War and Wishard 

You turn on the radio

You turn on the radio or your TV and there’s bound to be news of mayhem in Iraq. A bomb’s gone off, somebody’s been killed. It’s easy to get swept up in the stream of these sounds and images. Easy to forget about how this war was started. Easy to forget about all the ways it costs us. Indianapolis’ oldest hospital, Wishard, is also our city’s most vulnerable. That’s because Wishard has been the one hospital in this city that has always defined its role in terms not determined by the marketplace. Wishard’s vision statement says, “Wishard Health Services will be the provider of choice for all people of Marion County while strengthening our commitment to the needs of the underserved.” Wishard’s stated mission is to Advocate, Care, Teach and Serve “with special emphasis on the vulnerable populations of Marion County.” You may have noticed that Wishard describes itself in terms of vision and mission. This is different from presenting a business plan. That’s because no one, apart from those who traffic in the underground economy and loan sharking, would consider developing a business around many of the people Wishard is dedicated to serving. Businesses are usually invented to cater to people with the money to pay for goods or services. Wishard provides health care for people who probably can’t afford it. And there are more people who can be counted in that number every day. There are a lot of people in this community who don’t necessarily make the grade as top shelf health care consumers. They don’t have a lot of money. Or they’ve lost their health insurance. Chances are I’m talking about you. So it’s unsettling to learn that Wishard Hospital is in financial trouble. The fact that Wishard has not been run like a business — that it serves people regardless of their ability to pay — is being held against it. Health care, after all, is expensive. In a market-driven society, you’re only entitled to what you can afford to pay for. By effectively giving health care away, Wishard is finding it hard to, as people say, stay in business. This, traditionally, is where government gets into the act. Last June, Sen. Evan Bayh crafted legislation aimed at providing Wishard with a $50 million funding infusion from the federal government. The government, in this case, would provide the money that the marketplace will not. As of this writing, the people who run Wishard are waiting to find out whether or not this aid will actually be forthcoming. It’s a tense situation. This is because we currently have a federal administration that has made a priority of cutting back on federal spending for domestic programs. These folks tout the virtues of the marketplace. They believe that market forces generally do things better than government does. They’re not likely to just come out and say that places like Wishard — and the people it serves — are a waste of money. That would sound harsh. No, they’re more likely to say something like this: There’s a war on. War comes in handy for these folks because if they can get you focused on its hardship and drama they think you will stop worrying about affording your next medical procedure and start worrying instead about how we’re doing in Iraq. President Bush has asked Congress for $87 billion to spend in Iraq in the next 12 months. This is the same president whose administration (including people like his former Director of Management and Budget and Indiana gubernatorial hopeful Mitch Daniels, by the way) have been finding ways to cut money for education, job training, early childhood health and welfare and even veterans’ benefits. But while he’s looking for ways to cut funding for domestic programs, the president seems anxious to create a kind of New Deal for the Iraqis. The president has requested funds for books and supplies for 12,500 Iraqi schools; he wants to rebuild or renovate 25,000 schools there and enroll 4 million Iraqi kids. But in the States, the House Republican budget recommends dropping 28,000 kids from Head Start next year; no funds are allocated for school modernization and teacher-quality programs are cut 10 percent. The president proposes repairing nearly 3,000 miles of major roads in Iraq, but U.S. highway funding is slated for $6 billion in cuts over the next 10 years. Twenty thousand houses are to be rehabilitated in Iraq, but only 5,000 new housing units are budgeted for this country. The Bush Administration has fought against a $200 million budget boost for police officers here, but wants to provide $290 million to Iraqi first responders. Finally, President Bush wants to provide 13 million Iraqis with access to basic health care services, including maternity care for 100 percent of those who need it. Meanwhile, here in Indiana, we wonder whether or not the government can provide $50 million for Wishard, the fifth largest provider of outpatient, indigent care in the country. There isn’t room here to go into a recitation of all the broken-down reasons we were told why war with Iraq was necessary last winter. But even then it was clear that the president was making a choice based not on necessity, but his own desire. Rarely does a politician make his priorities this clear. If you ever wondered where you stood in George Bush’s scheme of things — now you know. This, I guess, is a kind of good news. Unless, that is, you think that Wishard Hospital is important.

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David Hoppe

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