Conflict Between County Supervisors and ACMC Trustees

The County Board of Supervisors is continuing to punish the Alameda County Medical Center for its $45 million deficit. They do not accept the main reasons for the deficit: A leap in numbers of patients who have no ability to pay (unemployment is particularly high now in the Bay Area, 6.6% in July), devastating cutbacks in state and federal funding, and the destruction of programs specifically meant to fund "safety-net" hospitals.

We've got a huge state (and county) deficit, and a Republican administration that believes tax cuts for the rich will solve all our problems, while asking for $87 billion to rebuild a country we just destroyed. How more hostile an environment could there be for a hospital system dedicated to serving the health needs of people who can't afford to pay?

The latest slap to the Medical Center came when the Supervisors dismissed CEO Ken Cohen from the Board of Trustees that governs ACMC. Three supervisors had people they wanted on the Board and there were only two openings, so guess who got the boot? They were also going to axe the only staff representative on the board, Dr. Ted Rose, but a strong plea from Jim Mittelberger, a long-time advocate and physician at Highland Hospital, stopped that move for the moment.

Some Supervisors say there's no accountability at the Medical Center. But replacing individuals whose careers are dedicated to its survival with new board members with little or no prior experience of running a public hospital is not the best way to move the institution forward. We believe the public will pass a ballot initiative to support this desperately needed institution, but they must believe that the money will be used wisely and be spent only for health care services. The Supervisors must lead in this confidence building and support to accomplish this.

The Medical Center has had many changes in leadership over the years, and few of the Chief Executive Officers have enjoyed the confidence of all the important players: Medical staff, employees and organized labor, county elected officials and the community. A new coalition including Vote Health, the three Service Employee International Union locals (health care workers plus other workers), Health Access, and additional local organizations, have expressed confidence in CEO Ken Cohen, who took the position in June, 2001. One of our demands is that the Medical Center be kept intact-no reduction in services-and that the administration be supported, not dismantled.

Vote Health is hoping that the language for the proposed ballot initiative, being developed through Supervisor Nate Miley's office, will be ready in October, and that it will be worded to achieve enough financial support for ACMC to stay on solid ground. We need financial support and help from everyone who is committed to the survival of the Medical Center to launch a campaign: First, we want the vote of all our County Supervisors for a March, 2004, ballot initiative to fund all services of ACMC; then we must educate the voting public throughout the county on why it is in everyone's interest to vote for it! Please contact us if you, or an organization you belong to, agree and can help.

Patient Dumping Legislation Dumped by Bush

It just got even more dangerous to be uninsured and ill, or need emergency care. The Bush administration has decided that the 1986 Emergency Medical Treatment and Labor Act, or EMTALA, was too great a burden for hospitals that participate in Medicare and offer emergency services. In typical Republican distaste for regulation and embrace of "corporate responsibility," this hard-won legislation is now more profit-making "friendly," and worse for patients.

EMTALA basically stated that if a patient shows up at an emergency room or clinic and proves to have a medical emergency, the hospital has to provide treatment to stabilize the patient's condition. This meant having backup specialists such as neurosurgeons on call, and admitting the patient to the hospital if necessary in the course of stabilizing the condition.

Unfortunately, not even the experts understand exactly how the new rules will change the system, but this much is clear: Patients will find it more difficult to obtain certain types of emergency care at some hospitals or clinics that hospitals own and operate. For instance, hospitals need not have specialists "on call" around the clock. Although specialists can be expensive and difficult to schedule, having access to them can mean the difference between life and death for some types of medical situations.

Even more important, the rule saying that hospitals have to examine and treat people who require emergency medical care, regardless of their ability to pay, is being "relaxed." During the 1980's, Vote Health was a major force in the two year campaign to pass strict legislation in California banning what is known as "patient dumping." Stiff penalties we given to hospitals and physicians who turned away emergency patients who did not have the ability to pay for services.

This landmark legislation, AB 214 by Assemblyman Burt Margolin, was made into law as Chapter 1225 of 1987. It took effect in January of 1988 and has saved many lives in the 15 years since then. Vote Health also worked closely with our local Congressman Pete Stark, who was the author of the federal statute now under attack.

SB2 Passes, SB921 Parked Until February

Governor Davis announced he will sign SB2, the "pay or play" bill that would insure up to one out of 7 million uninsured Californians through their employment. It was not opposed by insurers or hospital groups, and the CA Medical Association endorsed it. Considered "a modest proposal" at best by single payer advocates, SB2's passage won't necessarily hurt our campaign. However, we will be fighting against the insurance giants, since they will cease to exist under a single payer plan. Then we'll have health care for all, not denials and paperwork!

Newsletter committee:
Nancy M. Friedman, Brad Cleveland, Kay Eisenhower
Our thanks to CA Nurses Association for their help in producing this newsletter.