Obama for America

University of Chicago Medical Center Provides Extensive Charity Care, More Than Its Peer Institutions, And Has Spent Millions Finding Primary Care For Patients Who Don’t Have Providers

In her nearly 10 year career at U of C, Michelle Obama instituted community service programs, helped to restore community relations with the University, and established a network of health care clinics to provide patients with primary care.

Sun-Times, Wall Street Journal Editorial Pages Say Attacks On Michelle Obama Are Without Merit

Chicago Sun Times Editorial Defended University Of Chicago Policy, Describing It As “Good Public Policy.” On August 27, 2008, the Chicago Sun Times defended the University of Chicago Medical Center’s policy, describing it as “good public policy.” The Sun-Times editorial stated “Mrs. Obama and the South Side teaching hospital are being accused -- sincerely by some, for cynical political gain by others -- of essentially turning their back on the urban poor. On the contrary, we believe the university hospital's efforts to essential outsource non-urgent medical problems to neighborhood clinics is good health care policy, with the potential to become a model for the nation. If done right, it could help contain the escalating costs of medicine that burden all Americans while providing quality primary medical care for the poor and uninsured.” [Chicago Sun Times, 8/27/08]

American Enterprise Institute Medical Fellow Wrote a Wall Street Journal Op-Ed Saying “Michelle Obama Is Right About Avoiding The ER.” An op-ed from Dr. Scott Gottlieb, a fellow at the American Enterprise Institute argued, “When Michelle Obama was an executive at the University of Chicago Medical Center, she worked to expand a program that encouraged uninsured patients on Chicago's South Side to visit local health clinics in lieu of her hospital's emergency room. That "Urban Health Initiative" saved her hospital money, and it also surely improved the health of the people it served.” [Wall Street Journal, 9/2/08]

The Real Story From Those Who Worked With the University Of Chicago Medical Center

Statement from Senator Dick Durbin: "The fact that Sen. Grassley is questioning the work of the University of Chicago Medical Center -- especially those programs aimed at reducing emergency department overcrowding and promoting preventive health -- is troubling and shows that he simply doesn't understand the problems facing our hospitals today. Far too many of the 1.1 million people who live on Chicago's South Side depend on the emergency room for their primary medical care, rather than getting the health care they truly need. Residents of the South Side have rates of diabetes, asthma, hypertension and other debilitating chronic conditions that are as much as five times higher than the rest of Illinois. UCMC is providing more than $64 million a year in charity and unreimbursed care and has received high marks from everyone from community groups to the Illinois Attorney General for their efforts. I am prou d to have helped secure federal funds in support of that work."

Statement from Attorney General Lisa Madigan: "Compared to other hospitals in Illinois, University of Chicago Medical Center clearly provides care to a great number of low income patients. And you can see that in the large number of Medicaid patients the hospital serves." [Statement From Attorney General Lisa Madigan, 8/22/08]

ACCESS Community Health Network Statement on UCMC: “The University of Chicago Medical Center and Access Community Health Network share a common objective: primary care services for south side residents. The Medical Center has involved Access Community Health Network in efforts to expand access to primary health care. We are pleased with our strategic partnership with Medical Center.” [Statement From ACCESS Community Health Network Media Coordinator Elaine Hegwood, 8/22/08]

Health Care Consultant: UCMC’s Institutional Interests “End Up Being The Right Thing For The Community.” Pat Terrell, a consultant at Health Management Associates, said, “This is driven by their own institutional interests, but those interests end up being the right thing for the community.” [Crain’s, 3/31/08]

Holy Cross Hospital CEO: It’s Best For The Local Hospital And “It’s Best For The Patient” For Each Hospital To Treat Those Patients That It Is Best Suited To Handling. Crain’s reported, “‘There’s no question that it’s better for both of us if we handle more of these routine cases,’ says Holy Cross Hospital CEO Wayne Lerner, who is in talks to accept some U of C pediatric cases and expectant mothers. ‘And it’s best for the patient.’” [Crain’s, 3/31/08]

In One Year, UCMC Went From Turning Away Half Of Critical Care Patients To Taking Ninety Percent. Crain’s reported, “A year ago, [U of C] was turning down half the requests from other hospitals to transfer critically ill patients for complex treatment because it didn’t have space. Today, with partners taking care of routine cases, U of C can take 90% of the more-complicated transfers.” [Crain’s, 3/31/08]

Rhetoric and Reality

RHETORIC: Dan Shomon is a University Lobbyist.

REALITY: Shomon Was Registered To Lobby For The University At The State Level; The University Of Chicago And The University Of Chicago Medical Center Use Separate Governmental Relations Teams

2005 – Current: Dan Shomon Was A Registered Lobbyist In Illinois For The University Of Chicago. According to Illinois lobbying disclosures, Dan Shomon was a registered lobbyist in Illinois for the University of Chicago from November 2, 2005 to current. State lobbyist cannot lobby the Senate without registering as a federal lobbyist. [Illinois Lobbying Disclosures]

RHETORIC:Michelle Obama Recommended That The Hospital Hire David Axelrod's Firm

REALITY: Neither Michelle Obama nor Valerie Jarrett Reached Out To Ask Or Encourage Axelrod’s Firm To Apply For A Contract. As A Prominent Chicago Consultant With Decades Of Experience In Town, David Axelrod And His Firm Have Relationships At Institutions Around The Chicago Area That Are Completely Independent Of The Obamas. Susan Sher, Chief Counsel And Government Relations Director For UCMC, Knew David Axelrod From Her Work As Corporation Counsel For Mayor Daley While David Served As His Consultant, And She Encouraged Ask To Apply For A Contract. The Hiring Decision Was Made By UCMC CEO Jim Madara.

RHETORIC: The Hospital Spent Less Than The Average For Nonprofit Hospitals In Cook County

REALITY: THE UNIVERSITY OF CHICAGO MEDICAL CENTER PROVIDES MORE UNCOMPENSATED CARE THAN PEER INSTITUTIONS.

The University Of Chicago Medical Center Provides More Uncompensated Care Than Peer Academic Medical Centers (AMA). In 2004, the average academic medical center provided a mix of 50 percent private insurance and 50 percent government insurance, which included Medicare and Medicaid. At the University of Chicago Medical Center, the patient mix is 35 percent private and 65 percent government pay, of which 37 percent is from Medicaid, compared to the AMC average of roughly 20 percent. According to John Easton, the Director of Communications at the University of Chicago Medical Center: “The University of Chicago Medical Center is one of the largest providers of unreimbursed care in Illinois. The Medical Center provides more days of inpatient care for those covered by Medicaid than any other private hospital in Illinois. In fiscal 2006, for example, UCMC provided more than 70,000 days of inpatient care to those covered only by Medicaid, which reimburses hospitals only a fraction of the costs of care.” [The University of Chicago Medical Center Director of Communications John Easton, 7/28/08]

The University Of Chicago Hospitals Was Second In The State In Total Medicaid Patient Days In 2006. In 2006, the University Of Chicago Hospitals was second in the state of Illinois in the number of Medicaid patient days, a total of 71,633. [Illinois Department of Healthcare and Family Services, for the state fiscal year ending June 30, 2006.]

The University Of Chicago Hospitals Admitted 11,818 Medicaid Patients, Third In The State Of Illinois In 2006. In 2006, the University Of Chicago Hospitals admitted 11,818 Medicaid patients, the third largest provider of care in the state of Illinois. [Illinois Department of Healthcare and Family Services, for the state fiscal year ending June 30, 2006.]

Urban Health Initiative

THE URBAN HEALTH INITIATIVE IS PREMISED ON PROVIDING THE BEST HEALTHCARE TO THE SOUTH SIDE BY RECOGNIZING SERVICES AND OPTIMIZING EXPERTISE, INCLUDING PROVIDING UCMC RESOURCES TO COMMUNITY ORGANIZATIONS

Crain’s: UCMC Was The “White Knight For Small Health Centers And Cash-Strapped Hospitals On The South Side.” Crain’s reported, “U of C is assuming the unlikely role of white knight for small health centers and cash-strapped hospitals on the South Side.” [Crain’s, 3/31/08]

The Urban Health Initiative Is The Product Of A Realignment Of Thinking That Places UCMC Into A Community Context. “The new attitude embedded within the UHI represents the contemporary place of an academic medical center in an urban setting. We now look beyond our own four walls and view ourselves as just one piece of a larger healthcare network. Given finite societal resources, we must steward them so that each provider plays the right role at the right time.” [Urban Health Initiative Memo]

UCMC Was “Forging Alliances” With Other Health Care Providers To Help “Solve A Growing Health Care Crisis On The South Side.” Crain’s reported, “Seeking to free up beds to take more complicated cases like organ transplants or brain surgeries, the medical center’s CEO, James Madara, is forging alliances to treat the rising number of poor patients needing routine care. While the effort is aimed at stemming the tide of these patients coming through its own doors, U of C is also helping to solve a growing health care crisis on the South Side.” [Crain’s, 3/31/08]

100 UCMC Physicians Have Moved Into Clinics And Local Hospitals; UCMC Has Invested $2 Million In Clinics. Crain’s reported, “Almost 100 U of C physicians have been scattered across neighborhood clinics and a few hospitals on the South Side in the last year. The medical center also has spent more than $2 million in the last six months to expand walk-in clinics like Dr. Walker’s and relocate some of its own doctors and patients to other facilities, including moving its 10-bed psychiatric unit to nearby Mercy Hospital.” [Crain’s, 3/31/08]

UCMC Gave Access Community Health A $350,000 Grant To Expand A Nearby Clinic Where UCMC Specialists Will Begin To Treat Patients. “A $350,000 grant was provided from UCMC to Access Community Health (our largest clinic partner) to build out and expand its Grand Boulevard location near campus; several UCMC faculty specialists will begin caring for community patients at Grand Boulevard in the first quarter of CY ‘08.” [Urban Health Initiative Memo]

THE URBAN ACADEMIC MEDICAL CENTER’S MISSION IS COMPROMISED WHEN ITS BEDS ARE FILLED BY PRIMARY CARE PATIENTS ADMITTED THROUGH THE ER

JAMA Paper: Using The Emergency Room For Primary Care Is Inefficient And Displaces Patients In Need Of More Complex Care. Laurence D. Hill and James L. Madara wrote, “Urban academic medical centers frequently become default providers of routine primary care through emergency departments overcrowded with patients who often could be treated more effectively in neighborhood health care settings, absorb specialized patient care resources, and may displace access for patients more in need of complex care.” [JAMA, November 2, 2005—Vol 294, No. 17]

JAMA Paper: When Urban Academic Medical Centers Compete With Federally Qualified Health Centers, The Community Loses. Laurence D. Hill and James L. Madara wrote, “This is a particularly acute problem for organizations such as Federally Qualified Health Centers, which are provided a competitive advantage through governmental financial incentives to provide primary care to inner-city patients. When urban academic medical centers directly compete with Federally Qualified Health Centers, either through lack of appreciation of their existence or through advertising that inadvertently stimulates patients to bypass local health care centers, academic centers can drive these clinical care centers out of business. This in turn detracts from the neighborhood economy and places additional financial stresses on the academic medical center due to its intrinsically high cost structure.” [JAMA, November 2, 2005—Vol 294, No. 17]

South Side Health Collaborative

Initiated The South Side Health Collaborative, A Network Of 19 Community-Based Primary Care And Social Services Providers To Care For The Uninsured On The South Side.. Michelle Obama initiated the South Side Health Collaborative (SSHC), a network of 19 primary care and social services agencies that provide care for patients who have visited the University of Chicago Medical Center with medical ailments better treated at community health centers, regardless of the patient’s ability to pay. More than 4,000 patients have been linked with SSHC sites to better address their primary care needs. The SSHC has also successfully moved patients to community primary health sites, which, due to the prominence of the University of Chicago Medical Center, were operating under capacity and losing essential government funding. [The University of Chicago Medical Center Medical Center by Michelle Obama “Letter To The Community]

University Of Chicago Received A Two-Year Healthy Communities Access Program Federal Grant. In 2005, the University of Chicago received a two-year Healthy Communities Access Program (HCAP) federal grant, one of 230 received nationwide, totaling $430 million. The Medical Center used the grant to implement the South Side Health Collaborative in February 2005. [University of Chicago Medicine On The Midway Journal, Spring 2007]

South Side Health Collaborative Has Provided A Medical Home To More Than 15,000 Previously “Medically Homeless” Patients. According to the University of Chicago Medical Center, “Since 2005, more than 15,000 patients who came to the UCMC emergency department and self-identify as not having a regular doctor-the ‘medically homeless’-have found medical homes and received the primary and preventive care from SSHC facilities.” [John Easton, Director of Communications, The University of Chicago Medical Center, 7/25/08]

In First Year Found “Medical Homes” For More Than 1,200 Patients. According to the University of Chicago Medical Center 2006 Annual Report, “the South Side Health Collaborative, which, after a year of establishing relationships between the Medical Center and various neighborhood health centers, has found primary care “medical homes” at nearby clinics for more than 1,200 patients, substituting routine preventive measures for emergency care.” Michelle Obama stated of the program “We’ve been able to survive like an island, but now the world is seeping in, and our salvation will be the success of our partners. Now we’re working together to get people to the right place,” Obama says, “to make sure everyone stays generally healthy with routine care.” [The University of Chicago Medical Center: 2006 Annual Report]