KTOO’s Clarise Larson recently wrote about the current financial difficulties facing Juneau’s socialist, publicly-owned and operated hospital that is forcing the hospital administration to go begging to the City for more money. We dig deeper to get to the bottom of this important local issue.
There is no question that Bartlett Regional Hospital, the socialist hospital owned and operated by the City and Borough of Juneau, is facing a financial crisis. According to the KTOO article, hospital leaders have made clear the need to raise money quickly in order to maintain the current level of services that the hospital provides. Addressing these issues promises to be contentious and complicated.
“Unlike Juneau’s socialist, government-operated hospital, the vast majority of public hospitals are privately run non-profit hospitals,” said Dr. William Best, Director of the American Association of Hospital Administrators. “They are controlled by boards that look to metrics like financial feasibility, medical necessity and practicality when allocating resources to provide services in their communities. As far as day-to-day management goes, these hospitals are administered jointly by professional administrators on one hand, who understand the finances, regulations and markets, and medical professionals on the other hand, who understand treatment requirements.” He went on to say that this type of management leads to natural efficiencies, “what we see is that supply and demand kind of makes things work… services tend to go to where there is the greatest need, because patients are willing to spend more money on the services they need.”
However, this type of “economic efficiency” is a very close cousin to a profit-driven mentality, which clearly has no place in health care. “The biggest pitfall of a privately run hospital is that it removes politics and bureaucracy from the equation,” said Edward Beasley, Assistant Chief Deputy Manager in the Office of Hospital Finance of the Juneau Assembly’s Health Care Subcommittee. “It tends to provide services to where they are needed, instead of directing them to where the politicians and the bureaucrats want them to go.”
Things have changed over the years. “Just a few years ago, we were on Easy Street here in the office,” Beasley said. “The hospital mostly brought in enough money to pay for itself, so we spent most of our time playing Tetris,” he recounted. Nowadays, with the hospital bleeding money, things have really changed. Beasley remarked that the issue was causing a great deal of stress in his office, not just to him, but also to the office’s other 43 staffers. “We’re all laser-focused on finding somebody, somewhere to fix this problem,” Beasley promised. “I have meetings planned with several contractors.” He showed us his calendar, pointing out that nearly two of the four days of his work week were loaded with Zoom meetings.
The publicity and the taxpayers add more pressure to Beasley’s office. “The calls have been pouring in since the news got out about the hospital’s money problems. We tried using the voice menus on the phone system to dump calls to voicemail,” Beasely said “but before long they figured out they could just press “0” and still get to us. When that happened, we turned the phones off for most of the day, but then we actually had people coming in the building and wanting to speak with us directly. They didn’t realize that as bureaucrats, we’re not accountable to anybody besides other bureaucrats, so when we had the security guards throw them out of the building, some of them got irate.”
Unfortunately, good governance sometimes also requires Beasley’s office to butt heads with the hospital administration. “One of the best things about socialism is that it removes competition and replaces it with cooperation,” Beasley started, “But Pigs are more equal than Horses, after all. We can’t always get the hospital administration to fully embrace the socialist principles that demand that we call the shots. That’s when we run into problems,” he warned. “The hospital people think they can just come begging to the City for money,” he continued, “but, they don’t realize that the City has to go begging to the State and to the Feds for its money. That is basically shifting the panhandling burden to us, and it just isn’t fair. We don’t have the resources in our office to deal with that extra work.”
Beasley is largely correct. According to Juneau’s 2024 Adopted Budget, Juneau relies on nearly $100 million in handouts from federal and state governments annually. “Just look around,” Beasley remarked, “you don’t see any factories around here, do you?” He continued to explain that Juneau, as a capital city, has grown in a culture of government largesse that has resulted in much more affluent city that manages to produce very little. “Our median household income is north of $95,000, for Pete’s sake! That’s more than 20 grand more than the national average. We didn’t get there by working for it, obviously!” Beasley said. “That kind of money spoils our citizens. When the hospital comes begging to the City for money, it means that I have to make calls to the lobbyists and legislators. Just yesterday I spent almost 20 minutes on hold and I was almost late for lunch. We really need more people in our office in order to handle this kind of crisis.”
Most of the hospital staffers and professionals we talked with are on board with panhandling in lieu of streamlining services. “The City will cave in and then we’ll all get a raise,” said Jenny Toms, a surgical nurse with 15 years of experience at the hospital. “What are they gonna do? Reduce services? That’ll be the day.” The majority of her colleagues echoed her sentiment.
There are a few contrarian voices at the hospital – mostly senior health care professionals in varying stages of dementia. We spoke with Dr. Fred Brown, an OB/GYN who graduated at the top of his class at Harvard Medical School in 1970 and who has practiced in Juneau for nearly 50 years. “This is what you get when you let a bunch of damned commies run a hospital!,” Dr. Brown ranted, trying hard to conceal his diminished mental capacity. “We need to run this place like a damned hospital, not like a damned charity day care center!” he bellowed angrily.
Gwendolyn Deevers, Public Relations Director for the People’s Committee for Global Socialized Medicine told us that she encounters hateful rhetoric like Dr. Brown’s on a daily basis. “There is this dated and scary idea out there that freedom is actually better than socialism,” she said. “The elderly become misguided because they look at socialized medical programs around the world and they focus only objective things like delays in service, quality of service, survival rates and such. They just aren’t looking at the emotional aspects of inequity or the lack of social justice that can be seen in parking lots and emergency rooms of every hospital in America,” she said. The key to a successful socialized medicine system, according to Deevers, is to identify and access a limitless source of other people’s money to finance it. “Juneau has found that key,” she concluded.
It will take months for Juneau’s politicians and the bureaucrats to settle on a silly and politically expedient compromise method of running the hospital. While this compromise will no doubt fall apart in short order, in the interim it will allow the hospital to continue to inefficiently provide millions of dollars worth of services that it can’t afford, at least until the taxpayers raise hell about it again next year. And that’s what really matters.