Regent Koch Declares that UNMH is not a Public Hospital

This is a letter to University of New Mexico Regent Jamie Koch from Community Coalition for Healthcare Access (CCHA) Organizer Carol Anda and CCHA member Andru Ziwasimon MD that is currently being circulated.

At a recent UNM Regents meeting advocates from the community raised longstanding concerns about UNM Hospital (UNMH) policies and practices that have sent hundreds of thousands of patients into crippling medical debt over the last few years. By UNMH estimates there are over 300,000 accounts sent to collections each and every year.

In response to concerns raised, Regent Jaime Koch expressed his opinion loud and clear. “UNMH is not a public hospital.” He went on to point out that UNMH “doesn’t receive public money.” Mr. Koch has stated the same 3 years ago in preparation for the Governor's summit on UNMH.

With all due respect to Mr. Koch's personal opinion, UNMH is a public hospital. It receives over $82 million from Bernalillo County tax payers, $130 million in state tax support, $26 million in “disproportionate share” dollars from federal taxes, along with over $2 million in various other federal programs to support care for immigrants.

UNMH’s website for private donations begins its sales pitch by stating, “As New Mexico’s largest public hospital…” and goes on to note that “UNMH serves as the safety net for people in need of medical care.” Because of this effective sales pitch, UNMH receives millions in private donations from caring citizens.

There is no denying that UNMH is “privatizing” its programs, its doctors, its buildings, its lab, its collections practices, even it's real estate land base. This doesn't have to be negative. UNMH could use its market power to earn profits that support its public mission, thereby reducing its need to rely on the state to fulfill its original mission of caring for the poor.

But we are gaining an uneasy sense that Mr. Koch is saying something a bit more crass, implying that UNM Regents, as the final level of accountability, have no obligation to find solutions to such thorny issues as massive medical debt and an overwhelming collections burden placed on New Mexico patients and families. While political and administrative leaders deny the public mission in words, in budget projections and in long term planning, students, workers, clinicians, patients and the public invest in UNMH as the largest and most important public hospital in NM.

We in the community, along with advocate clinicians and staff working at UNMH, can understand the need for sophisticated messaging, which is needed at times to aim an institution towards better quality of care. There are negative stereotypes associated with “public hospitals” in terms of lower quality of care. Perhaps Mr. Koch is simply trying to distance UNMH from that perception. Mr. Koch. If you mean to make a sophisticated messaging point about public vs. private, you are missing your audience. You need to back up your opinions with action that brings UNMH to a higher level of quality for everyone who depends on it.

On the other hand, if you mean to state that UNMH has no public mission, that uncompensated care is simply a burden instead of a responsibility, you are wrong. Please clarify your position. UNMH is one of our greatest and most important public resources in New Mexico. Our community cannot afford leadership that leaves them in deeper debt in an economy that has little room for mercy. There is a mission mismatch occurring between a few steering the institution and those putting their hearts and souls into it.

Community Coalition for Healthcare Access (CCHA) Organizer Carol Anda CCHA member Andru Ziwasimon MD