None of the 22 Shriners children's hospitals has a billing department. Every child is treated for free. But a money crunch is forcing Shriners to reconsider its 81-year tradition of free care. Low interest rates and a three-year stock market slump have eroded the fraternity's endowment, which provides 90 percent of the hospitals' funding. Since December 1999, the endowment has decreased by $2billion, to $6.2 billion. Meanwhile, operating costs have soared. Administrators proposed closing as many as eight Shriners hospitals, beginning with the little-used Minneapolis hospital. But last week, delegates at the national Shriners convention nixed that idea and told administrators instead to study other solutions. One possibility is boosting the endowment's investment returns. If the stock market returns to 1999 levels, the budget problems would be solved. The Shriners also hope to boost fund-raising and cut costs.
Perhaps the most difficult option under consideration is to begin billing patients' insurance companies. The hospitals would not turn away uninsured patients or charge insured patients for expenses such as co-pays that aren't covered. But Shriners hospitals say they will be cautious about pursuing the insurance-payment option. They worry that doctors, who have the rare privilege of practicing medicine as they see fit, would have to justify their treatments to insurers. Doctors worry, for example, that HMOs wouldn't cover surgeries deemed experimental or would limit the length of hospital stays or number of therapy sessions. "We're not going to decrease the quality of care, and we're not going to turn away any patients that can be helped," said Lewis Molnar, chief operating officer of Shriners Hospital Corp.
In addition to its hospitals, the 500,000-member Shrine of North America is known for its colorful parades, distinctive red fezzes and playful Middle Eastern rituals. The Shrine opened its first hospital in Shreveport, La., in 1922. Chicago's hospital opened four years later. In the early years, the Chicago hospital mostly treated kids with polio. After polio cases dropped with the introduction of vaccines in the 1950s, the mission was broadened to include several specialties. Today, two-thirds of the hospital's patients have cerebral palsy, a condition that occurs during infancy and causes abnormal motor control. The 60-bed hospital also treats spinal cord injuries, cleft lip and palate deformities, clubfoot, curvature of the spine and spina bifida. It is perhaps the world's leading hospital in treating rare brittle bone disease. There are 500 kids on the waiting list.
| The Shriners, if you're not familiar with them, are the guys with the funny hats you see at small town parades. Occasionally you'll find them at conventions, drinking beer, cracking jokes, and sometimes pinching cocktail waitresses. I've never read about a Shriner being arrested for dipping into the till. Sanctimony, Incorporated, tends to ignore them, belittle them, or make fun of them, because they do things for untrademarked Children and most of them are businessmen or retired folks. When they come by shaking the cup, kick in generously. And if you have the time and you're an extrovert, join them. |
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