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Lawmakers weigh more oversight of UNC Health Care

Posted April 10, 2012

— State lawmakers on Tuesday considered a proposal that would give them more control over UNC Health Care and require the hospital system to provide more indigent care.

The Republican-led House Select Committee on State-Owned Assets was supposed to consider the sale of some of the state's more than 11,000 assets. Instead, the panel narrowly approved the nine-page draft bill that would radically alter the operations of the Chapel Hill-based hospital system.

The move allows the General Assembly to consider the move in the legislative session that starts in May, but Senate leaders have already said the bill would be dead on arrival.

Sen. Rules Chairman Tom Apodaca, R-Henderson, said he plans to bury the bill in the his committee if it makes it through the House.

"I just think it’s basically a solution looking for a problem," Apodaca said. "I haven’t seen any real problems in the university hospital system. I think they do an excellent job, I think they save the state a lot of money. I think this bill went way too far."  

The legislation would put the UNC Board of Governors in charge of UNC Health Care; require the hospital system to obtain legislative approval for most business transactions, including any expansion or purchases; require more public disclosure of the system's finances; require UNC hospitals and clinics to provide a proportional amount of care for low-income patients in counties where they're located; and change the system's mission from patient care and medical research to focus on training doctors.

Many members of the House committee said they didn't even know what the bill did before they voted on it. Rep. Julia Howard, R-Davie, said she doubted the committee had the power to rewrite the governance of the UNC system. She said she would prefer to delay the vote.

"I don't want to be (former U.S. House Speaker) Nancy Pelosi (and) vote on something and figure out what's in it after we do it," said Howard, senior chairwoman of the House Finance Committee.

But Rep. Marilyn Avila, R-Wake, said the state shouldn't be in the health care business.

"The state may find itself in a position we really don't want to be in – that's a market that we hold an unfair advantage in against some of the competition," Avila said.

Rex Healthcare logo Fight over Rex prompts proposal to tighten reins on UNC Health Care

Rep. Tim Moffett, R-Buncombe, handled the bill in committee, but later said he authored only the governance changes. The rest of the proposal, from limiting expansion to requiring more charity care, he said, “was a collection of recommendations that came from different members, and I’m not sure what members made what recommendations.”

UNC Health Care officials said they plan to fight the legislation, saying it would wind up costing taxpayers money.

"When doctors become doctors, they take an oath to first do no harm. This bill does harm," said Kevin FitzGerald, chief of staff for UNC Health Care.

“There’s a belief, I think – and an incorrect belief – that government should not be delivering healthcare," FitzGerald added. "The reality is that healthcare is very much dependent upon public support, taxpayer support."

FitzGerald said university hospitals are the people's hospitals across the state, and the proposed changes would mean less access for patients.

Senator Tom Apodaca conceded some tweaks to the UNC Hospital system might be in order, particularly making the board of governance more transparent. “But making them come to us to purchase another hospital or another practice? It’s just way too much.”

UNC Hospitals signed a management contract with Apodaca’s local hospital, Pardee Hospital in Hendersonville. “Every response I’ve gotten back from my local hospital has been outstanding,” he said. “It’s really helped serve my constituents."

Lawmakers have been examining UNC Health Care since last year, when WakeMed made a $750 million bid for crosstown rival Rex Healthcare, which UNC has operated since 2000.

WakeMed officials have charged that Rex's state ownership provides it with unfair advantages, including taxpayer subsidies and a higher reimbursement for Medicaid care than WakeMed receives. They also say Rex doesn't treat many uninsured patients, shifting most of the county load to WakeMed.

UNC Health Care officials dispute those charges, claiming that Rex has shifted about $2 million a year to the UNC hospital system over the last decade. Also, they said, UNC and Rex together provide $300 million in charity care a year, which is about double WakeMed's level.

A bill forcing UNC to sell Rex to WakeMed was also put before the committee Tuesday by Rep. Bill Brawley, R-Mecklenburg, but lawmakers declined to even discuss it, let alone vote on it.

36 Comments

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  • SENCLand Son Apr 11, 3:35 p.m.

    Bill Atkinson is presenting with a hidden agenda....that is becoming clearer with each step he has taken. Lawmakers need to think very carefully before they take away the choices that hard working citizens need, especially in this time of ridiculously high medical costs. We will only see lower standards of care and higher costs with such a monopoly. jewel08

    This is so right- Atkinson tried to play hardball negotiating a renewed contract with his cardiologists, and screwed up. He said this is what we're offering- take it or leave it, thinking he had them over a barrel. It was only after the cardiology group said fine- we'll leave it, that he realized his huge mistake. Which is why they hired lobbyists and tried the hostile takeover.

    What puzzles me is the lack of analysis by the media; even if the sale of Rex was forced, do they think it could just be awarded to their competitor without a bidding process? There are companies who'd love to get a foothold here...

  • almagayle50 Apr 10, 6:48 p.m.

    Diva RN, it wasn't "a" bad experience, it was many over several years. A nurse attempted to give my son three shots of heperin at once, because she had failed to give them on the two prior days and was catching up. This was in the epilepsy unit, which has a lower nurse to patient ratio than other areas. They also attempted to give someone else's medication to him, to give him the wrong dose of one of his medications, and sent him out of the hospital on an inappropriate medication for an autistic. He was strapped down in the emergency room on one occassion and left by the nurse against state law. When I asked that he be transferred to Duke, they refused. He was again sent out on a seizure medication with improper instructions. He received an MRI there and while I checked and double checked prior to going in that a Tesla 3 would be done and was assured it would, they did a Tesla 2, which had no value at all toward his diagnosis. They then said they would repeat it free of charge,

  • Diva RN Apr 10, 6:30 p.m.

    "The nursing staff is poor"
    -almagayle50

    Every single one of us? Worse than any other hospital? I'm sorry that you had a bad experience but I take offense at you lumping all nurses that work at one hospital into the category of "poor." Nurses do a lot more in a 12-hour shift than passing bed pans and pills.

  • almagayle50 Apr 10, 6:23 p.m.

    How dare the chief of staff fall back on the do no harm oath. UNC Hospitals do little but harm. It's error after error after error. The nursing staff is poor. The inpatient meals are spare and not perticularly healthy. Most of the doctors aren't willing to put in the time to train residents. And there's always the implication that they have to provide so much indigent care that we can't possibly expect good care there. Unbelievable.

  • priorities Apr 10, 6:19 p.m.

    Also, FYI this has nothing to do with Wake Med.....get over it. But again, I am in a position to know and I can assure you with out a shadow of a doubt that UNC by in large is a DANGEROUS place to receive healthcare......if the public at large had any idea what they have been cited for.....scary!

  • priorities Apr 10, 6:16 p.m.

    Also to you fools who think UNC provides care to the poor and needy get a life and get some facts!!! The largest provider of medicaid care and indigent care in the state of NC is Duke University Health System. Absolute, undeniable fact, look it up!

  • priorities Apr 10, 6:14 p.m.

    UNC health care is already ripping the state off! Care is very poor, the doctors are arrogant and if you don't have private insurance you will receive a very different level of care. It is the only hospital that gets the exact amount billed to medicaid paid by medicaid and they are charging through the nose!!! They get a higher reimbursement from medicaid (what they ask for) than from any private payer. The state of NC's medicaid program is also reimbursing for care at Rex at an education level simply b/c UNC owns it but you will not be seen by a resident or intern ever. (which is the medicare & medicaid rationale for paying higher rates to educational hospitals) Medicare doesn't pay an education rate to Rex b/c it isn't an educational hospital. UNC healthcare has been taking the citizens of NC for a ride for a long time, if this can stop it, more power to them!!! Yes, I am in a position to know this is all fact.

  • jewel08 Apr 10, 4:44 p.m.

    Bill Atkinson is presenting with a hidden agenda....that is becoming clearer with each step he has taken. Lawmakers need to think very carefully before they take away the choices that hard working citizens need, especially in this time of ridiculously high medical costs. We will only see lower standards of care and higher costs with such a monopoly.

  • jewel08 Apr 10, 4:39 p.m.

    This continues to be a political move on the part of WakeMed..... They are not concerned with providing the care needed by all residents of Wake and surrounding counties....it is always about the $$$$ to them. It would hurt all residents to have Wake (or any other hospital) hold a monopoly . Please be done with the politics and turn towards improving care there so people want to go...indigent or NOT....

  • CastIronEgret Apr 10, 4:27 p.m.

    I am very happy with UNC Healthcare, and don't understand why there are complainers here. Both of my children have received excellent, prompt, thorough medical care in emergency situations. I am also glad that they are taking in the poor and needy. It's comforting to know that disadvanaged and mentally disturbed people are treated with such excellent dignity and care. Who knows that any of us might not end up on the streets one day?

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