Sunday, January 23, 2011

My View of the Healthcare District

I have been following the Hospital since I first applied to be appointed to the original Board in 2002.  At that time, the Hospital was losing significant amounts, but had a strong balance sheet and almost no debt.  I was somewhat ambivalent about the District, but persuaded by the arguments regarding the isolation of the Island along with a (mistaken) belief that the subsidy was intended to be a short term fix so that the long-term structural problems could be addressed.  At the time, the supporters of the Hospital estimated that seismic retrofit would cost about $1 million.

At the first meeting in 2002, it was surprising to find the Hospital was in much better shape financially than the voters had been led to believe.  Nonetheless, the Board voted to impose the full amount of the parcel tax.  (I spoke at that first meeting asking them to evaluate the needs of the Hospital rather than just imposing the maximum tax.)  This approach continued for the next 8 years.  No non-incumbent was ever publicly elected to the Board.  In 2008, the number of candidates running were equal to the number of seats so the race did not even appear on the ballot (and some new blood was added in the person of Mr. McCormick, but Mr. McCormick is intimately tied to the political power structure in Alameda so it's unclear how new his perspective was).  To my knowledge, no vote until after my election to the Board has ever been by anything but consensus and if anyone wants to correct me, I'd love to hear about whatever issue actually caused any kind of controversy.

The appointment process during this time was just as sclerotic (thank you Steve Rogers for that word).  Jordan Battani talks about how that process was a transparently open and robust debate, but I have a different opinion.  For example, within 2 minutes of hearing Leah Williams begin her presentation back in 2009, I knew that she had been pre-selected to be the appointee.  James Oddie was sitting right next to me; I think I wrote a note to him that indicated who I thought would be selected.  I felt sorry for Mr. Oddie because he had been induced to apply by Rob Bonta, and I think he thought he had a chance, but the cards were stacked against him.  I had no illusions and was simply being quixotic when I applied.  Stewart Chen, the only person who had pulled paperwork before the Board decided to extend the deadline, had no chance to be appointed at that time.  He, along with me, are now both sitting members.

The major issues facing the Hospital have not changed since 2002 and I have detailed them in previous posts.  The things that have changed most remarkably are three things.  Standards of care consistently move forward requiring new resources of both the financial and human variety to keep pace (which the hospital is in no position to accomplish easily).  The financial picture of the Hospital has deteriorated significantly as evidenced by the fact that there was only $72,000 in cash at one point this year.  The seismic requirements have not been met and, it appears, cannot be met by the legally mandated deadlines.

Based on the above, there is no way that I would vote to form the Healthcare District today.  Whether I was deliberately misled by the campaign in 2002 or history just took an unfortunate course, circumstances have changed radically.  The majority of the Board (and several previous Board members) have suggested that great deference is due the 2002 vote, but given what has happened over the last eight years and the misrepresentations (perhaps unintentional) made in the original campaign, I think that is mostly an argument that is simply used to justify their prejudice.

If you have read this far, then perhaps you are interested in an actual discussion rather than loathsome personal attacks.  I welcome alternative viewpoints in the comments.

1 comment:

  1. I don't recall how I voted in 2002, probably for it. But I certainly didn't know then what I learned over the last 7 months from its own public documents; namely that AH cannot be made seismically safe 10 yrs from now, given any amount of money. Yet, according to California's Health Care Districts, the parcel tax will continue! The AHCD will just have to decide on a different way to spend the money. Had that been made known to the electorate, the vote outcome mya have been quite different.

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