Time for a local march
EDITOR: Around the world on January 20, 2018, there will be many demonstrations protesting the actions and policies of the current inhabitant of the White House and Republican Congress. The big cities of the world will be hosting these marches and demonstrations.
Question: How can we have a local march/demonstration right here? We could have our own Sebastopol march. And, those who can’t march can stand on a corner with a sign. It’s time to be heard. Many retirees’ and seniors’ issues are Social Security, Medi-Care and Medicaid. Someone has to march for all the seniors in rest homes who are on Medicaid. Think of all the voices who are never heard.
Kathy Fong
Sebastopol
Defend the Constitution
EDITOR: Trump crowed on to his so-called “base” two weeks ago, signing away health care for more than 13 million lowest earning American citizens. Like Homey’s boss Mr. Burns, owner of the Springfield Nuclear Power Plant in The Simpsons, Trump is looking forward to more cheating, money grabs, and sexually abusing young women. Next on his list will be to gut Social Security and Medicare.
This tax revision was Trump’s Christmas gift to billionaires including himself. Those with annual incomes over $418,400 can count on their income tax rate dropping from 39.5 percent to 37 percent. On January 1, 2018 the multinational corporations tax rates dropped from 35 to 21 percent. Gone from the middle class are deductions for medical care, mortgage payments, and payment of local and state taxes.
Simultaneously this latest tax revision will eventually bring misery for many; even penury and premature deaths, for many in the middle and lower classes. Most Americans will lose money in the long run, as the GOP and Trump add on at least $1 trillion, probably much more, to our national debt.
Let’s consider the Constitution. It says a president can be removed for “high crimes and misdemeanors.” Any objective observer would call his racist, crude remarks against Hispanics, women and African-Americans as misdemeanors. In addition, he colluded with President Putin and the Russian government to get himself elected in 2016; also he’s refused to allow the public a look at his tax records, which is certainly a bad action. Not only that, he’s being sued by 20 different women for sexual abuses; again, almost certainly, 20 more misdemeanors.
Where are courageous individuals ready to defend our Constitution? How is it this ignorant braggart racist is permitted to remain in office?
Frank H. Baumgardner, III
Santa Rosa
Radical and reckless strategy
EDITOR: Reflecting on the Dec. 18 Palm Drive Health Care District board meeting I remain at a loss to understand why the board is so adamantly embracing a radical and reckless financial strategy. Considering Sonoma West Medical Center’s substantial operating losses since reopening the hospital, and the district’s $28 million in debt, the board clearly has a fiduciary responsibility to be cautious and prudent in their decisions.
The proposal for an ad hoc committee to draft a Request for Proposal (RFP) for the sale or lease of the hospital for the board to review and discuss in February or March is an example of prudence. There was no motion to require the board to ever issue the RFP; it was pointed out that if the RFP was ever issued the board would be under no obligation to accept an offer.
It was also pointed out that should an RFP be needed in the future the process would be drawn out, with a likely six to twelve month time frame (if not longer). Taking preliminary steps now could potentially save the district a significant amount of time and money should the need arise. And if the need does not arise, nothing has been lost – i.e., there’s no downside, but substantial upside. Any reasonable person would consider this to be sound business practice.
That this motion was rejected because directors Thomas, Colthurst and Powers have decided the hospital’s financial problems will be solved by the nascent toxicology testing partnership, so no contingency plans are necessary, is baffling.
In fact, no reasonable person, examining the known facts, would say that the toxicology testing program is better than a 50/50 bet to provide a sustainable revenue source to offset the hospital’s ongoing operating losses, though everyone, myself included, hopes this does happen. However, wishful thinking is not considered a sound business practice, and is not sufficient justification for abrogating a fiduciary responsibility.
The rejection of the motion to draft the RFP is another of many indications that directors Thomas, Colthurst and Powers will not entertain any discussions regarding any strategy other than their own – to blindly support a full service hospital, by any means, and at any cost.
Such behavior is disappointing in a publicly owned and funded health care district. But what makes this situation truly disturbing is the decision that future toxicology testing revenue precludes any need to consider alternative strategies, especially considering the decision to embrace toxicology testing was done without conducting due diligence. Directors Thomas, Colthurst and Powers have no factual reasons to believe the toxicology revenue will solve the hospital’s financial problems.
Concerns that have been directly expressed to the board, and dismissed, include:
The toxicology business partner is newly formed and has no track record in the business;
The toxicology business partner has no local involvement, no local staff and no actual investment in the hospital;
The high profits involved are due to the arbitrage nature of the partnership – SWMC conducts tests for a business in Florida (capable of performing the tests itself), but uses SWMC to leverage SWMC’s higher rural hospital billing rates. Is this a business a publicly owned community hospital should be involved in?
Is it ethical to charge $1,000 to $2,000 for tests that could be performed for a few hundred dollars? Does this conform to our community values?
Should a community hospital’s primary focus be on toxicology testing for out of state patients?
Is the business sustainable? Has PDHCD confirmed with the insurers that pay the SWMC bills that the hospital’s contracts and reimbursement rates for drug testing will remain in effect if the hospital engages in high volume testing for patients who are not treated at this hospital, or even in the state?
There are multiple examples of similar business arrangements between rural hospitals and large volume toxicology testing companies ending very badly for the hospitals. How is our arrangement different?
If high volume toxicology testing triggers lower reimbursement rates for SWMC will our partner guarantee they will continue using SWMC?
If high volume toxicology testing triggers lower reimbursement rates could SWMC be held liable for paying back what insurers were overcharged (as has happened in multiple cases around the country)? Will our partner assume responsibility for all, or even some, of the forfeited revenue?
To engage in a business partnership without due diligence is itself a failure of fiduciary responsibility. To fail to employ basic sound business practices is a failure of fiduciary responsibility. To reject prudent business planning and then justify it with wishful thinking about a sketchy business arrangement is incredibly irresponsible and altogether is an egregious abrogation of fiduciary responsibility.
Michael Windsor
Sebastopol
