Health care worth a bet

— Rollie Atkinson
Does our right to life include access to health care? Or, do we
deserve the over-expensive, broken system we now have in
America?
Is this $2.5 trillion monstrosity that is out of reach to 46
million people the best we can do?
Clearly not. And we have come to a national moment where the
majority of American people want major health care reform and they
want it now. Most of the reforms needed have been agreed upon by
both parties in Congress. All but one major part of President
Obama’s plan is winning majority support.
And that is, who pays?
Obama wants a reformed health care plan that provides access to
quality care for everyone by adding both more private and public
program choices. That sounds expensive already. The president wants
to increase taxes on households that earn more than $350,000, while
adding much smaller extra costs to everyone else. Proposed reforms
would limit profits taken by private drug and insurance
corporations and extra savings would come from Medicare reforms,
the Obama plan promises.
It appears that our popular president is going to persuade a
Congressional majority to support some, or most, of his heath care
reform plan. This means our local health care landscape will be
shifting in new directions. Doctors, patients, Medicare-aged
seniors, hospitals, clinics and insurance companies will all have
new rules to live by.
So, what’s new? Local health care leaders and hospital
administrations have been taking aim at a field of moving targets
at least since the collapse of the Health Plan of the Redwoods in
1997. Each succeeding year has arrived with new promises (threats?)
of federal health care reform. Local industry leaders have learned
to craft many scenarios and call all bets “off.”
Again, as federal reforms from on high hang over us, we see real
changes to the Sonoma County health care landscape taking place on
their own.
The preliminary review this week of Sutter Medical’s plans for a
new “trimmed down” 70-bed hospital in Santa Rosa suggests major
market shifts of patient loads between the county’s seven
hospitals. The smaller community hospitals in Healdsburg,
Sebastopol and beyond want the county review process slowed
down.
Everyone from here to Washington, D.C. agrees we are headed to a
future where fewer hospital beds will be needed. More preventative
care, better technology and improved access to primary care will
reduce and shorten everyone’s hospital stays.
Sutter Medical Center of Santa Rosa’s plans are largely based on
this kind of future scenario. However, Rita Scardaci, the county’s
health services director, this week reminded Sutter and the
county’s Board of Supervisors that “predictions about the health
care future are less than precise.”
She said the Sutter proposal and the region’s overall health
care landscape deserve more analysis. “What are the alternatives
that need to be considered?” she asked. She cautioned that federal
and state governments that are hampered with “seemingly limitless”
debt will likely make slow progress. “We are in a constant
flux.”
Indeed. The county turned over operations of the former County
Hospital in 1996 to Sutter medical under a 20-year Health Care
Access Agreement, requiring Sutter to provide indigent care,
women’s reproductive services, government-supported care and other
public health services. This was before the startling collapse of
Health Plan of the Redwoods and before the voters took over their
community hospitals in Healdsburg, Sebastopol, Sonoma Valley and
Petaluma.
Sutter itself has drafted, negotiated and abandoned at least
three major business plans here in the last two years, including
quitting the county.
Obama’s strongest critics don’t want government-controlled
health care. Many others want for-profit forces thrown out of
business.
But whether it is government-led, market-driven or self-choice,
it seems what we lack is control. A map of Sonoma County’s changing
health care landscape proves that. It would be great if more of
Sonoma County had a future health care plan we could bet on,
instead of “all bets off.”