The Trust pays the Denver-based National Civic League more than half a million dollars per year to administer the healthy-communities program. It is also paying a team of researchers to evaluate the initiative, led by a "social ecology" professor from the University of California at Irvine.
Critics of the Trust say such expenditures are inappropriate at a time when thousands of Coloradans are without health insurance and community clinics are closing for lack of funds. "The Colorado Trust is not using its dollars to support clinics and other services," says Boland. "The dollars for those services are diminishing. The Trust's funds aren't being dedicated to funding health care."
Trust officials insist they have provided funding for community clinics and other direct health-care services. They say critics like Boland don't understand that it would be impossible for one foundation to cover the health-care needs of Colorado's uninsured.
"Government should be taking care of the medically indigent," says Konrad, vice president of the Trust. "If we used our money to pay for that, it would all be gone. How long would our $300 million last in caring for them? As much money as we have, it's a drop in the bucket."
Konrad says the Trust is trying to get at "root causes" of problems, funding experimental programs that wouldn't happen otherwise. "We're the venture capitalists of the nonprofit world," he says. "The medical profession doesn't have time to focus on keeping people healthy. That's what we're trying to do with the Healthy Communities Initiative. We don't have enough money to take care of all the sick people in the world."
A similar philosophy appears to guide the Rose Community Foundation, now Denver's second-largest charitable trust. "To say that a hospital conversion should put all its money into health, to me that's too narrow of a vision," argues foundation president Don Kortz. "When you look at health in a macro sense, I see kids not being educated and hungry. I have a hard time saying that's not part of the health of the community."
The fact that Rose was founded as a direct result of ethnic discrimination has brought a special focus to the question of the new foundation's proper role. After an extensive period of soul-searching, the foundation board decided to focus on five areas: education, the elderly, health of the community, children and families, and Jewish life. The foundation has been criticized in some quarters for taking its time in getting under way, but Kortz says the first major grants will be made later this year.
The next big foundation to arrive on the local scene will be the one founded by Blue Cross Blue Shield of Colorado. After witnessing the controversy in Ohio and California, the Colorado Blues decided last year to ask the state legislature to set up a public conversion process. The law, which won the support of both Blue Cross and consumer groups, calls for insurance commissioner Jack Ehnes to determine the market value of Blue Cross. The Blues received a lesson in what public oversight means last spring, when Ehnes shot down a plan to give Blues executives bonuses after the conversion.
Hearings on the Blue Cross conversion will be held around the state beginning in July. Ehnes will set a value on the company later this year. The Blues have proposed funding a pair of independent community foundations with the money paid by Blue Cross. As much as $300 million may flow into the charitable trusts, whose boardmembers would be appointed by Governor Roy Romer.
Health-care activists want to make sure the foundation or foundations that emerge from the sale of Blue Cross will reflect the health plan's origins as a service to the poor and uninsured. Instead of boards dominated by establishment types, they want to see people with diverse backgrounds, including those from outside the health-care industry.
"The guys who are running the health-care show are failing us, so the hell with them," says Robert Danknich, a Gray Panthers activist who is involved in the coalition now monitoring the Blue Cross conversion. Danknich says a foundation board that breaks away from the mold and includes everyday people will be more likely to fund innovative programs. "There are probably 100,000 children in Colorado without health insurance," he says. "We've got to have some earthshaking changes in how we deal with health care."
If Father Mulroy were still around, he'd probably be distressed by the new reality of health care in Colorado. As nonprofit hospitals and health plans--including his beloved Blue Cross--are converted into profit-seeking companies, doctors are pressured to cut costs, patients are tossed out of hospital beds as quickly as possible, and thousands of Coloradans are still without health insurance.
And just as demand is increasing for services at places like Clinica Tepeyac, funding is being cut back. Several other low-income clinics around the metro area, including Clinica Campesina in Westminster, are turning away patients for lack of funds. Last month, the Westminster clinic's director told reporters, "There's no room at the inn."
But for those with an invitation, there's still plenty of room at the inn. Columbia posted record profits of $1.5 billion last year. Fourth-quarter earnings alone were $414 million. The corporation recently announced it would pay $1.12 billion in cash to buy another health-care company. It also said it would buy back $1 billion of its own stock so it could guarantee its shareholders a 15 percent increase in earnings per share.
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