanted to continue his chairmanship of the Department
of Medicine. Dean John Walsh, however, told him he would have
to retire, as was school policy at the time. Burch then proposed
staying on at Charity by establishing a Burch Heart Institute.
Tulane officials feared Burch’s name would attract the
best students to Charity rather than Tulane for fellowships,
and openly fought against the Institute. Burch resigned from
Tulane acrimoniously and the institute was abolished in 1974.
In the 1970’s
Tulane’s involvement with Charity took two interesting
and opposing turns. In 1975 Tulane opened its own private
hospital as a source of income, mainly through the efforts
of John Walsh, and in the process making potential trade-offs
with its educational and research mission at the time. In
order to generate revenue, both Tulane and LSU accelerated
the practice of “skimming” patients from Charity
that needed sophisticated, expensive procedures to their private
hospitals, while “dumping” patients whose private
insurance had stopped paying for a hospitalization to Charity.
In contrast to
competing against Charity for paying patients, in 1974 Tulane
agreed, with LSU, to take administrative control of Charity
from the state. This meant Charity was less attractive for
political patronage jobs, and state funding to Charity declined
further. As an example of Charity’s diminishing research
prowess, Andrew Schally, a Tulane endocrinologist, won the
Nobel Prize in 1977 for the discovery of hypothalamic releasing
hormones while conducting all his research at Tulane and the
Veterans Administration hospital.
The 1980’s
and 1990’s continued Charity’s decline. The physical
plant continued to deteriorate. State funding shortages coupled
with a slow economy meant Charity was chronically underfunded.
The once grand hospital lost its accreditation due to poor
conditions multiples times in the 1980’s. Partly in
response to this, in 1999 the 1974 sharing agreement between
Tulane and LSU for administrative control was revoked and
LSU was given full control over the state’s charity
system. During this time, Charity continued to function mainly
as a result of Medicaid Disproportionate Share funds, which
are federal funds paid to hospitals that see a large uninsured
population.
2005 marked Charity
Hospital’s death knell. On August 29th, 2005, Hurricane
Katrina inundated the city, including Charity Hospital. Patients
had to be evacuated by boat, described in sensational detail
elsewhere. Charity has been declared unfit to provide health
care and remains shuttered as of this writing. The debate
over the future of Charity still rages.
prev | 1
| 2 | 3
| 4 | 5
| 6 | 7
| 8 | 9
| next |