Tuesday, January 29, 2008

Sutter/CPMC's Multimillion in Tax Breaks for Dubious Charity Care

Last week, I wrote about what it would do to working people in SF's southern neighborhoods like the Excelsior, OMI and Bayview, if California Pacific carried out its plans to shut down St. Luke's Hospital. This week a Dept of Public Health report shows that despite garnering tens of million in tax breaks for providing charity care, CPMC's real delivery of such care is nothing more than an accounting trick.

Mile of city blocks and unequal services separate California Pacific's campuses. It is commonly known that CP's Laurel Heights, Pacific Heights and Castro campuses serve mostly people from more white and affluent communities. These hospitals provide the least in charitable care, well below what they gain in tax breaks. Disastrously, for SF's southern neighborhoods, St. Luke's, the one hospital that is truly serving low income communities of color, is also the one hospital that CPMC has threatened to downsize.

We need greater access and more comprehensive services, especially here on the south side of San Francisco. Unfortunately, I can think of few worse examples of how our health care and tax system can join together to uphold separate and unequal services.

Saturday, January 26, 2008

On Shutting Down St. Luke's NICU

It is appalling that profit continues to drive our health care system. Sutter Health’s decision to close St Luke’s Neonatal Intensive Care Unit is not one to strengthen access for San Francisco residents. The closure will simply force families who live in the more outlying neighborhoods of the Bayview, Excelsior and OMI to seek newborn intensive care across town or outside of San Francisco. The reality is people do not always have easy choices for where to find lifesaving care. Lifesaving care is either there or not there, close or far away. And if it’s not there or far away the outcomes can be disastrous.

Take my family’s story: In 2001, while on the road to Los Angeles, something went terribly wrong with my wife’s pregnancy. Minutes after getting off the freeway and finding an emergency room she was whisked off to labor and delivery where two days later our daughter Rene was born.

Rene was four months premature and weighed 1 lb 3oz. Her skin had the appearance of cellophane and broke apart at the touch. After 6 days she had a heart operation. And for the first two months of her NICU stay she lay prone in an incubator with a
breathing tube down her throat, struggling to stay alive. She was so fragile that transferring her here to San Francisco was out of the question.

Rene survived the ordeal. She had a strong spirit, but even with that she could never have survived without the round the clock care of talented NICU doctors and nurses. Because we were so fortunate to have a NICU blocks away from the exit we took off of Highway 101, our daughter has been able enjoy her first six years like most other children her age.

Infant deaths and the complications of traumatic birth are unthinkable for expecting parents. At the hospital we witnessed other babies who despite capable and compassionate NICU care, die or who left the hospital with lifelong disabilities. We know two families who have lost babies at childbirth.

Because emergency births are all too common, parents feel infinitely more secure knowing that reliable hospital services are minutes away. But once the time is doubled, successful outcomes become much more unattainable. That is why deliveries at St Luke’s without the safety net of NICU will come with great risk.

No child should suffer for lack of access to newborn intensive care services. Sutter must rethink its plan to close vital services at St. Luke’s Hospital. San Franciscans throughout the city need close access to full service hospitals, but this is especially true in Districts 10 and 11 where most of the major hospitals are far across town.

Monday, January 21, 2008

From Madrid to Munich, Moscow and Milk

So it's been three months now since we made the move from Madrid to Munich, four blocks towards Geneva and six blocks towards McLaren Park. We're on the 500 block of Munich Street. It runs down a gradual hill and dead ends at Crocker Amazon Park. Living on a dead end street offers lots of advantages. It's pretty easy to get to know all your neighbors. After all, no one but the locals use the block. On our block it's quite likely that if you start a home improvement job on the outside of your house, one of your neighbors is going to come out to lend a hand. Last month, Karen, Rene, Emiliano and I spent our first holiday season here. It was about as neighborly as you can get. Cookies, pies, candies, wrapped and unwrapped presents and wrapped tamales crossed willy nilly along the street. The 200 block of Madrid was never so lively. While we made friends with our Madrid neighbors we never stood with them in the middle of street getting to know them or bantering away about nothing in particular.

This part of San Francisco -- District 11 -- is pretty much overlooked by the rest of the city. Many people spend their entire existence in San Francisco never quite getting any further south than Bernal Heights, let alone Cesar Chavez. District 11 is not known as a destination spot. You won't see adds in the Bay Guardian for trendy restaurants; no active theaters, only converted ones now packed with faithful evangelical congregations; few bookstores. But we do have our share of parks, some in better states of repair than others and some like the Oceanview Rec Center in seemingly perpetual states of repair. We have some nice homey spots, like Mama Art Cafe where you can get a coffee, listen to live music and chop it up with friends. City College's main campus is right on our border.

We've got our own form of diversity here too. Since most everyone here is either working class or middle class, we don't have the huge disparities you might find in other neighborhoods like in the SoMa where the jet setters might sleep 25 stories above homeless people on the street. On my block alone quite of bit of San Francisco's diversity represented. We have elder Italian immigrants whose numbers have dwindled rapidly over the past couple of decades, Chinese, Filipinos, Latinos, European American, queer folk, African American, etc. Most of us are homeowners. A good part of us are struggling just to keep up with the house payments.

Like a small town in the USA, District 11 has few notables well-known to people outside San Francisco. There's DJ Qbert of the Invisbl Skratch Piklz fame; Joe Cronin, a hall fame shortstop who played for the Boston Red Sox back in the 20s and 30s (you can see him referenced on the Excelsior Playground wall of fame); and most famous of all we got Jerry Garcia of the Grateful Dead. According to one online encyclopedic reference, "a movie was once filmed there with Julie Andrews."

Now, director Gus Van Sant with his Harvey "Milk" biopic is putting Dan White, the District's most infamous native son back on the map. This morning, the Milk trucks and trailers were lined up ten strong down Moscow Street where they're filming in the firehouse just blocks away from White's former London Street home. Josh Brolin, who acted the lead in the Coen Bros' "No Country for Old Men" is playing Dan White.

Let the world know.

I'm hoping that "Milk" can show us how the attitudes that led to Harvey Milk's assassination have changed despite Danny boy's efforts to keep them all the same. Even though it's been 30 years since the times of Harvey Milk, I expect Dan White would find San Francisco and his Excelsior District stomping grounds unrecognizable.