OUR FIGHT TO SAVE A COUNTY HOSPITAL
Privatization takes over a County Hospital, but people are fighting
back.
by Gregory Wonderwheel , Vice President, SEIU Local 707
North Coast's Sonoma County, California, is facing the nationwide
night-mare of privatization of public services, and local activists are
fighting to wake up from the bad dream. The County Board of Supervisors-without
financial or impact studies, without an appraisal, against the virtually
unanimous public opposition at so-called "public hearings," and
before an initiative certified for the ballot could be voted upon-signed
a commercial lease with Sutter/California Health Systems to turn over the
public county hospital to a private corporation. Fortunately, the countywide
initiative, Measure E, to be voted on in the November election, gives the
public the opportunity to take back their public hospital and force the
Supervisors to get public approval before any other attempts to close, sell,
or lease our County Hospital. The Supervisors could have put Measure E on
the March 1996 ballot, but they used a loophole in the law to delay the
vote until November 1996. During this time they consummated the lease and
turned over operation of the hospital to Sutter/CHS on March 25, 1996 in
an attempt to make privatization a fait accompli.
The first Sonoma County Hospital was established in 1866, the second in
1876 near its present location. Community Hospital of Sonoma County was
built in its current location in 1937 under the New Deal National Public
Works Administration. In the depression years, the construction of county
hospitals reached its zenith when the general public and the State and Federal
governments acknowledged the necessity for public health care for all the
public, including the poor and uninsured.
Nothing has changed in the last 60 years to reduce this need. Public health
officials estimate that 90,000 people, about 20% of Sonoma County residents,
have no health insurance-no private insurance, no MediCal or Medicare. These
people are not just the so-called "indigents"; they are our neighbors
and friends who are the working uninsured.
In 1993 the Board of Supervisors, after repeated demands by the public employees
union, SEIU Local 707, established a hospital Board of Trustees to oversee
the operational management of the hospital. But instead of allowing this
board to function, the Supervisors responded to private overtures from major
private health companies to take over Community Hospital and began the process
of privatization.
As happens time and again across the country, this process began as a call
for "affiliation" or "partnership" with a private health
care company to make the County Hospital "competitive" in today's
health care market. Then, as so often happens, after back-room discussions
the much-touted "partnership" turned out to be a commercial lease
which itself states, "Nothing in this Agreement shall be construed
to render County, in any way, or for any purpose, a partner, joint venturer
or associate, in any relationship with Sutter." There was no prior
public debate or discussion as to whether the County's residents wanted
to enter into such an agreement, and once the Supervisors announced that
privatization was their goal, it was opposed by the public at every public
meeting. However, the Supervisors continue to this day to call the privatization
and commercial lease a "partnership."
The current ballot Measure E on the November election was filed on July
31, 1995, to begin gathering signatures (22,000 registered voters signed
this initiative in record time to qualify it for the ballot). Instead of
waiting to see how the public responded, the Supervisors voted to authorize
a lease and to sue the supporters of Measure E. First, the Supervisors took
the legally unprecedented step of trying to prevent the gathering of signatures
by suing itself to keep from having to issue the required title and summary.
When that failed, they continued asking the court to remove the measure
from the ballot. Fortunately, the court refused to do so. Unfortunately,
the legal costs have drained the campaign of tens of thousands of dollars.
Measure E gives the people of Sonoma County the right to vote on any proposed
closure, sale, or lease of Community Hospital. Measure E will take back
our County Hospital so that public health care policy and practice will
be in the hands of the public where it belongs.
The Supervisors claimed-as public boards across the nation claim when turning
over public assets to private pockets-that giving the hospital to Sutter/CHS
would put the hospital in a better position to compete with managed care.
However, seldom does the lure of privatization live up to what it promises.
As Moshe Adler wrote in the NY Times (4/7/96), "Privatization has,
in fact, been the norm, not the exception, through much of [the last century]
in the country-and equally common has been the need for the government to
take over these services after failure by private providers." The LA
Times, (8/17/95) reported, "E. Richard Brown, director of UCLA's Center
for Health Policy Research, said the studies he is aware of show 'no evidence'
that privatization saves the public money."
A recent California example is the privatization of El Camino Hospital in
Santa Clara County in 1992. The cost savings/competitive market argument
was used when the district board of trustees turned over the hospital and
its assets to a private nonprofit group. The San Jose Mercury News, (8/17/96)
reported, "Under Camino Healthcare's first year of management, the
hospital posted a $17.7 million operating loss in 1995, the first time it
has been in the red in its 35-year history." That hospital district
is now suing to take back their public hospital. Alameda County also has
a Measure E similar to Sonoma County Measure E to make sure any privatization
plan is approved by the voters. Fortunately, their Supervisors were intelligent
enough to sponsor a task force to study health care issues and have not
precipitously rushed to privatize their county hospital.
Is Sutter/CHS the "proven" good partner which the Supervisors
claim? The Sutter/CHS conglomerate of interlinking profit-making and non-profit
corporations is set up to funnel profits to executives and to avoid taxes.
One change since Sutter/CHS took over our County Hospital in March 1996
is that mental health inpatient charges have been raised from $595 to $944
per day. Also hospital overall patient days are down under Sutter/CHS' "leadership,"
and we expect that if Measure E loses there will be massive layoffs due
to their poor management. In Marin County, California, voters are currently
trying to cancel the Sutter/CHS lease of Marin General Hospital for breaches
of the lease. Sutter/CHS has been indicted for fraudulent Medicare billings.
This is not the corporate "partner" Sonoma County or any other
public entity needs.
The Supervisors and opponents of Measure E use the scare tactic of saying
that Measure E "will cost taxpayers millions," but in fact they
have not spent one dime on a professional study of the costs of keeping
or giving up the hospital. Their claim is just unsubstantiated fear-mongering.
Since 1976, Community Hospital operated without a penny from the taxpayers!
Any costs now associated with Measure E are the responsibility of the Supervisors
wasting the taxpayers' money by entering into a bad deal without the voters'
consent.
The Supervisors and opponents of Measure E like to cite figures without
explanations. They say Sutter/CHS promises to provide "up to $38 million
in charity care, $12 million in lifesaving medical equipment" but don't
always point out that these are 20-year and 12-year figures respectively.
When we do the math, Sutter/CHS's "charity care" promise is from
$950,000 to a maximum of only $1.9 million per year, compared to the $3.9
million per year Community Hospital provided from its own revenues at no
cost to taxpayers (from audited financial statements ending FY 1992-1994).
During the same period Community Hospital provided $1.03 million per year
in capital improvements (what they call "life-saving medical equipment")
which is $30,000 more per year than the Sutter/CHS promise.
One hopeful alternative includes the building of a countywide "HMO"
style plan similar to Contra Costa County or the plan recently unveiled
in San Francisco. (See San Francisco Examiner, 8/14/96, Front Page.) The
proponents and supporters of Measure E, including SEIU Local 707, have consistently
called for a countywide health-care summit meeting to assess and plan for
public health-care policy in Sonoma County. A public-health task force-including
county officials, health care advocates, local business, hospital workers,
insurers, and taxpayer advocates-could be convened to draft a plan which
would combine Medicare, Medicaid, State CMSP, and small private businesses
into a single health-care package. Businesses need not be forced to participate,
but with tax incentives and good will they should be motivated to do so.
All alternatives need to be reasonably and realistically studied. Such studies
were never done when Sonoma County Supervisors rushed to give up our County
Hospital. Only local efforts will slow the process of privatization nationwide
and keep local public hospitals like Community Hospital in public hands.
As Rabbi Michael Robinson, one of Measure E's proponents, says, "This
is just another instance of the corporatization of our lives. Think locally.
Act locally."
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