The report was written by Jason McGahan, a researcher from the unions trying to organize a blue-collar union at the hospital. He works for the Hospital Debt Project of District 1199/SEUI. His report charges the hospital with a fundamental conflict of interest: Yale New Haven Health Services Corporation (YNHHSC), the hospital's parent company, owns 95 percent of Century Financial Services, the state's largest medical collection agency. So, the reports suggests, the hospital has a vested interest in hounding poor, sick people.

Click here to read the report in its entirety.

The new report also focuses on a second potential conflict of interest: Two of the subsidiary's directors also happen to work at Yale-New Haven -- and make decisions about collections.

One of them is William Gedge, a hospital senior vice-president.

"Gedge is responsible for the billing and collection departments of Yale-New Haven and Bridgeport Hospitals. David Wurcel is senior administrator of the billing and collection departments. This pair of top executives was ultimately responsible for Yale-New Haven Hospital’s charity care and collection reforms in the aftermath of the controversy," the report states.

The question of how Yale-New Haven pursues debts from poor and middle-class patients has dogged the hospital for years. The hospital says it has made dramatic strides in improving that process. Click here, here and here for background on the issue. Click here for information about how to get involved. Click here to read Yale-New Haven's side of this issue.

The report's conclusion: "Not only is Yale-New Haven Hospital an abusive debt-collector, it also owns the largest and most aggressive hospital-specific debt collection agency in the state, managed by the same men and women who serve as senior billing and collection executives for the hospital. In its quest to maximize the revenue from debt collection, Yale-New Haven seems to have left no stone unturned. Reason to question the hospital’s commitment to its charitable mission has never been lacking. But the Hospital seems to have succeeded in pushing the envelope even further beyond the bounds of civility, much less charity. Yale-New Haven Hospital will never reform of its own accord. The City of New Haven must step into the breach separating the low-income community from accessible health care."

William Gedge denied the charges leveled about both him and the hospital in the report.

"I'm not sure I would characterize it as a conflict of interest," he said.

Century Financial Services isn't "aggressive," Gedge said. It doesn't handle cases in which the hospital determines someone can afford to pay a bill but isn't. Lawyers do that. Century, he said, "sends out letters, and they make phone calls. This isn't a law firm. They don't have legal authority."

"Virtually all hospitals will refer an account to a collection agency," Gedge said. "The reason many hospitals participate and are part owners" of the company is to "pool resources and do it as one. I view it as purely an extension of the business office."

"I think people are growing very weary of these tactics," spokesman Petrini said. "People simply want to see this cancer center built without these tactics."

The union report's release comes a day before a special committee of the Board of Aldermen considers the hospital's controversial request. Disputes over traffic, parking, design, and community involvement have held up the proposal for a year. The biggest hold-up, though, has stemmed from a dispute between the hospital and District 1199 of the Service Employees International Union over the process for how blue-collar workers would choose whether to unionize. The fight has taken on the trappings of a political campaign, with the hospital investing heavily in billboards, telephone push-polls, and direct mail to New Haven residents calling on them to pressure lawmakers to approve the plan the way the hospital wants it.

A promising compromise offered by DeStefano failed to break the impasse. Wednesday night's aldermanic meeting, beginning at 6 p.m. at the Betsy Ross School, 150 Kimberly Ave., should signal whether a new compromise will emerge, or whether the fight will continue.