Autobiography - The Galindo Group

Ram Galindo THE MAKING OF AN AMERICAN Page 230
My involvement in volunteer missions continued when, in 1983, I received a visit from a
management consultant whose company had been engaged by Bryan-College Station’s
then only hospital. St. Joseph’s Hospital was owned and managed by the Sisters of St.
Francis from Sylvania, Ohio. I knew very little about the organization, except that its
administrative staff had just been reinforced with new talent to avert difficult financial
times. The visitor was doing a sort of opinion survey among community high-profilers. I
listened to his presentation and candidly answered his questions. Months later I
received an invitation to serve on the board of directors of the resurging hospital. Sister
Gretchen Kunz, the new hospital administrator, insisted that I serve despite my
explanations that I knew nothing about her business.
In a thirteen-year span from 1984 through 1997, I learned more about the hospital
business than I ever thought I would. I also learned to admire and respect Sister
Gretchen, as she is known in the community. Under her watch the hospital made, and it
continues to make, unprecedented advances in the quality of health care in the
extended Brazos River Valley. It also became a powerful economic force in the area.
The last seven years of my tenure on its board, I served as chairman of the finance
committee. Thus I was well informed about the profitability and balance sheet items of
the operation. I must admit that frequently I was a dissenting voice when it came to
raising fees and increasing expenses. My economic posture represented the view that
after accounting for some charges lost to “charity”, the hospital’s fees should have been
somewhat lower than similar tax-paying facilities.
The reasoning behind my position is amply laid out in several parts of this book. But
both the central board from Ohio and the local directors always superseded my view.
The unfortunate truth is that even if I had prevailed, it would not have made any
difference in the cost of health care. It appears that every other tax-exempt hospital in
the nation is out to maximize its earnings, regardless of any tax advantages their “nonprofit”
status confers upon them. If Sister Gretchen had accepted my view, the hospital
may have been one of the very few private tax-exempt facilities actually acting as a
charity provider – a rather Quixotic and unpractical position, usually left to wholly owned
county or city public hospitals.
In the labyrinthine world of medical billing, the government, through the Medicare
program, sets the tone for medical invoicing. Medicare’s menu of acceptable charges
for hospital procedures have become the benchmark from which any other customer is
billed. The point I wanted to validate with my dissenting vote about raising fees, is that
the savings in taxes at all levels received by St. Joseph’s Hospital, less the charity work
actually given away, should have been reflected in our own menu of charges. I was
never able to sway the hospital’s administration to consider this view. Perhaps due to
the difficulty of the undertaking, no such in-house price benchmark was ever calculated,
or even attempted. St. Joseph’s “managed care” prices were set in competition with
other local taxpaying hospitals, which, due to tax exemptions, allowed to it accumulate
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