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A new trauma epicenter

If activists want to see a trauma center on the South Side, they may want to take their cause to City Hall.

“You can’t always get what you want.” That seems to be the University of Chicago Medical Center’s response to the activists who have pressed adamantly over the last three years for the UCMC to reopen its adult trauma center. Most recently, we’ve all seen photos of the questionable arrests, tense protests, and well-documented police blunders that have kept the issue at the forefront of campus consciousness. But will these new pressures finally make the behemoth Medical Center cave in to the demands of protestors who have all but beaten down its doors?

Probably not. I think that the activists face a handful of institutional barriers that have successfully kept the University from bowing, and that are not likely to yield any time soon. The folks who care about a trauma center are going to have a lot better luck if they bring the fight to people who can help them win it—namely, the city or state government.

Let’s look at the situation from the administrators’ angle. Like it or not, the UCMC administrators who incessantly put the kibosh on a trauma center are simply doing their jobs. The University tried a trauma center during a bizarre citywide trauma fad in the 1980s. When it became apparent that the center was not financially sustainable, the UCMC shut it down in 1988. That’s what private institutions do—not out of sheer self-interest, but because it is their charter. It’s the same reason that the UCMC emergency room (which has to close its doors more than 20% of the time due to overcrowding) has not been expanded; the ER is bad business, since entitlement programs and meager insurance reimbursements can’t keep up with the costs of treatment.

Activists claim that in spending exorbitant millions on shiny new research and specialty care facilities in lieu of a trauma facility, the University is once again neglecting the needs of low-income South Side residents. But as a private hospital, the Medical Center is accountable for its balance sheets. Cruel as it may sound, the hospital has every right to focus on saving the lives that can pay, and UCMC decision makers cannot responsibly make choices that will hemorrhage money.

So if the UCMC cannot be coerced to act, where exactly should the trauma advocates turn?

City Hall would be a fine place to start. In 2011, Chicago City Council passed a formal resolution acknowledging the need for improved trauma care access on the South Side. Unfortunately that was the last of it—the Council passed the buck completely, urging the UCMC to reopen its center and asking the state congress to figure out the federal funding. Now, two years have passed without a stitch of progress. The activists should make the aldermen revisit that issue and start revamping the city’s trauma system in earnest.

Of course, dealing with local government requires cutting through an entirely new maze of red tape and political maneuvering. But it’s worth a try—after all, opposing health care for low-income populations looks awfully bad to constituents on Election Day, particularly for aldermen from South Side wards. If forced to take action, a sizeable portion of City Council might just climb on board.

Aldermen are also more accountable to the public than to University bigwigs, so a big enough push could bring results. If the degree of hubbub that often happens outside the Medical Center happened at City Hall, for instance, aldermen (and maybe even the Mayor) would feel serious pressure to act. At the very least, the protests would get more TV airtime and headline inches—and with enough bad press, local governments can be leveled with (just look back at the Chicago teachers’ strike).

But if the aldermen continue to shirk responsibility, trauma advocates can take their fight straight to the Statehouse. Despite Illinois being deep in the red, there is a great deal of federal money available to states for precisely this sort of community health project. Obamacare allocated a huge chunk of change for improving trauma systems, and the state of Illinois could make a convincing case for getting access to more of those federal dollars. The state could then funnel that money to the reopened UCMC trauma center and bolster its lackluster revenue, which would at least get the ball rolling.

In the end, it’s essentially a question of intent. If the protesters’ goal is to shame the University, then they should stay the course and keep showing up on the UCMC’s doorstep. But if their goal is expediting care for trauma victims, they should take the fight to City Hall, or maybe even Springfield.

Although I love the activists’ passion for enacting positive change in our community, passion misdirected is passion wasted. The trauma center activists can’t get what they want from the UCMC—but if they take this fight somewhere they can win it, they just might get what they need.

Jake Smith is a fourth-year in the College majoring political science. 

  • BN

    The only way to get a trauma center back on the South Side will be to expand Medicaid for adults. The University kept the pediatric trauma center open because Medicaid reimburses it for children’s healthcare but not so for adult’s, or at least not to the same degree. It loses money on adult care not that of children.

  • MP

    As an surgical resident at a level 1 trauma center I cannot agree more with UCMC executives. Every day I see the inordinate amount of resources provided to patients who have no ability to pay. And the failure of federal, state and county governments to fully fund trauma services leaves a hospital like mine with the bill which in turn actively impacts the quality of services, facilities and bottom line of the health system. Frankly, when no one from government or the community is willing or able to pay for the services they demand in such a loud voice, they should realize how foolish they look.

  • Medical Doctor

    Many people fail to realize that opening a trauma center would drain resources away from other critical programs at the medical center. If you are willing to cut programs that treat cancer (UCMC has the best cancer program in the state) or cardiac care (they do more heart transplants than any other hospital in Chicago) or numerous other programs for the sake of a trauma center, then by all means…

  • JBR

    I am a trauma surgeon who once worked at a Chicago area hospital and I just could not keep silent anymore. My son is a U of C student and sent me this article.

    The fight for improved trauma care, wherever it may be located, has been repeatedly brought to city hall and to Springfield. The trauma network is currently voluntary. The state and the city cannot force a hospital to join the system as it exists. Why is that? The biggest lobbying group for hospitals in the state fights activist groups and trauma surgeons to keep it that way. When has there ever been a problem in our state, our city, of private corporations and private hospitals giving TOO much? Funding is out there and trauma is not as big of a drain as hospitals pretend it is. There are many benefits to doing trauma. But it is about will.

    And it is a question of what is right. Academic medical facilities are not hurting for money. This particular hospital is not hurting for money. Instead of pretending that individual hospitals can do what they want and hurt no one by operating “for their balance sheets,” look to the system: some hospitals (Advocate Christ) unfairly have to pick up the slack dropped by the others. Why do they keep their unit? Because the surgeons and doctors there value the public good a trauma center offers, and realize the prestige and importance to the medical community. Other hospitals are impacted by the lack of participation from the University.

    So I agree in a sense. Keep up the fight with politicians. But I have been following this campaign, and I have to say, when things like this get forwarded to me I feel furious. Advocating for politicians to get involved does not mean that these activists are wrong for targeting a specific institutions. It just means that the University, if money really is the problem, should be cooperating with these activists to bring about a trauma center. A property and sales tax exempt hospital, by taking those cuts, obliges to participate in a public community. In my experience trauma surgeons want to save lives, and they do a good job. Look at Boston. This is a service critical to the public.

    The hospital’s hands are not tied, they clearly do not want to be doing trauma, and for that, given the problems on their Southside, they deserve to be targeted.

    I hope that all the super smart students at the U of C will take a good long look at all the facts, at the history, and at the wool being pulled over their eyes by people who think in patterns evident in this letter.

    • SP

      THANK YOU

      • RN

        First create a policy/program whereby the institution does not lose millions of dollars a year treating trauma patients. Then you’ll see people jump on the bandwagon of having a Level 1 Trauma Center. Unfortunately, the Chicago healthcare market is fiercely competitive and losing money isn’t an option.

        As a point of reference, U of C has the highest number of acute care Medicaid days of any hospital in the State of Illinois (higher than Northwestern, Rush, Advocate Christ, etc).

  • AB

    When I used to work for the University years ago, I overheard a conversation between a doctor and the helicopter dispatcher. The doctor called UCAN and said, “Don’t send the helicopter–it’s a Medicaid patient.” However, I was very proud of the dispatcher because she said, “Doctor, we have to send the helicopter. It’s hospital policy.”

  • SN

    Activists expect UChicago to single-handedly fix–or prop up–America’s health insurance problem.