David Shafer: Healthcare Policy Nerd

I’ve never even heard of disproportionate share hospital funding.

A state senator who has become known as a fierce critic of certain practices and methods of operation at Grady Hospital now is questioning why Grady has lost money under a grant program intended to help hospitals like the Atlanta institution which care for a disproportionate share of indigent patients.

Sen. David Shafer, R-Duluth, complained in a letter to state officials that the federal Disproportionate Share Hospital (DSH) program is being misused as an


  1. Inside_Man says:

    Disproportionate Share Hospital funds are the state level manifestation of the Federal Indigent Care Trust Fund (like Peachcare is unto SCHIP). The distribution of funds is based on a set of criteria authored by a committee of hospitals from across the state and implemented by DCH. Like so many state funding distribution schemes, the formula is outdated. Definitionally, virtually all our hospitals now qualify as a “disproportionate share” provider and thus are eligible for DSH money. The Hospital committee is working now to revise the formula, so we will see what comes out of that. There is a desire on DCH’s part to allow the hospitals to amend the process themselves, but it remains to be seen that they will do right by Grady. The argument (alas, shades of CON) is that rural hospitals can’t do without the DSH money they have come to expect as part of their bottom line and could close if the state shifts the funding back to hospitals like Grady. Sounds like yet another good reason to fix the health care finance problem writ large. It has become apparent (to me anyway) that tinkering along the edges of our health care problems will not solve anything.

  2. Bill Simon says:

    David Shafer reminds me a lot of Eric Johnson.

    Several years ago, Johnson fired-off a letter to Shirley Franklin belittling the City of Atlanta’s request for state help in dealing with their immediate sewer system problem.

    A week or so after that letter (which was full of “NFW!” type of rhetoric), Eric turned around and became quite concilatory and his whole demeanor changed towards Franklin and the plight of Atlanta. In fact, he became Atlanta’s #1 lobbyist for getting the state to help the City of Atlanta.

    NOW, Shafer is following the same path on the subject of Grady. First, tell them to screw-off; then become their loudest advocate.

    I wonder which government relations specialist got ahold of Shafer’s ear?

  3. Harry says:


    Your doubt of Sen. Shafer’s motive needs adjustment. A good politician will attempt to define, communicate and propose resolutions. Until I see otherwise, I don’t believe any lobbyist “got ahold” of his ear.

  4. John Konop says:

    Until we all face the healthcare system is broken nothing much will change. All both sides are doing is putting band aids on a gushing wound ie SCHIP.

    The truth is we have a dysfunctional form of socialized medicine with no incentive to lower cost via preventive medicine.

    We have a system that punishes people who play by the rules and take personal responsibility by buying a good health insurance policy.

    We have a system that insurance companies can dump people and stick the tax payers

    We have a system that is making healthcare out of reach for most middle class families.

    Anyone who claims they are a VALUES VOTER and they put an issue like Gay marriage ahead of the health system that is bankrupting families and leaving parents and kids without proper care demonstrates the definition of hypocrisy!

    Ask yourself whatever religion you are what would GOD focus on?

  5. As I have said from the start, money alone cannot save Grady. It will require a combination of governance, contract and culture reform, and I am pushing forward on all three fronts.

    Regarding the Disproportionate Share Hospital program, Grady would certainly benefit if the funds were actually distributed to hospitals that care for a disproportionate share of the indigent. But the misuse of DSH funds is a bigger issue than Grady. One of the reasons that government spending is so difficult to control is that programs get hijacked for entirely different purposes than they were created.

    Grady or no Grady, DSH should be fixed. DSH or no DSH, Grady must be fixed.

  6. John Konop says:


    In all due respect this is a comment on my website, and I hear similar stories like this from people who bought heath insurance.


    So, with a nation facing real problems with the dollar, debt, foreign loans, a President that may ask for a trillion more over the next few years to fight a war with Iran as well as Afghanistan, Iraq and who knows where else, what is your solution?

    We can

  7. Bill Simon says:

    Hey, I read that PriceWaterhouseCoopers won a $23 million contract to figure out where Grady can save money. Grady will be fixed now thanks to investments like that, right?

  8. John Konop says:


    Since you banned any comments about Ron Paul on RED STATE is that the same rule at the PP?

    Attention, Ron Paul Supporters (Life is *REALLY* Not Fair).

    Effective immediately, new users may *not* shill for Ron Paul in any way shape, form or fashion. Not in comments, not in diaries, nada. If your account is less than 6 months old, you can talk about something else, you can participate in the other threads and be your zany libertarian self all you want, but you cannot pimp Ron Paul. Those with accounts more than six months old may proceed as normal.

  9. John Konop says:



    You think all Ron Paul supporters are liberals?


    Now, I could offer a long-winded explanation for *why* this new policy is being instituted, but I

  10. Chris says:


    I think Ron Paul supporters are kooks. You included.

    I find it sad to many Ron Paul supporters are kooks, because he is right that our federal government has grown way beyond bounds the Constitution limits it too.

  11. Doug Deal says:


    The reason he attracts kooks is that he doesn’t stop at what he says about the government, he continues to speak on things that go off the deap end.

    You don’t score many runs when all you do is swing for the fence in an all or nothing fashion. It takes work getting men on base by winning the small victories here and there.

    RP and his ilk need to realize that as long as others are pulling in the same general direction they can work together for the same end. But when the end is all you will accept, everyone will be pulling against you.

  12. John Konop says:


    I do not 100% agree with Ron Paul, but any rational person would not call him a liberal. As far as your insult at me I just consider the source. Chris you talk a big game about spending but you fall in line like a well trained dog at the end!

  13. Harry says:

    Dang, how can Grady spend $27 million on an audit? That’s ridiculous. On behalf of all beancounters everywhere, I apologize to all taxpayers in Fulton and Dekalb.

  14. Harry says:


    So PWC gets paid to propose various techniques by which feds and Georgia can be induced to bail out Grady? Just curious.

  15. Holly says:

    Because Ron Paul is the answer to everything that is wrong in 0ur state, Chris.

    I liked it better when Cynthia McKinney was the answer.

  16. Tommy_a2b says:

    I too am glad Sen Shafer is working to correct a real problem. Many politicos only try and fix pretend problems. I do not think Bill Simon is at all accurate with his statement, “I wonder which government relations specialist got ahold of Shafer

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