What's at Risk if Measure A Doesn't Pass?

The very survival of the Alameda County Medical Center (ACMC) could depend on two thirds of voters affirming Measure A on March 2nd. Prior to knowing the outcome, various plans to restructure ACMC are being considered, due to the current burden of debt, and present an idea of what failure to pass Measure A would look like. On January 20th, Chief Operating Officer Judy Armstrong presented three scenarios of budget-balancing strategies to a joint committee of the County Board of Supervisors and the Medical Center's Board of Trustees. All three of these are incomprehensible to those who know the vital functions these services provide.

Imagine for a moment being given a tentative diagnosis of cancer, for example, and having no affordable access to an oncologist for a definitive diagnosis and treatment plan, because the one cancer clinic that took the un/underinsured in the county had closed. If you have no other resources to pay (for fees that are much higher if you're not covered by some form of insurance), you wait until the pain gets so bad that you go to an emergency room. The ER is backed up for many hours or even days, because everyone else without affordable health care has also waited to see a doctor until they can't function anymore.

The first scenario Armstrong outlined would create just this nightmare, by cutting the specialty care clinics within Highland hospital-cancer/oncology, lungs/pulmonary, heart/cardiology, intestinal/ gastroenterology, bone/orthopedics, and many more, leaving a "limited hospital" with few clinics referring patients.

Scenario Two would close the inpatient hospitals, Highland and perhaps John George Psychiatric and Fairmont Skilled Nursing and Rehab Facility, leaving some outpatient clinic services. This plan would mean the northern part of the county would have no trauma services; Highland Hospital's Trauma Center now sees 60% of all trauma cases in the county. This puts everyone even passing through Alameda County at greater risk of losing precious moments that can mean the difference between survival and death, by extending travel time and perhaps landing in an ER with less expertise than desirable.

Scenario Three would maintain a limited inpatient and outpatient system. The results would be even longer waits for specialty clinics (from 2-6 months now)-if they were kept at all; fewer hospital beds with more frequent diversions to other facilities, particularly during flu season; and half the number of county psychiatric beds, which are already in short supply.

ACMC Trustee Stan Schiffman said "The Supervisors said 'Show us how to completely eliminate the losses by June 30th,' which is why these scenarios were created. Neither of the first two scenarios are acceptable. If it is a hospital only, it can't survive, because you need the feeder systems (clinics) to keep the beds filled. We will continue to analyze what the appropriate size and mix of services should be. Our goal is to be able to reopen the freestanding clinics that were closed. The newest term is "right sizing"-adjusting so that you have the right services in the right place. " This would mean, for instance, that the hospital-based clinics that are not eligible for federal freestanding clinic reimbursements (FQHC) would be moved off site.

The trustees have hired Cambio Health Solutions, a "turnaround" organization, to work with the executive team to help make decisions of what to cut. The 18-month Cambio contract has a 30-day termination clause, should it be deemed undesirable to continue the relationship for any reason. The consulting group has agreed with some already-identified solutions, including paring expenses to the bone, pursuing payment from potential paying patients, and renegotiating contracts with physicians. They also determined in their first two weeks something known for years: ACMC needs to do a better job of funneling patients into Medi-Cal and other health insurance programs and soliciting co-payments for services.

Measure A Campaign Updates

"A half-cent for health care- we can't afford to do less"

Endorsements are pouring in, as well as $400,000 in campaign pledges, but we can't afford to leave one organization or voting individual uninformed about the importance of Measure A, which needs 66% approval to pass.

There are plans in the works for a candlelight vigil at Highland on Thursday, February 26th, and a major media event Friday the 27th in Hayward organized by Supervisor Gail Steele, hopefully with many supporters connected by long ribbons and balloons lining a major thoroughfare during commute traffic. This week the campaign billboards will go up, a direct mail piece was mailed to permanent absentee voters, and cable ads will air soon.

This is the most important local campaign (not including SB921, a statewide effort) Vote Health has worked on in years. If you care about maintaining a health care safety net in Alameda County, we need you to help in the few remaining days before the March 2nd election. There are numerous campaign offices throughout the county waiting to feed hungry phone bankers, give literature to people who enjoy talking to people at farmer's markets, and arrange speakers or facilitate endorsement gathering.

Click on www.MeasureA.org, or contact Neelam Pathikonda, Vote Health's organizer, (510) 290-1243 or pathikonda03@yahoo.com to find out how to plug in.

The 140,000+ uninsured and underinsured people in our county cannot afford the defeat of Measure A-none of us can.

SB921 Update-On Feb. 2, despite a rainstorm throughout the region, a meeting for organizations that have endorsed SB921 drew over 150 people to Sacramento to hear Sen. Sheila Kuehl kick off the campaign to pass the bill in the Assembly Health Committee this spring. In addition to lobbying members of the Health Committee, more city council endorsements of the bill are needed. In Alameda County, Berkeley has endorsed; and in Contra Costa County, El Cerrito has endorsed. Contact Sue Bergman, co-chair of the Vote Health Single Payer Committee, if you can facilitate an endorsement.

The new SB921 (Kuehl) Campaign Video was shown publicly for the first time on Feb. 2, and 75 copies were sold. It is a great educational tool to help spread the word about single payer and build support for SB921. Senator Kuehl actively participated in its production. The video can be ordered on-line by going to www. healthcareforall.org and clicking "SB921 (Kuehl) Campaign Video Available Now."

Since SB921 was introduced a year ago, Health Care for All-California (HCA) has used membership dues to pay for the production of the campaign video, build community forums and district office lobbying efforts statewide, and develop an ever-growing network of organizations to advance the bill. HCA now has more than 1,000 members in 22 chapters. Vote Health is HCA's East Bay chapter. Currently, HCA is conducting the 2004 membership drive. You can use your credit card to become a member of HCA (or renew your membership) by going to www. healthcareforall.org and clicking "Join Now."

Newsletter committee:
Newsletter committee: Nancy M. Friedman, Dan Hodges, Kay Eisenhower