Bob Campbell: The Case for Measure C; the funding for Doctors Medical Center

blogimage.jpgIt has been more than a year since I have written anything dealing with politics, locally or otherwise, so I thought I would pen a few words on a major issue taking place in West Contra Costa County, the potential closure of the Doctors Medical Center in San Pablo, California. 

The Doctors Medical Center (formerly Brookside Hospital) was created as a tax supported district hospital over a half of a century ago and for the most part has done an outstanding job, especially given the circumstances under which it has had to operate. The original supporters for the creation of the Doctors Medical Center, and those  who have followed, noted that West Contra Costs County could not function as a viable community in which its citizens could live, work and recreate if it didn’t have the institutions that provided for a quality of life, chief among them a hospital. 

Before I continue I want you to understand that I know that the general public (tax payers) is tired of having to vote in every election cycle for some kind of a bond (School, College, Water, etc.) parcel tax or benefit assessment districts (I own three properties myself) and there is always some merit in saying enough is enough because they have seen their combined tax bills go through the proverbial roof. But there are some instances when an issue is so important that one has to stand up and say; “wait a minute” let’s stop and take a close look at what might happen if a Parcel Tax measure fails; Measure C is such an issue.

Other kinds of tax measures or bonds, principally school bonds, are as important as any and if the general public occasionally votes one down the situation isn’t life or death. Sure buildings won’t get painted as often as we would like and there might be some overcrowding in some of the classrooms, but the school district will continue to function and can deal with these problems with a later school bond or with other potential sources of funding.

Virtually all publicly supported programs are supported in great part by taxes. Take local transit agencies like AC or Muni in San Francisco, the fares the public pays that use them generally only cover between thirty five to forty five percent of the operating costs, the rest are subsidized by those of us who drive automobiles and buy gasoline or pay for bridge tolls, a percentage going to mass transit in hopes of keeping people off of the highways; there are very few public programs that are totally funded by those who use them.

Urban hospitals like Doctors Medical Center in San Pablo are required to take anyone who shows up at their emergency centers and are never compensated for the entire costs associated with their care. I was told that eighty seven percent (87%) of the patients Doctors Medical Center sees every year are either Medi-Care of Medi-Cal, which means they are paid for by the government or have no insurance whatsoever. This means when the hospital bills for a thousand dollars they might be lucky to get reimbursed $350 to $450 and sometimes even less. During years past most of the urban hospitals were able to bill private insurance carriers for the medical care their clients received, but there are fewer and fewer private providers these days because a full thirty five percent of Californians have no insurance and another twenty percent or more of working Californians are under insured. Obamacare will take care of some of this and in time reimbursements might catch up to the actual billings, but until then we are stuck with the present system. In spite of all of the underfunding that Doctors Medical Center has had to endure they have been able to attain and hold the designation of a Class A hospital.

Because of the above Doctors Medical Center has been incurring debt at the rate of over one million dollars per month, or an estimated sixteen million dollars this year; had Doctors Medical Center received only half of what they weren’t reimbursed by the government, they would have had no debt whatsoever. The passage of Measure C will mean that Doctors Medical Center will receive enough to run the hospital for the foreseeable future ($20 million per year).

The extra $20 million raised by Measure C (parcel tax) will do another thing for the Doctors Medical Center; it will make them more attractive to other larger institutions that are looking to affiliate. The simple fact is that today standalone hospitals are a thing of the past. Today almost all of the major hospitals are a part of a consortia or group that provides their members with greater purchasing power and expertise. Many district and other types of hospitals are associating with teaching hospitals like Stanford and UCSF and in some cases with county hospitals. The same is true with doctors as well; many doctors are now choosing to join alliances or groups so they can provide better and broader care for their patients.

You will undoubtedly be receiving mail to vote no against Measure C because of the afore mentioned reasons and they will probably be from some landowners, who generally don’t live in the community and have adequate health coverage to pay for their visits to more upscale private hospitals, which most of Doctors Medical Center’s patients wouldn’t be able to afford (private insurance providers generally reimburse a higher percentage of the amount billed than do Medicare and Medical). Their mail might also tell you that Kaiser’s emergency facilities can handle the emergency room traffic if Doctors Medical Center were to close down. While Kaiser runs a great medical facility they can still only handle 30 to 40 percent of the existing emergencies with Doctors Medical Center taking 60%. My wife took her mother to the Kaiser emergency center last week and she was there for seven and a half hours, let me say that again seven and a half hours.

During my almost twenty two years of elective office, representing Wests Contra Costa County (five and a half as a Richmond City Councilman and sixteen years as a State Assemblyman), the issue of proper funding for hospitals, schools, colleges, universities, child care, in home supportive services, public safety as well as most programs dealing with public assistance of some kind has been a major issue because all governments (federal, state and local) have not had sufficient funds to keep up with the needs of a population that is living longer and requiring more and more assistance, at a rising cost per hour for that assistance and the new technologies and inventions that go with it. This has forced our citizens to make tough choices on what our priorities should be and then vote to fund them; I can’t believe there can be any higher priority in West Contra Costa County than keeping Doctors Medical Center open.

The fact that the Doctors Medical Center Board of Directors has tried virtually everything possible to keep the hospital open in itself says a lot about them as leaders and the community as a whole. As a state legislator I served on an agency called the State Allocation Board, which was created by the state legislature, to set policy and direction for the dispersal of voter approved school bonds to local school districts. Because there was always more need than funds we were to devise a methodology in distributing those bond funds to the most needy and those who did the most to help by either passing local bond measures or creating other funding instruments (developer fees, certificates of participation etc.). Needless to say those that did next to nothing received next to nothing. The moral of this story is that in time there will be funding instruments created by both the Federal and State Governments to assist local district hospitals and they will be looking at what the locals have done to help themselves. I can recall vividly, the statement by one of my colleagues on the board, a state senator, saying to a representative of a local Southern California School District, whose county voted against a recent bond measure, “why should we fund your program, didn’t your county vote against the bond?” Obviously the senator’s question was rhetorical and unconstitutional, but nonetheless was the sentiment of many who hold public office and vote on programs that fund our projects.

I could go on and on, on the importance of voting for Measure C but I am sure you will be receiving a lot of mail, phone calls, e-mails and other social media blitz’s on this issue with why you should vote for Measure C and some on why you shouldn’t vote for it. I can only hope that when you review all of the facts that you will continue on in the same vein as did the original visionary supporters and the succeeding decades of supporters of having a district hospital to serve the citizens of West Contra Costa County.

A society will always be judged by how it treated its citizens especially it’s young and it aged. Before you vote think about the importance of having an emergency room that can handle your child who might have accidently swallowed some poison…an older person who might have fallen down the stairs and broke a leg…a worker who might have been severely injured on the job…a family member who might have been severely burned in a fire…or heaven forbid a massive disaster like the recent explosion at a nearby petroleum company that sent thousands to Doctors Medical Center. And don’t forget about the hospital as a whole, over 80,000 patients visit DMC every year, represents 79% of the patient capacity for West Contra Costa County and 59% of the emergency care. Finally don’t forget the Richmond Cancer center, said to be one of the finest in Northern California, of which I can personally attest.

Bob Campbell is a former member of the California State Assembly.  He represented the 11th District from 1980-1996.

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