Inside and Outside the Rightsize

So what’s it like getting right-sized? Is it like loosing 30 pounds in one week without dieting for only $19.99? Not exactly, the Cambio Health Solutions consultants are in the process of fixing the Medical Center’s “financial picture.” They want to produce some attractive little charts and graphs to show how much money they are saving, some dramatic power pointable figures. Consultants produce piles of pie charts and fancy reports. In fact their contract says they will produce a MAP “Management Action Plan.” The Medical Center paid extra for the clever language. None of the little people who provide the care have seen the MAP and budget meetings are top-secret: open only to consultants, bureaucrats and politicians. The Medical Center’s staff sincerely hopes that somebody has a plan, or a map, or at least a clue.

On the ground level, the consultants have been cutting and chopping. By most reasonable estimates staffing the new Critical Care and Clinic Building would require 140 additional employees. The consultants ran their secret formulas and determined the new building could run just fine with no extra employees. It will look great in the report, more for less, better, cheaper, faster.

So, back on the farm, what actually happens? Well, waits in the new building’s sparkling new pharmacy are up to four hours long just to drop off your prescription, that’s before you start waiting to have it filled. The housekeeping staff is stretched so thin that they don’t have time to mop and clean in the old building, and in the new facility the dust bunnies are winning the war. The radiology department also finds itself barely limping along.

Cost containment isn’t good enough for the Board of Supervisors; they brought in the consultants to cut costs! And that’s exactly what they plan to do. Through more expert analysis they determined that, all three of these departments have an excess of staff. They have proposed cutting 5 positions from pharmacy, 12 from radiology, and 14 from housekeeping. These consultants really know how to pinch a penny.

Understaffing and lay-off offs are the sunny side of the right-sizing and fiscal responsibility program. The really mean-spirited stuff is aimed at the patients. The Medical Center has a new “Charity Care Plan.” Around the hospital it’s called the “You Better Get Blood From a Turnip or Else Plan”. Patients must now pay a $100 deposit per Highland clinic visit. This plan ought to keep people from coming to the hospital. They haven’t figured out how we will control or monitor diseases like TB or SARS with the new financial barriers to care, but the saving should be stupendous. It’s the no money no honey medical services model.

But enough about the insides of the rightsize, what about the outside. What about the nice numbers, the pie charts, the return on investments and the politicians who will cash in on these cuts. Well, if things keep on their current path, the Board of Supervisors should be whistling all the way to the bank.