Hamilton County Commissioners are bristling over the initial selection of Erlanger’s reformatted Hospital board members by the state legislature. Question: Why is the legislature involved in a local matter? Answer: Hamilton County does not have a County Charter. They don’t want a charter, because if they had a charter they would have additional governing responsibilities. Without the charter, commissioners do not have the privilege of making all legislative decisions. When a county lacks a charter, the privileges and responsibilities for important decisions, not specifically addressed by existing state law, fall to the state legislature.

Now that the legislature has performed its legal duties, the Hamilton County Commission is whining about being left out of the process. While knowledge of the state legislative process has been front page news for months, the commissioners are offended not to be stroked and granted full board appointment privileges. The legislature’s stated goal was to craft a process to remove future political influence from hospital appointments. Yet, the County Commission is angry that the legislature did not continue political perks for them.

Some commissioners justified their rights to naming board members because Hamilton County taxpayers allocate a million annually to offset the cost of indigent care in Hamilton County. They also whine because the proposed legislation includes a provision that ties the county’s annual funding to inflation. Erlanger is a multi-million dollar facility that requires multi-millions to provide indigent care. The commissioners think that because county taxpayers annually pay $1 million toward its upkeep, they should have the right to pick board members. From what planet do these screaming babies hail from? If commissioners want to rule like big boys, they need to pull up their big boy pants and take more responsibility. Get a charter or remain quiet. Don’t demand full parental rights while shirking almost total financial responsibility for your child.

According an article in Chattanoogan.com, Joe Graham, the Commission’s wonder boy of wit, publicly admitted the county’s desire to control the hospital board “Is political.” His recent comment though disgusting, was an honest, assessment of what’s wrong with the County Commission’s thinking. Though the public does not appreciate political shenanigans, it is refreshing to hear a County Commissioner freely admit what motivations drive their actions.

It is tragic to see the welfare of a hospital dangling in the political wind of a group so devoid of expertise in health care. Sadly, their collective lack of knowledge of healthcare has been seen before. Some Commission members once discussed refusing construction of full federal funding to replace a current aging and obsolete clinic structure used by the Health Department Clinic that services homeless men, women and children. It was an attempt to punish the Chattanooga City Council, but would have actually punished Hamilton County’s homeless residents.  The County Commission also considered cutting funding for the Health Department women’s health program. Commissioners argued some birth control dispensed by the Health Department was tantamount to local funding of abortions. Those comments again demonstrated the healthcare ignorance held by those who feel they have the knowledge to save Erlanger via their appointments to Erlanger’s Board. 

Question: What were they thinking when they launched the aforementioned bright ideas? Answer: The healthcare mavens, aka the Hamilton County Commission, somehow reasoned that care provided in an outpatient setting would be more expensive than emergency room or admissions for late treatment for care of the homeless in Hamilton County. While studies show withholding birth control does not reduce the number of teens having intercourse, some commissioners believe they know better.

Those who remain uninformed need to understand reality of the consequences that come from remaining a uniformed elected official. Question: What happens in the real world of Chattanooga’s healthcare financial issues? Answer: If sexually active women use birth control, they are less likely to burden to Erlanger with the labor and delivery costs associated with uncompensated indigent care. If unintended pregnancies are prevented, the cost associated with supporting the children of indigent women is decreased. Young people are more likely to finish school on time and less likely to be distracted from school, if they aren’t becoming new parents at the same time. Sexually active teens that use birth control are less likely to have need of the prenatal care services funded by taxpayers at local Health Department clinics. Teens using birth control are less likely to arrive at Erlanger’s emergency room in preterm labor and deliver low birth weight babies that require hundreds of thousands of dollars of uncompensated care in Erlanger’s neonatal intensive care unit.

The current and past actions of some County Commissioners indicate they are not qualified to lead healthcare decision making for Erlanger or the Health Department. Politically speaking, they would do themselves more good to remain silent, for they showcase healthcare ignorance too much and too often. Their failure to ratify the revised Erlanger hospital charter means the current legal process for Erlanger Board appointments is for the city of Chattanooga and Hamilton County to continue to jointly appoint the board members. The County Commissioners doesn’t like that either. Commissioners, please settle down and move out of the way. The hospital is “on life-support” and those of you who voted not to ratify the state legislation are tugging at the power supply on the ventilator plug. Don’t you understand that politicians are terrible at making healthcare administration decisions? The newly crafted Obama care plan is a perfect example of what happens when elected officials get lost in mission creep.