Latest / The SEANC View / Atrium Takeover of WakeMed Sparks Community Outcry

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Atrium Takeover of WakeMed Sparks Community Outcry · The SEANC View

0:11
Hello, and welcome to another edition of the Scenic View podcast.
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I'm Jonathan Owens, along with Artis Watkins, Executive Director of Scenic.
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Today joining us is Nathan Foster, Healthcare Policy Specialist from the NC
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Justice Center, and Anthony Pope, a co-founder of Men of Southeast Raleigh,
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a community organization here in Raleigh, obviously.
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And we're going to be discussing the proposed WakeMed atrium merger.
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And both of these men were at the recent town hall event in Raleigh where both
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sides were represented.
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Yeah, both sides showed up.
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So we thought we'd have them on and kind of discuss a little bit of their perspective
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and add our perspective to it and, you know, help inform our members.
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Yeah, because if you're a state employee or a retiree listening and you think,
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okay, I live in Ashe County, why do I care if WakeMed and Atrium merge or whatever,
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word of the week they want to use for this unholy alliance?
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It matters to every state employee and non-Medicare retiree because,
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as the state health plan has said,
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your costs under your state health plan would go up by more than $100 for every
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single state employee and non-Medicare retiree if this merger happens.
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Because, as we've talked about many times, consolidation leads to higher prices,
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always in this business, and that's what we would be looking at according to
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the experts at the state health plan.
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So it is a state employee retiree issue, but it's also a community issue.
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So this is one of those times where scenic and representatives from the community
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writ large are trying to get together to make sure all of the information gets out there.
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So no matter where you live, if you're listening to this, this affects your bottom line.
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And by the way, even if you're not a state employee or non-Medicare retiree,
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your health care costs are dependent on stopping all this consolidation that's,
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marching towards monopolization of the health care industry.
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We're so far down that path, I'm not sure if we can even turn around.
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But even if you're listening to this and you work for private industry,
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far away from Raleigh, if you're in North Carolina, this affects you,
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and it's one of the reasons we stay number one costliest state in the nation for health care.
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So that's kind of setting the table for where the conversation will go.
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And Raleigh is home to the largest amount of state employees in the state,
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obviously, because it is the head of state government.
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Well, Mr. Pope, why don't you start and tell us a little bit about you,
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yourself, and why you're involved in this. Absolutely. Good morning.
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My name is Anthony Pope. I'm a lifelong resident of Wake County.
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Born and raised here, have lived here in this county for 68-plus years.
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I'm the co-founder of an organization, the Men of Southeast Raleigh,
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which is a grassroots community organization that came together about five years ago.
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And our sole purpose for coming together was to connect, collaborate,
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and partner with our community, particularly the Southeast Raleigh community,
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which is historically the Black community here in Raleigh.
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And so what we do is we advocate, we engage our community to make sure they're
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informed about issues that will impact our community more so than anything else
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because of where we're located.
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So we came together for that sole purpose, and we connect, collaborate,
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and make sure that we keep our community engaged, keep them informed.
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And so we are not a nonprofit. We are just a group of men who were born and
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raised in Southeast Raleigh.
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We started out with two men, and we now have about 80 men.
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And all we do is interact and engage our Southeast Raleigh community.
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It's not that we're not concerned about the entire Wake County,
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but a lot of the things that happen in Wake County, it affects us more so than
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anyone else because of being the historically black community in Raleigh.
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Okay. Yes. Yes. Great. Like when DMV moved out. Absolutely. The headquarters moved out.
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And I was on that commission as well for the planning of what was going to happen with that building.
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Mr. Foster, so tell us a little bit about the Justice Center and why they're
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involved in this fight, I guess, first.
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Absolutely. So the Justice Center works on a number of issues around fairness
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and economic opportunity for everybody in North Carolina.
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And specifically on health care, we really care about health care affordability
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because we know that it's one of the biggest costs that,
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really everybody faces in their lives. The Justice Center has worked a lot on
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medical debt in the past.
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And in fact, that's one of the reasons why this takeover was so concerning to
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us because Atrium was one of the most prolific sewers of people in North Carolina for medical debt.
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So we actually worked with some community members in Charlotte who,
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you know, this person who had a lien taken out on his home by Atrium and went
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on national news about that.
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And the liens were forgiven, you know, within the week after he went on national
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news, but that was only two years ago. Yeah. I'm shocked at that.
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No. Yeah. I mean, you said sewers and I was thinking of the other sewers, but anyway.
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So, Mr. Pope, does WakeMed serve a lot of your community?
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I mean, is it the primary health care provider? Absolutely. WakeMed is the primary
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health care facility for Southeast Raleigh. In fact, it's located in Southeast
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Raleigh right off from Newbern Avenue.
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Prior to Wake Med, it was Wake Memorial, and that was a merger between St.
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Agnes Hospital, which was the only hospital in the city of Raleigh that served the Black community.
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In fact, prior to segregation or integration, this was where all of the Black
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babies were born, myself included.
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And so that's on the campus of St. Augustine's University. Wow.
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When the merger happened, it became Wake Memorial Hospital.
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And so that was a great merger because what it allowed us to do was to expand
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the health care services for residents of Southeast Raleigh.
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And so as a result of that, that merger was great because we got the same quality
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service that we had prior to integration.
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And it was just a seamless transition from St. Agnes to combined with Wake Memorial at that time.
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So it is an extremely important asset to our community. And we are very concerned
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that if this takeover, I'm not even going to call it a merger.
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They've called it a merger. It's went from merger to partnership to this.
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As far as we're concerned, it's a takeover, and it's going to drastically impact
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the quality of services that we get now in Southeast Raleigh.
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So our residents more so are going to be affected more so than anyone else.
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And, you know, it's an interesting thing. I'm so glad you touched on the history of how Wake Med started.
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And, of course, the county, the taxpayers funded the hospital to begin with. They got it going.
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And they did so because it was a really important need.
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And then it was an important need not just to have the health care available,
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but to make that health care available for all. And affordable.
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And affordable, available for everybody.
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You know, that if the richest person in Raleigh went in, that's a millionaire
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at the time, that would have been the richest person in Raleigh.
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And the poorest person in Raleigh, that they would receive the same care.
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Absolutely. Something now we take for granted that it should be that way.
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But Wake Med's now arguing, look, the county really doesn't have a role in this.
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The county is trying to say, the county commissioners, we don't really have
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a role in this. Yet they still do, even because...
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I know people say, well, since 1997, when the hospital went from being really
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a county hospital to being this independent nonprofit.
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But the taxpayers built this place. Yes. And so Wake County still kept representation
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on the board to a level that would indicate taxpayer interests would be looked
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after and that the community interests would be looked after.
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Yeah, 100%. But y'all are upset, it's my understanding, because that would kind
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of turn on its head in this new agreement. Yes. Yeah, it would.
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So the idea that WakeMed doesn't have this, you know, connection to the county, I think, is just wrong.
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The county appoints a majority of WakeMed's board right now.
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And there's provision in the when WakeMed went from being a county hospital
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to being a private nonprofit that is sort of with the board appointed by the county.
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There is a provision in that that said WICMA can't change its Articles of Incorporation
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unless the county agrees to it.
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And that was exactly to prevent something like this. And so,
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you know, people are saying, oh, well, this is just signing some papers.
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If Atrium could have done this without the county commission,
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they would have done it without the county commission. And the fact that they
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have to go through the county commission just shows that the county commission
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really does have power here.
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Well, of course. I mean, they wouldn't put it on the consent agenda at all when
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they tried to sneak it in on the consent agenda. Absolutely. Yeah. I mean.
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Obviously, they have a role. Get it while they're trying to avoid it,
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because that's a lot of responsibility.
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If you give away this hospital that's a big part of Raleigh's history and,
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frankly, a big part of what taxpayers build, I wouldn't want to be responsible
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for that as a politician either, but that's where we are.
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So this leads us to what's coming on Monday. Can you all tell us what's coming
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Monday and what you think we should do?
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So on Monday, there's, of course, the county commissioner's regular meeting.
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We intend to be present at that meeting.
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I've had the opportunity to speak with a couple of our county commissioners,
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and there are some that are for and some that are opposed to this takeover.
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And so we want them to understand that as elected officials of Wake County,
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what they need to do is vote in the best interest of the residents of Wake County.
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This meeting, this county commissioner's meeting on Monday, is pretty much for
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us, again, to voice our concerns about this takeover, how it's going to impact
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our community, how it's going to impact our citizens. And the cost,
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of course, is a major concern.
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I think they tend to, when I say they, some of the board members tend to look
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at this as, oh, this is going to be great for Wake County and,
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you know, we're going to do this, we're going to do that. But the thing that
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we're concerned with mostly is how it's going to impact the quality of care.
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The costs and how it's going to impact people that are currently employed by
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Wake Bay Hospital. And you didn't really get answers about that when you asked
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them. No, it's still not clear.
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We've got some partial answers, but there's still a lot of unanswered questions
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that need to be addressed prior to this vote taking place in September,
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the early part of September.
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And so right now, that is our major concern because as a community,
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we don't vote, but we have the opportunity to make sure that we stay on top
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of our commissioners to vote in the best interest of what the community wants.
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And right now, that's kind of split between board members, the county commissioner members.
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And so we don't like that. We want to make sure that we're present,
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to make sure that our voice is heard, even though we don't have the vote.
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But we have the power to make sure that as going forward, that these kind of
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commissioners are held accountable. Now, Mr. Pope, we have asked our members
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to contact their county commissioner. Yes.
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Took them to the place on the website where you do that. A lot of people have
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attempted to do that with basically no response from almost every county commissioner.
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Has that been your experience or are you hearing back? Because I live in the
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community, I see the county commissioners. I know a few of them personally,
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so I see them. And when I see them, I have the conversation with them.
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I've had some feedback in terms of people trying to reach out to the county
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commissioners and have not had the success of getting in touch with them.
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And so that is a concern to me because you're saying, you know,
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contact your county commissioners. We're open to hearing what you have to say.
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But the process of getting in contact with them is not as easy as it. No.
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At first, I thought they had a really aggressive spam filter or something,
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and maybe they just weren't getting our emails, except there was one county
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commissioner who was always responding.
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Yes. And so that told me, oh, this isn't about a spam filter.
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This is just about a, I can't hear you. Absolutely. Absolutely.
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Every detail of this, even down to what Atrium's powers over WakeMed would be,
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is being kept secret as part of this deal. And it's being called competitive
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health care information.
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And if they showed it to a majority of the commission at once,
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that would be a public record because it would be a meeting of the county commission.
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So they've been doing these groups of three out of seven commissioners,
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and they've been showing it to them in a highly controlled environment where,
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the CEO of Atrium flies in from Charlotte or Chicago or wherever he's coming from on his private jet.
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And they all sit down with the lawyers and in a very controlled environment,
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show parts of the deal to three commissioners at a time. And they've done that
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with six of the commissioners, but they haven't shown the public.
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Now, explain why they would do it three commissioners at a time.
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Well, if you know four commissioners, then it's a meeting of the county commission
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and you can submit a public records request. Right.
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So this, I mean, the really continued. It was so it was just such a chump move
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to put it on the consent agenda in the first place. What a what a weak move. Right.
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So they're continuing, however. Instead of learning a lesson out of that and
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saying we're gonna be transparent and accountable to the public.
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They're having meetings that are small enough in small enough groups to keep
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the public from knowing what they're doing still.
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Yeah. And I think these six commissioners who have seen the deal have signed
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nondisclosure agreements about it.
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And I think an important question for them is, you know, you've had five hours
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to sit down with these papers. You haven't really had the opportunity to understand them properly.
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Do you really feel comfortable moving forward with this when your constituents
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don't know what you saw and you legally aren't even allowed to tell them?
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A non-disclosure agreement to look at a contract that affects your constituents.
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About a hospital that was made in the first place with the constituents' taxpayer money.
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Right. Well, my understanding is this is a private agreement,
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so it's not necessarily privy to the public.
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But there again, these are elected officials that we put into office.
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Right. But yet still, we don't have access to all of the information.
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And yeah, when you meet in these small groups like that, it makes you wonder,
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well, you know, what's going on in these small groups? Are they trying to influence
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just a majority of the commissioners to get them in their corner?
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It's really disheartening because as a community, we really need to know what's going on.
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And there's still a lot of questions that are not answered and we don't know.
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That's wild to me. It's just absolutely wild. So on Monday, which,
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by the way, I kept saying Monday, Monday, August 17th is at two o'clock,
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I think. Yes. Unfortunately, it's at two, but that's when they're doing it.
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Yeah. Two o'clock, the Wake County commissioners will have a public hearing
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that will last however long, right? Everyone gets three minutes to speak.
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It depends on how many people show up. Three minutes. Okay.
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And then they probably won't vote on it, is my understanding,
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the Wake County commissioners, on the 17th. From my understanding,
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this vote has been delayed into September.
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I don't know all the logistics of that. I had the opportunity at the previous
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county commissioners meeting a couple of weeks ago.
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I was one of the speakers, so I had the opportunity to express our concerns
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from the viewpoint of our community, in addition to Rob Stephens,
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who is also one of the men of Southeast Raleigh.
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So we expressed that, and there were several other people from the community as well that did speak.
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So from my understanding that this vote has been delayed to September,
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and I hope that is the case because when they had this closed-door meeting with
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the county commissioners a few months ago, So nobody was even aware that this
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meeting was taking place except the county commissioners and the people that
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are involved in this takeover process.
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So I'm hoping that as the information goes forth, that the public will be kept
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kept informed in terms of when this vote will take place.
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But we're going to kind of keep the pressure on no matter how long it takes,
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whether it's September, whether it's next week.
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The pressure is on now. And they know that. Yeah, they know that.
16:56
Well, you know, the deal that they'll vote, they're not going to vote right
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after they hear from the public. Absolutely.
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Let some space happen and then just randomly vote one day.
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But, okay, Nathan, you were talking about the small group meetings of the Wake
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County Commissioners so that they wouldn't be subject to the Public Records Act.
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And this was the reason given for that was that it was competition.
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Protect competitive information.
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Yeah, so Atrium acts like a for-profit corporation. It pays its CEO $26 million
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a year. It's part of this conglomerate that's the third largest,
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you know, quote-unquote nonprofit hospital system in the country across six states.
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But legally, Atrium is the Charlotte Mecklenburg Hospital Authority, and it's a public body.
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And there's a law that uniquely protects these public hospital authorities from
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having to release this information to the public and protects them from public records requests.
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And so they're saying that because of that, the entire deal is competitive information, you know.
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And I think we would understand if there's really, really specific numbers in
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there or like that would potentially be competitive information.
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But it's basic things. What are Atrium's powers over Raqmed? That's in the deal.
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Are prices going to go up, you know? Are any service lines going to be cut?
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Are they going to do any kind of shenanigans with replacing nurses or outsourcing
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nurses or outsourcing other hospital employees?
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We don't know any of these. We don't know if there's any guarantees.
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And the idea that we'd be voting on this without the public knowing,
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or frankly, without the county commissioners knowing, because sitting down for five hours with
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you on one side of the table and all of the hospital lawyers on the other side
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of the table, that's not an environment where you can really understand what's
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going on with, you know, these hundreds of pages of deals.
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Like, it's crazy to move forward with that level of obscurity around what's
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actually being voted on.
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And we've dealt with similar secrecy surrounding the state health plan and the
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third-party administrator contract.
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With the hospitals, yeah. It makes you think, like, if North Carolina is the
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most expensive health care state in the country, and we have all this secrecy,
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don't those go hand in hand? Like, is one causing the other?
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Well, I mean, think about it. There's so many state employees in Wake County,
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and all over the state, but their salary, you know,
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if I'm a maintenance worker for a DOT yard, my salary is public information.
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Because people have a right to know what public employees are paid.
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But these contracts about the state health plan, those are with taxpayer dollars.
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One of the biggest taxpayer dollar contracts around is the state health plan.
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But we cannot see what we're paying these different hospitals right now with
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the announcement the Board of Trustees of the health plan made about the 2028 changes in the state.
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It would be access level provider reimbursement and then preferred provider
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for hospitals that have good quality
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and have given a fair and competitive rate to the health plan.
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They'll get preferred provider status.
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Now, the two that are fighting trying to get access but apparently not coming
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to the table willing to give a fair and reasonable enough deal for the health
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plan to be happy, the two loudest are Atrium and Wake Med.
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Yeah, ironic. So what does that tell us, Nathan, do you think about what Wake
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County citizens might be looking at price-wise?
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Well, I mean, I think what you're saying about the secrecy of the prices is
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so important because the only thing we know about the difference between Atrium
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and Wake Med prices is from the state health plan.
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They said they pay Atrium between 15% and 40% more than Wake Med.
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Now 15% of what 40% of what we don't know because this is all so so secret and
20:44
you know I don't think any of these prices should be secret like I think the
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public should know all of all
20:48
of these deals whether it's with the public entity or a private entity but,
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yeah yeah I mean I think it wasn't a surprise to anyone that Atrium was made
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a non-preferred provider because they're just so much more expensive than other
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providers and I think we're maybe unwilling to come to the table So.
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I think it is a little bit of a surprise that WakeMed was made a non-preferred
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provider as opposed to an access provider.
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And I think, you know, I don't know what happened there. You do have to wonder
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if WakeMed has their eyes on this deal. And so that made them not really want
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to be, you know, doing things in the here and now to make sure that they were
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accessible to the state employees.
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So, Nathan, you're our expert in this podcast.
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Tell us a little bit about what happens when a large hospital swallows up a
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small hospital like WakeMed.
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What happens to prices just overall? Yeah, so prices generally go up.
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There's data showing that they go up by between 6% and 17% when you have like
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a hospital from a different market coming in like this.
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And Atrium will say, well, we're not in Wake County right now.
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So really, there's no consolidation happening. But that's just not true.
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These negotiations happen at the state level. And, you know,
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Atrium has Charlotte. They have Winston-Salem.
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If they also have the largest hospital in Wake County, they'll be able to go to the payers, a.k.a.
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Us, you know, or our insurance companies and say, you have to deal with us because
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we're in all three of the biggest markets and you're just going to have to charge more, you know.
22:14
And that's kind of what they're doing with the state health plan, right? It is, yeah.
22:17
That's exactly what they're doing. I mean, Atrium having $10 billion in reserves
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and the state of North Carolina having $4.2 billion in reserves,
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to me, it is awfully, let's just say, gutsy.
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To lord around wanting your privacy and expecting to get included in any deals
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that other providers who are giving good deals get to partake in.
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I mean, that is the absolute peak of arrogance.
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Well, if you look at the salary of the CEO for Atrium, which is in excess of $25 million.
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And compare that to what the CEO of WakeMed makes, which is 10 times less,
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that in itself tells you the type of conglomerate health care system that they are.
23:05
And so my concern and the concern of my community is that the people at the
23:10
top for WakeMed and Atrium, certainly they're going to benefit more so than anybody else.
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Also, the concern is if health care costs increase, it's going to impact the
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Southeast Raleigh community and marginalized communities more so than anything else.
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But you have a lot of people that are moving, 66 people a day moving to Wake County.
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And a lot of those are people that work in the tech industry.
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That's Associated Research Triangle Park.
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They can afford it. Yep. People that are indigent, that are some people that
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are in a good majority of the folks that live in Southeast Raleigh,
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they're going to be impacted by the fact that,
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they no longer may have access to be able to go into wake med and get services
23:52
that they need because they can't afford it. Which is terrifying.
23:55
And then you look at Atrium's record. They've had liens against people's property.
24:00
They've sued people that could
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not pay their bills. And what does that say about a health care company?
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We are not really concerned about, you know, whether you can afford this or not.
24:11
You owe us this amount of money. So until you pay us, we're going to put liens
24:15
against your property. We're going to sue you.
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And so that in itself just really does not sit well with the community.
24:23
Well, I wanted to ask about that. So if WakeMed has said all along,
24:28
the CEO of WakeMed has said, look, we wanted to choose, because what we're not
24:33
talking about is the fact that there was another offer on the table,
24:36
which was for more than twice as much, I think, from UNC Health Care.
24:39
Five billion instead of two billion. Yeah, they said, we'll marry you,
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since one of the board members of WakeMed called it a marriage.
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We'll marry you, and we've got more than twice as much to give.
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So, number one, that kind of makes me think this whole thing about we can't
24:53
see the contract because that might mess with the competitiveness. I'm sorry.
24:59
I don't think you've got to worry about that. Somebody already offered more than twice as much.
25:04
In addition to that, the CEO of WakeMed saying, look, Atrium's the like-minded
25:09
partner because they also started as a hospital with a mission to protect the community,
25:17
and to serve underserved areas in the community.
25:22
With what Mr. Pope was just talking about in terms of some of the collection
25:27
practices and stuff like that, those stories have been told all over the place
25:31
about Atrium. So what does that signal for what WakeMed customers?
25:37
How are they like-minded in terms of caring about the most vulnerable members
25:41
of the community? I'm still missing that piece.
25:44
I just don't see it. I mean, Atrium did grow out of the public hospital authority
25:49
of Charlotte-Bachner County, but they've grown into something that's so profoundly different than that.
25:53
And even compared to other of these big private nonprofit hospital systems in
25:57
North Carolina, and I'm not saying the other ones are great,
26:00
you know, Atrium stands out, Atrium stood out in terms of suing patients for medical debt.
26:04
So between 2017 and 2022, 40% of all of those lawsuits were coming from Atrium in the entire state.
26:10
Wow. They had more than 11,000 liens on people's homes, and they canceled those
26:15
liens in 2024 because it was making national news and embarrassing them.
26:18
And then they were like, look, we're so great. We canceled 11,000 liens.
26:22
It's like, dude, you had 11,000 liens on people's homes. Like, who does that?
26:27
And then they had money given to them to alleviate some medical debt of some of their patients.
26:35
Under Governor Cooper. And I think that actually got extended one more time.
26:40
My concern there was not, it's good if we can get rid of people's medical debt,
26:44
but not if it just perpetuates a system that's going to put more people in further medical debt.
26:49
And that's what concerned me about sort of throwing money at these hospitals,
26:54
to cover the debt incurred because of overpricing, basically.
26:59
It's good that we had the Medical Debt Relief Program, and it's really made
27:02
a difference in a lot of people's lives.
27:04
And also the hospitals agreed to it in exchange for quite a bit of money from,
27:09
the state and from the Medicaid program. And so it's sort of a mixed bag there.
27:13
Also, you got to look at the United States Department of Justice actually sued
27:18
Atrium because of their anti-competitive marketing or whatever it is.
27:23
They sued them because of that.
27:25
It's clear this is not a marriage. This is actually a takeover.
27:29
And what's going to happen, if you look at the board make-up,
27:32
Adrian will have six board members out of the 14.
27:36
So Wake County commissioners oversee the WakeMed board.
27:40
But there's concerns that these six board members, once they're in place,
27:45
they will have the opportunity to say, you know what?
27:49
You're not in line with what we want to do, so we need to get you off the board.
27:53
Right, because they can remove them for cause, right? Right.
27:56
So how do you have six board members that can overrule eight board members if
28:00
they are in the minority?
28:01
That is concern. Why would you give six people that type of power over our county,
28:07
over our health care system? Well, how did it happen in Charlotte?
28:10
Well, so I just want to follow up on that point about the board because it's
28:13
so important. And the hospital executives have been saying, well,
28:17
you know, Wake County can still appoint eight board members.
28:20
And that's not really true. Right now, Wake County appoints eight board members.
28:25
Under this deal, the eight board members would be nominated by the existing
28:30
board. They would have to be nominated by at least two of the board members
28:34
that, as Mr. Pope says, H-R-M appoints. So H-R-M would have a veto power over those nominations.
28:38
And then the county commission gets to approve those nominations.
28:41
So it's not appointment, it's approval. And it's Even worse than that,
28:45
because the language says the county commission is not allowed to unreasonably
28:49
delay their approval. They're not allowed to condition their approval.
28:52
So if WakeMed is doing something wrong and the county commission says,
28:56
we want you to stop that and we're not going to approve your board nominees,
28:58
they're not allowed to do that.
28:59
And if they don't approve somebody, the existing person in that seat can stay
29:02
on past their terms. So really everything possible has been done to make the
29:06
county commission completely meaningless in this process.
29:09
And are these paid board seats? I don't think they're paid, but I'm not sure.
29:14
Okay. Wow, that's... That is stunning. Yeah. That is...
29:18
Yeah. Okay, so that's a complete takeover. Like, you use the word takeover.
29:21
Yeah, that's what it is. It's a takeover.
29:24
And I think that our county commissioners, and I've had conversation with one
29:27
of our commissioners concerning the makeup of this board, yes,
29:31
they do point, more or less approve through Atrium's design that, hey.
29:38
We want these X amount of people, certain people in place on the board.
29:42
And it just doesn't sit well that you have six people that are being appointed
29:46
by ATRIM, but they can come in and they have authority over these other eight
29:51
board members. It's really a concern.
29:54
Nathan, how is it legal for the county commissioners to see the contract and
30:00
have these meetings? How is that legal?
30:03
I'm not a lawyer, and I think that regardless of whether it's legal or not,
30:09
But it really shouldn't be the case that the county commissioners have to sign
30:14
an NDA to see something that the public should be seeing.
30:16
And I think Atrium has a lot of lawyers, and often that means that you know
30:23
exactly how far to go up towards the line and how to sort of manipulate the
30:27
process to keep things legal.
30:28
But I think it's certainly not appropriate for these deals to be seen in this
30:32
way that kind of sneaks around public meetings laws.
30:35
And have y'all found any, through the community organization efforts,
30:40
found any county commissioners who you think are truly deeply concerned about
30:46
the public in this? And you can shout them out here.
30:50
Yeah, actually, I've had the opportunity to speak with one of the county commissioners
30:54
who right now, I think their position is that they are against this merger.
31:00
I've had a conversation with them, and I think there are a couple of county
31:05
commissioners that are kind of on the fence right now.
31:08
And that's because of all the publicity surrounding this that the community
31:12
has brought to the forefront.
31:14
And so they really now have to think through this process. Is this something we really want to do?
31:19
But I think there are a couple of county commissioners that are against the
31:23
approval of this takeover.
31:25
And there are some that are on the fence. I know of two that have made it clear
31:30
that they are for the merger.
31:32
And I really don't want to put names out there because I don't want anyone to
31:37
really think that we're trying to undermine their efforts as county commissioners.
31:41
But at the same time, I do want to remind them, you are elected officials by
31:46
the residents of Wake County.
31:48
You have an obligation, a fiduciary obligation, to speak and represent what
31:54
we want. I know there are people out there on the other side of the fence that are for this.
31:59
But at the same time, think about the community, particularly the commissioners
32:03
that serve Southeast Raleigh.
32:06
Think about our community and the makeup of our community and the percentage
32:11
of folks that are probably indigent, some people that can't afford it.
32:16
And then you think about the other parts of town where you have these high-tech,
32:21
high-paid folks that are coming into the county, and they can afford it.
32:25
But we can't. Well, their names will be out there once they vote.
32:28
Absolutely. It will be. And at that point, what happens?
32:32
Well, I think they're going to
32:33
have to deal with the consequences because there's an election coming up.
32:37
So we will, as citizens of Wake
32:39
County, we will have the opportunity to vote them in or vote them out.
32:44
You kind of— Y'all are effective at it, too. Absolutely. You wish that the commissioners
32:49
or even the people of Raleigh could speak to someone in Asheville who has been
32:53
through this with mission and the problems that they're having there.
32:57
Or, you know, have there been any kind of outreach like that?
33:00
Or is that because I know there's a lot of people in Asheville,
33:03
in the Asheville area who are not pleased with the hospitals.
33:07
There have been people from the Charlotte community who have come and spoken
33:11
at County Commission meetings,
33:13
really powerfully about the way that Atrium, they got a lot of money to build
33:17
affordable housing in the Brooklyn neighborhood of Charlotte,
33:20
which is the historically black community in sort of an urban renewal site,
33:23
you know, so an opportunity to fix some of those mistakes.
33:26
And then instead of building affordable housing, they're building luxury housing,
33:30
but they're keeping the public money, of course.
33:32
And so there's a big fight in Charlotte right now about that.
33:35
And in fact, the Charlotte-Mecklenburg County Commission decided that they didn't
33:38
want to approve Atrium's board slate because Atrium hasn't been acting right by the community.
33:43
And so for the first time, since anyone can remember, this year,
33:47
the county commission said, hey, you know, usually just Atrium presents the
33:51
board slate and the county commission approves it. They said,
33:53
hey, we're not approving this. We want more community representation.
33:55
We don't want it to all be business people who care about mergers and acquisitions.
33:59
We want some people who actually represent the community.
34:02
And what Atrium said was, we don't care.
34:05
Our existing board members are just going to stay in their seats past the end
34:07
of their term and we have more lawyers than you. Absolutely. Wow. Yeah.
34:11
There was a gentleman at the last county commissioners, the press conference
34:15
prior to the commissioner's meeting.
34:17
And he actually spoke at the commissioner's meeting as well.
34:21
That pretty much gave us the inside scoop of once Atrium got into position as
34:27
county commissioners, well, once they got in position in terms of their board
34:32
members that were appointed,
34:34
they were able to say to the other board members, just as Nathan mentioned,
34:38
we have more lawyers than you.
34:40
So if you think you can take us on, we'll bring it on. And that seems to be the mentality.
34:45
And that really concerns me because it just opens the door to saying we're going
34:51
to do whatever we want. Once we're into a position, we're going to do what we
34:55
want regardless of what you say and you can't do anything about it.
34:59
And I don't know if that is that the kind of view that you get,
35:02
Nathan? Yeah, absolutely. That certainly seems to be how they act towards people.
35:06
Well, I mean, you should have a deep bench of lawyers if you're a nonprofit
35:11
hospital in this day and time, because I was stunned to see this.
35:15
And since you do a lot of research about this stuff, Nathan,
35:18
nonprofit hospital investments have grown 57 percent from 2010 to 2023.
35:25
And they now reach two hundred and ninety six billion dollars nonprofit hospitals.
35:32
Two hundred and nine. Nonprofit in quotes, right? Right. So I would guess so.
35:37
I mean, with that kind of money, yeah, you've got all the lawyers,
35:39
you've got all the lobbyists.
35:42
And I want to put in a good word for WakeMed here as it currently exists,
35:45
because WakeMed, I think the
35:48
CEO of WakeMed is looking at Atrium and saying, well, I want that money.
35:51
But what WakeMed is now is a hospital that is one of the most affordable hospitals in North Carolina.
35:57
And it is also one of the best hospitals in North Carolina. There was a recent
36:00
ranking called this group called the Lown Institute ranks hospitals on social
36:04
responsibility and quality of care.
36:05
WakeMed was the best in North Carolina. And I think it just goes to show that
36:11
if you have these community roots, if you have,
36:14
I think the public control through the county commission is so important here
36:17
because it keeps WakeMed aligned with what the community wants and needs.
36:21
If you have that, you can provide, frankly, better care and better service to
36:25
the community while taking less money out of the community. And that's what
36:28
we're trying to preserve by keeping MacMed independent.
36:31
Yeah. I mean, and if you're having to listen to the boardroom more than the
36:36
community, of course, things are going to go sideways, you know?
36:39
And I think that's what the fear is here. Wake Med really is respected.
36:44
The problem with any of this in the healthcare industry is that all the money,
36:49
that's not going to doctors and nurses.
36:52
You know, when we think of our hospitals, we always think of the people that help us.
36:57
Doctors, nurses, people that keep the rooms clean, people that keep the dining
37:01
services going so that we can
37:03
go grab a bite while we're waiting with a loved one while they're sick.
37:08
There's so many pieces to running a hospital, but the folks who do that actual
37:13
work, they are not, they're not getting enriched. They're not making big salaries, even the doctors.
37:20
Yeah, that was a community meeting that was held at John Chavis Memorial Park
37:24
in Southeast Raleigh, and the CEO of WakeMed was there.
37:29
And so we had the opportunity, which was, this all came about as a result of
37:34
this closed-door meeting that the public had no knowledge of.
37:37
And so at that meeting, I had the opportunity to speak to the CEO of WakeMed.
37:42
I was really concerned because he was telling me that, oh, I came from a community
37:47
just like Southeast Raleigh.
37:49
And so when he said it, I thought he was saying that he lived or he was born
37:53
in Southeast Raleigh. And I was like, oh, yeah, what high school did you go to?
37:57
He said, no, no, no, from my community. I said, so you're saying that your community,
38:01
has the type of makeup that we have here in Southeast Raleigh?
38:04
He said, yeah, my community was similar. I said, I don't know.
38:08
But anyway, but nonetheless, it concerned me.
38:11
And I think you're right when it is going to benefit those at the top more so
38:16
than the people that are on the front lines doing the work every day.
38:20
It just doesn't sit well. And I think that when you're talking about money,
38:25
it's usually the top tier that normally reaps the benefits of a type of takeover.
38:31
I want to throw money at the ones that save our lives. Yeah, absolutely.
38:34
You don't make $26 million by providing a good service. Absolutely. Right.
38:39
And I think that that makes fights like the one we're having with the state
38:44
health plan and this one hard, you know, that people really do trust their hospitals.
38:49
And they love their hospitals and they want to go to the same hospital,
38:53
but they don't see the other issues, the larger issues about the— That there is no end to it. Yeah.
39:01
You can give them, you know, we've got members right now saying,
39:03
we want Atrium to have access level or preferred provider level.
39:10
Give them whatever it is they want. But if you give them that, guess what?
39:14
You're giving up a lot more. Yeah, they want a lot more the next year. Absolutely.
39:18
And also, taxes would have to go up. So, those same people would tell you,
39:22
absolutely not, do not raise my taxes.
39:25
Or your premiums would go up. Right. So, if you keep writing blank checks,
39:29
somebody's paying for it. Yeah.
39:31
And like we said before, I think the hospital executives know that. Oh, yeah.
39:37
They have that in their back pockets. Another concern for me is that mental
39:42
health has become a major thing, not only in North Carolina,
39:46
just throughout the country.
39:48
And so you have a lot more people that are dealing with mental health issues.
39:53
And so I haven't heard any conversation around how will the hospital address
39:58
this. When they closed Dorothy Dix many years ago, there were a lot of people
40:03
that were receiving services.
40:05
And so they were kind of put out there. So now you have this growing trend of
40:09
people, young people. I see it driving through my community.
40:13
Young people that are just out in the streets and their mental health is just
40:17
out of control. It's epidemic. So how is this takeover going to address this
40:22
issue of mental health, which is really a major thing in our communities now?
40:27
So WakeMed has this podcast that they said it's a short-run podcast just around
40:33
the issue of the merger, which I only happened upon that the other day,
40:36
and I was fascinated. So I've listened.
40:38
And one of the executives from Advocate Health that owns Atrium said.
40:44
Brought up mental health as being one of the things that would be a benefit
40:47
to the merger, but then he doesn't, I mean, I listened to his portion on that
40:52
several times and could never hear why.
40:56
Like, he said it would help.
40:58
Yeah. But I did not hear the why. Have y'all heard anything about it?
41:02
Because that, to me, would be important if true.
41:05
I haven't heard a lot, but I know that is a concern. Yeah, if you can't explain
41:09
to me how it would help. Yeah. Well, I think I think to be, you know,
41:12
to be fair to their argument, they're saying that a term is going to come in
41:16
and invest money in WakeMed and then we're going to be able to expand services.
41:20
And I think one of the things that they're saying is that they're going to expand
41:25
mental health services.
41:26
But, you know, as far as we know, this isn't guaranteed.
41:29
And in fact, there's no guarantee that they'll even maintain existing service lines.
41:33
Like that's another thing that often happens in mergers is the hospital will
41:36
come in and it'll shut down on profitable service lines.
41:38
So, you know, I think the argument is being made that that will expand,
41:43
but there's no there's no guarantee or if there is a guarantee,
41:46
it's in the secret document and there's no guarantee to maintain either.
41:49
Has that been the case in Charlotte? Do they have significantly better mental
41:55
health services through Atrium in Charlotte than we're seeing at other hospitals?
42:00
Because I think of Charlotte as having a fairly significant mental health crisis,
42:06
like so many urban areas, particularly
42:09
where there's more people in North Carolina and in the country.
42:13
And those have borne out very publicly in the last year.
42:18
So have you heard anything about there being particularly more mental health services?
42:23
I have not, no, but I don't know exactly how Atrium's mental health services are in Charlotte.
42:30
Right. I haven't heard either, which makes me wonder, like, so upon which evidence
42:35
are we making this leap in logic that that's, I'm just curious,
42:38
because, again, I do think, Mr. Pope, you bringing that up, it would be a really fundamental point.
42:45
But nobody's offering.
42:47
Any evidence to base it against or any promises to base it against that anyone has seen. Yeah.
42:55
And that's unfortunate because there again, your marginalized communities are
43:01
the ones that's going to be impacted more so if the services are not there.
43:05
Holly Hill is just overrun with people with mental health issues.
43:09
And it's a revolving door.
43:10
These folks come in because they're trying to get out of the rain.
43:12
They got all kinds of reasons for coming in, but their mental health issue is really a concern.
43:18
So what are we going to do about that?
43:20
You know, and that is something that Atrium needs to, you know,
43:25
at least put out there. What are your plans for that?
43:27
You know, I'm just so done with all of this stuff about, you know,
43:33
we're really concerned about getting input from the community.
43:37
I've been on a number of projects that are happening in Southeast Raleigh.
43:41
And so one thing that I've made clear, if this is one of those,
43:45
things that you've already made a decision, but you're just going to have the
43:50
community meeting or whatever to check the box to say, oh, yeah,
43:54
we met with the community and we got their input. I've seen it happen too many times.
43:59
And so I've refused to be on certain projects where they say,
44:04
you know, we want the community input because I know the decision is made.
44:08
And that's normally what happens in my community in Southeast Raleigh.
44:12
Decisions are made. It's already a done deal. Now we're going to bring it to
44:16
the community so that we can say we had these community meetings and you had
44:20
the opportunity to speak up, but you didn't say anything because the decision
44:25
and people are getting discouraged about that.
44:27
And so I would like to see that there are more community meetings,
44:31
but on a larger scale, which is one reason we kind of organized this town hall meeting. That's great.
44:36
Because, and we had a larger place, we probably would have a lot more people
44:40
there speaking out on this.
44:42
It's just always my community, and when I say my community, Southeast Raleigh,
44:47
that seems to be left out of the decision-making.
44:51
And we're going to do what we want to, but we're going to listen to you over
44:55
here on the side. Tell us what you like, and we'll check the box and say, we met with you.
44:59
Yes. And it just bothers me. Yeah. It should.
45:03
Well, let's talk about a little bit in closing the meeting on Monday,
45:07
just the logistics and, you know, what we can do.
45:11
The meeting will be in the Wake County Justice Center at 2 p.m. on the second floor.
45:17
It says here you have to submit online your request to do public comments.
45:22
Is that the same for this hearing as well?
45:25
Yes. Okay. That is, yeah. And the link will be posted the morning of the meeting. Absolutely.
45:31
It opens at 9 a.m. and then it's open until the start of the meeting.
45:35
So you want to sign up as close to 9 a.m. as possible, but as long as you sign
45:38
up before the meeting starts, you're good.
45:39
And we'll share that link on our Facebook page to get people out to the meeting.
45:45
And do you expect a big cry? Is a lot of your group coming? Yes,
45:48
yes. We've already put it out there. In fact, we had a meeting on Sunday,
45:52
and I informed my men we need you there. We need you in your attire.
45:56
We need you to be visible.
45:59
I think there's going to be quite a few folks there because we're getting to
46:02
a point now where we realize the commissioners, they're listening,
46:06
they're hearing now. Whatever their decision makes, that's a totally different thing.
46:10
But we're voicing our opinion, and we have an audience now, so we need you to
46:14
really be out there and push it.
46:15
So I'm saying to as many people as can, it doesn't matter what organization,
46:19
what agency, come out and voice your concerns and be present so that people
46:24
will see this is not something that only a handful of people are concerned with.
46:29
There's a whole community that really is against this merger or this takeover. Yeah.
46:36
Well, thank you so much for joining us. Is there anything else we want to discuss or any?
46:42
No? We've come to the meeting. We've exhausted it. State employees and retirees in Wake County.
46:48
Please get to that meeting on Monday at the Wake County Justice Center at 2 o'clock.
46:53
Sign up at 9 a.m. online to speak because I know y'all have some stuff to say
46:58
about this, especially when well over $100 is coming out of your pocket just
47:03
because the merger goes through, according to the state health plan.
47:06
So don't forget that. This would cost you money and do God knows what to your services.
47:12
And even more than that, if you ever have to use Atrium when it does take over Wake Med.
47:18
And we'll have signs available for people if they would like to go in the meeting with signs.
47:23
We won't be able to hold them up, but we can at least march in the meeting.
47:27
So please, let's pack the courthouse. Let's pack the Justice Center so that
47:32
people can know that there's more than just a handful of people that are concerned
47:37
about this. There's a whole community. Oh, there is. Yes, it is.
47:40
And there's a lot of organizations that are in opposition to this takeover. Okay.
47:45
Well, thank you both, and you're welcome to come back to be on our podcast anytime.
47:51
We'd love to talk more about health care with you, Nathan. Yeah, absolutely.
47:56
We were talking before the podcast. We had a lot to talk about,
47:59
so maybe we can get you back on and talk about it. Health care policy.
48:03
Thank you. Thank you. Thank you for joining us. Yeah, thank you.