Pulling the Plug

A government on the mend makes our hospital look sick

It used to be that MetroHealth was the gem of county government, a place where marvelous medicine was practiced and the poor were served frequently and with dignity. Now the taint of a government that promoted corruption has stained the hospital's reputation.

First there was John Carroll, the Metro construction manager who accepted bribes and gifts as if he were a charity himself. He was sentenced to nine years and ordered to pay some $700,000 in restitution.

"Carroll was the pig of pigs," one businessman involved in the case says. "He was constantly chiseling trips, tickets, food — anything he could get. He once wanted a guy's wife in return for a contract."

While the county government was being voted out of office by an enraged public, Metro officials were courting former Commissioner Tim Hagan to be a consultant at $90,000 a year. The fact that hospital leaders felt comfortable in doing so raises doubt about their cognitive wellness. It may also partially explain why Metro had to call on a PR firm to figure out how to sell you on its vast sums spent on consultants and salaries.

Here was Hagan, a senior leader of a government that rotted on his watch while he never whiffed the stench. His lack of judgment on the acquisition of the Ameritrust Building cost taxpayers millions. The early returns on another of his public projects, the $465 million medical mart, look iffy at best.

With Metro facing an uncertain future, adding Hagan — now celebrating four decades of living off the public — to its burden creates the perception that those running the hospital don't understand that people are fed up with business as usual. County Executive Ed FitzGerald and the county council — who have their jobs as a result of that anger — are casting a critical eye on the very manner in which the system is run.

Metro is supported by a county levy designed to provide a safety net of indigent care. Cleveland's other two hospital systems are also required to provide free care to the poor in order to keep their tax status.

We love to tout the superiority of our medical community, but the one thing nobody wants to hear is the notion that we might have too much medicine. That could lead to greater competition between Cleveland Clinic, and University Hospitals, a game Metro can ill afford to play.

Our dwindling, shifting population has caused a reduction in trauma centers — especially in the city, leaving the poor with fewer options. The Clinic's closing of Huron Hospital will add to Metro's burden and yours: In effect, it's a convenient cost shift to taxpayer wallets.

Metro is in trouble and needs money — which is to say, more patients with health insurance. Officials need to urge the other health-care systems to pick up a greater share of indigent patients, whose numbers will undoubtedly grow.

Despite Metro's recent change in leadership, its problems can be traced to a detached, decadent, and duplicitous government as much as an increasingly changing environment.

The criticism by FitzGerald of Metro's expenditures on consultants raises questions about the competence of those running the health-care system. Lofty salaries and billable hours are a hard sell to voters who are asked to support levies meant as aid to the poor.

If the new government continues to examine agencies and authorities as it has with Metro and the Veterans Commission (an inert body that spends more in administrative costs than it does on clients), it is certain to find a repulsive residue of double-dipping, patronage, and incompetence.

It may be that theft in office is the least of the damage we suffered in what has to be one of the darkest episodes in our history. It may have cost us a half-century of progress as well.