Metro-Atlanta legislators looking for support from their rural colleagues for commuter rail have always pitched it as part of a planned inter-city network of passenger rail lines.
That way, voting for a project of direct interest only to the Atlanta region could benefit the farthest corners of the state.
The same dynamic is now at work as legislative leaders attempt to convince even the most rural lawmakers that it's important to save downtown Atlanta's Grady Memorial Hospital from financial ruin.
House Speaker Glenn Richardson, R-Hiram, set the tone by suggesting that the state could help by imposing a 911 surcharge on phone bills to fund the statewide trauma care system, including Grady.
"If there's anything positive that has come from the problems with Grady, it's that it has brought more attention to the statewide trauma care crisis," said Kevin Bloye, spokesman for the Georgia Hospital Association.
The GHA worked with Sen. Cecil Staton during this year's legislative session on a bill creating a commission to oversee a network of trauma care centers throughout Georgia.
A legislative study committee co-chaired by Staton, R-Macon, had brought to light the shortage of trauma centers in some parts of the state. Of particular concern was the lack of a Level 1 trauma center along heavily traveled Interstate 75 south of Macon.
While lawmakers passed Staton's bill, they didn't see fit to fund the effort.
But that was in April. Last month, a Metro Atlanta Chamber of Commerce task force warned in a preliminary report that unless Grady received a major infusion of funds, it would be forced to shut down.
The state's largest public hospital has operated at a deficit since 2000. According to consultants, Grady lost $67.3 million last year and could lose twice as much this year.
Staton said all of that red ink may be what it takes to get the General Assembly moving on trauma care.
"It's often the case that a crisis has to occur before legislators or politicians take action," he said. "I hope the situation at Grady will accentuate how serious the situation is in Georgia."
Grady's plight clearly has caught the attention of Richardson and other metro-Atlanta lawmakers.
Richardson named three House members from the Atlanta area to the special committee he created two weeks ago to examine Grady's finances and develop a plan to keep the hospital open.
The panel will be chaired by Rep. Sharon Cooper, R-Marietta, and includes Reps. Melvin Everson, R-Snellville, and Pam Stephenson, D-Lithonia.
Hospitals across the metro region would be the first affected if Grady were to close. Grady serves more indigent patients than any other hospital in the state. Without Grady, the vast majority of those non-paying patients would end up at other area hospitals, placing a financial drain on those facilities.
But Grady's fortunes also affect the entire state.
Richardson said most of Georgia's medical residents train there.
Grady also has one of only two burn centers in the state and the only poison center.
In keeping with that reality, two lawmakers from outside of the Atlanta region also will serve on the House committee: Reps. Ben Harbin, R-Evans, who heads the budget committee, and Penny Houston, R-Nashville.
Stephenson, who also serves as chairman of Grady's governing board, said the chamber report served as a wake-up call for the General Assembly.
"I think for most of the legislators, understanding the importance of Grady has just now taken flight," she said.
While sympathetic toward Grady's plight, Gov. Sonny Perdue is emphasizing the hospital's need to change the way it operates.
Indeed, the final report issued by the task force on Friday called for reorganizing Grady as a nonprofit.
"Every other urban hospital authority in Georgia has become more financially stable by updating their corporate structure," Perdue said Friday in a prepared statement.
The governor, too, made the linkage between Grady and improving trauma care statewide in his statement.
But Staton warned that it may be easier to set up quality statewide trauma care than to fix Grady.
While he was seeking $85 million this year to jump-start the trauma care network, the report from the chamber said Grady needs an estimated $370 million to achieve a two-year turnaround, plus $50 million a year to cover the annual operating deficits it rolls up serving so many uninsured patients.
"If we came up with the $85 million we were hoping for, all of that wouldn't solve Grady's problem," Staton said. "Their issues are far larger."
E-mail Dave Williams at firstname.lastname@example.org.