Greenville, UNC are at odds just like old times

Don’t mess with the leadership of the N.C. General Assembly. That seems to be the central message in a dispute between the legislature and Vidant Health, the corporation that operates the Greenville hospital depended upon by thousands of eastern North Carolina residents and by the East Carolina University Medical School.

The Pitt County Board of Commissioners poked its finger in the eye of the N.C. Senate, which responded not with a finger but with a fist. The Pitt County board claimed the authority to appoint all 20 members of the Vidant board instead of the eleven members (a majority, if you’re counting) they had been appointing. The state Senate had been selecting the other nine, and senators didn’t like anyone messing with their authority to control (or at least influence) things.

When the Senate’s proposed state budget was released, a $35 million Medicaid reimbursement to the Greenville Vidant hospital was omitted. Even in the stratospheric world of health care costs, that’s a big loss for a hospital. Vidant claims that revenue as its just deserts for being a teaching hospital for the ECU Medical School. Senate leaders say if they can’t appoint board members, the state will have no control over the management of the hospital and should not put additional state money into Vidant.

Legislative leaders have indicated they are so serious about this that they are willing to force the ECU Med School to cut ties with Vidant and build an all-new med school teaching hospital in Greenville at an estimated cost of $500 million.

As Raleigh columnist Colin Campbell has pointed out, few Republicans (who hold a majority in the Senate) opposed this power play, even those whose districts are served by Vidant-affiliated hospitals. One exception is Rick Horner, who represents Wilson and Nash counties. Vidant, feeling robust, had made aggressive moves in the Wilson market with new physician offices, health care services and strong public relations moves.

A Greenville TV station has reported that UNC has a secret plan to take over Vidant. UNC Health flatly denies the report. When I heard about this alleged conspiracy, I said, “Sounds like the ghost of Leo Jenkins.”

Jenkins, the legendary chancellor of ECU, grew that university to prominence partly by claiming that the entire state, and especially UNC-Chapel Hill and university president Bill Friday, was prejudiced against ECU. His perception was that no one west of I-95 gave a hoot about anything east of I-95, except the beaches (and then only for visits). He lamented the poverty rates in eastern N.C. counties, the out-migration of people from small towns down east, the poor-quality public schools, the lack of jobs, etc. surrounding ECU.

Jenkins’ salesmanship and determination greatly expanded ECU, but his “us against them” perception lives on long after ECU has expanded its undergraduate and graduate student populations and national recognition. The suspicion that a conspiracy led by UNC-Chapel Hill is out to destroy ECU lives on. Although an ECU alumnus is chair of the UNC Board of Governors, the heirs of Jenkins’ thinking persist in believing that the UNC board is aligned against ECU.

Besides the UNC board chair being accused of siding with the enemy (or something akin to that) and senators voting against their constituents’ health care interests, this whole episode seems bizarre. Refusing to give Vidant $35 million in Medicaid reimbursement while considering spending $500 million to build a new teaching hospital turns fiscal responsibiity on its head.

I’ve seen no reporting on whether the Pitt County board had the authority to change the composition of the Vidant board. If not, the whole issue, which is in the courts, might be moot. Pitt has submitted a “compromise” that looks a lot like a list of demands, but a sensible compromise should be doable. Let Pitt commissioners have their eleven appointees, or even twelve, and let the hurt-feelings Senate appoint the remaining nine seats or eight. You could even enlarge the board to 21 members and let Pitt County appoint twelve members.

Pitt commissioners aren’t going to win a poker standoff against a player who has all the chips.