Comments on: Hospital board talks seismic planning

By: H. Ewert

H. Ewert — Sun, 28 Mar 2010 03:32:39 +0000

Thank you Elliottg!! I really wish more people would understand the hospital situation.

By: elliottg

elliottg — Mon, 08 Mar 2010 18:28:29 +0000

You would be hard-pressed to find a District with a parcel tax as high as ours, never made a profit (without misleadingly counting the subsidy), as small as ours, as insular as ours. Of the Hospital Districts in the Bay Area, two have zero parcel tax. I believe West Contra Costa’s is about 1/2 of ours and they started out in more dire straits and have been more proactive. San Leandro and El Camino don’t have a tax. The truth is that Healthcare Districs throughout the state are very happy NOT running hospitals, but not this one. They are bound and determined to waste money in a futile effort to keep the doors open. Keep in mind, there is no healthcare need for Alameda Hospital to remain open. It provides lower quality care at a higher cost. That certainly is not a popular view with the Board and probably wouldn’t resonate with the public no matter how much proof you bring to bear.

By: Jan

Jan — Mon, 08 Mar 2010 16:42:28 +0000

I understand quite well how the district works. And you’ll be hard-pressed to find a hospital board that puts itself out of existence unless there are extreme circumstances. But the public process allows for members of the community to organize and argue their point of view with the board. This happens all the time in other communities (look at Marin General).
If you want to discuss further, feel free to email me: mail@janwrites.com.

By: elliottg

elliottg — Mon, 08 Mar 2010 04:42:08 +0000

Jan, I think you misunderstand the governance structure of the Hospital. The Board has total control subject only to the limitations of the original District proposal approved by the voters and state law. The only check or influence anybody else has is the degree to which they can convince the Board or influence the election of Board members. The Board has shown itself to be incapable of listening to anything that deviates from it’s internally generated party line that the Hospital MUST survive. The current Board is not the kind of incompetent that the original Board was, but that doesn’t mean they can bend reality by sheer willpower. The Hospital is doomed and, you can believe me or not, but the quality of care at Alameda leaves much to be desired. I would never willingly allow a family member of mine to go there. When the AFD recently applied unwarranted pressure and a family member of mine arrived at the Hospital ER, I kicked myself for allowing them to go against my explicit instructions (and got them to Kaiser ASAP); I may still report the ambulance crew to the State. I saw firsthand the low quality care. Again, just like with the Board, it’s not the fault of individuals; these people are good people trying their damdest in most cases, but institutionally (too small, too few beds, no critical mass of expertise) the Hospital is incapable of giving the best care and incapable of sustaining itself financially (too small, too much overhead, too many fixed costs).

By: Jan

Jan — Sat, 06 Mar 2010 18:54:21 +0000

I’m not going to get too opinionated here about the hospital’s future in case I write about it again as a journalist. But there are plenty of ways to influence the process besides being on the board. That’s the point of it being a public hospital. If the only people speaking knowledgeably in public about ways to maximize the public investment in the hospital are on the board or administration of the place (and therefore with a natural inclination to maintain the status quo) then you can’t expect substantive change. Elliott, you raise interesting questions and should pursue them. I would just hope the debate centers on real questions of what Alameda gets for its investment and how the hospital can maintain 21st century quality of care in all the service lines it is attempting to offer. Alameda has some pretty smart health care nerds lurking out there…maybe some would be willing to express an opinion.

By: elliottg

elliottg — Sat, 06 Mar 2010 05:45:21 +0000

One other thing about the insularity of the Hospital Board. To my knowledge, no Board Member has ever been elected as anything other than an appointed incumbent. In addition, no appointment has ever been given to anybody who was not recruited by a Board Member including this last one where Leah Williams was appointed. If I hadn’t expected it, I would have been insulted and felt very sorry for Mr. Oddie (even though Robert Bonta had asked him to apply, Mr Bonta had not explained the process was rigged) who was not aware of how these things are done and thought he had a chance.

By: elliottg

elliottg — Fri, 05 Mar 2010 05:29:54 +0000

Alameda Hospital should be shut down. The facility can be converted to a SNF which does not need to be seismic retrofitted. The hospital itself is too small to sustain itself and provides relatively low quality care. It doesn’t have the staff or facilities to provide the best lifesaving care – no cath lab, no stroke center, radiology and lab relatively slow, etc., etc. The argument that the island’s population would be vulnerable in the event of an earthquake is not plausible especially given the 5 million dollars a year could fund a contingency plan of a fleet of helicopters to ferry the sick and wounded off the island if the worse happened. Given the original governing documents that formed the District capped any single item budget allocation at 10,000,000, it may not even be possible to fund the seismic retrofit without weaselly legal workarounds. When the District was formed there was an option of doing something different than shutting the Hospital down with planning, but now 40 million dollars later 8 x 5 million/year and the Hospital still losing money, there is no reasonable alternative. I’ll bet any Hospital Board member 10,000 that the hospital will be closed in 10 years. Why should we pay the parcel tax as it goes through its death struggles and the Board complacently insists that there is no real problem, just challenges. The right thing to do is to make a plan to close the place now instead of having events overtake us.

By: Jan

Jan — Thu, 04 Mar 2010 15:44:46 +0000

Elliott, I know you’ve been following the hospital’s situation for awhile now. Would be interesting to hear what you think they should do with the place.

By: elliottg

elliottg — Thu, 04 Mar 2010 00:55:37 +0000

With all due respect Jan, attending the meetings is useless. The Hospital Board has never done anything except drift from crisis to crisis.

By: Jan

Jan — Tue, 02 Mar 2010 23:05:31 +0000

I would encourage anyone interested in this issue to attend the hospital board meeting. They don’t get a lot of public participation but seem quite open to it.