Cover Story: A Q&A with Mike King, author of ‘A Spirit of Charity’

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I have always felt that public hospitals like Grady make it easy for us to claim that we have the greatest health care system in the world when in fact, even after the latest round of reforms, we still have a health care system that is not equally shared by all Americans.

You said the “journalistic pull” of Grady was one of the reasons you moved your family here from Kentucky to join the Atlanta Journal-Constitution. You’ve covered the hospital for nearly 30 years. What about it fascinates you?

Bellevue, Charity, Parkland, County (in Chicago), all these iconic hospitals with one-word names like Grady — I always thought that as a journalist interested in how we care for the poor in this country, you needed to get inside one of these places, see how it works, understand the mission and explain that to readers.

Why has Grady so often been viewed as a political hot potato and a liability, rather than an asset that should be supported?

Because it is seen as a poor people’s hospital. It is so much more than that, of course, but that’s the perception that’s hard to overcome. That, and the fact that this state, like others in the South, has never committed the money or support needed to have a true safety net for the poor. We would still rather deal in outdated and demonstrably false stereotypes attempting to separate the deserving poor from the undeserving, even though disease and disability makes no such distinction.

State lawmakers and governors spent years first refusing to help fund Grady and, more recently, expand Medicaid. What have they squandered?

Credibility, among other things. And not just about Grady. They can provide no economic justification for refusing $9 million a day in money paid into the federal treasury by Georgia taxpayers — more than $30 billion over 10 years — to expand Medicaid, assist rural hospitals that desperately need it, not to mention a half million or so Georgians who could be covered. Unfortunately, they are paralyzed by the extreme right-wing politics of the majority party.

There’s speculation that Georgia next year will consider some form of Medicaid expansion. What’s a solution that makes sense?

I’m not sure it is next year, but it will happen. Too much money is at stake. The state will create a plan, probably like the ones adopted in Arkansas and Indiana that can be sold as not being a giveaway to the poor. And so they can claim it’s not Obamacare.

What do you think the future looks like for public hospitals such as Grady?

Depending on what happens in November, I think we could slowly, incrementally move toward getting more people covered through a public option-type plan. Or we could try to turn the clock back to the days when the system was even more unfair, inefficient, and amoral. We’ve been trying to avoid this hard choice for over a century and forcing public hospitals to adjust to our indecision.