Monday, October 17, 2016

NOTICE TO Del Norte County Voters

Del Norte County Voters Can Choose Two Candidates for Healthcare District Board:  Doctors Caldwell and Duncan are on the ballot 
This election, residents of Del Norte County can vote for
two candidates to represent them on the Del Norte Healthcare District Board.

Dr. Kevin Caldwell, current Chair of the Healthcare District Board, and I are running for the two open seats.  Dr. Caldwell and I share the same goals--better, more affordable healthcare, and expanded health services for residents and visitors in our region.   

If you would like Doctors Caldwell and Duncan to represent you on the Healthcare District Board, please vote for both.

Please feel free to contact us with your ideas for improving healthcare in our region.


Greg Duncan, M.D.  (707) 465-1125  email:
Kevin Caldwell, M.D. (707) 465-5566

Shared goals of Dr. Duncan and Dr. Caldwell:

--Bring top notch health care to the Del Norte/Curry County area, making Del Norte and Curry "destination communities" for living and recreation

--Listen to the community's ideas for improved health care

--Support other health care systems interested in expanding into our region

--Bring back hospital jobs which have been outsourced to other regions

--Stop "out-of-network" doctors overcharging patients in the Emergency Room

--Bring affordable, full service hospital care to residents of Curry and Del Norte Counties 

--Oppose Critical Access designation of Sutter Coast Hospital, which would reduce beds and triple costs to patients covered by Medicare insurance

--Oppose transfer of ownership of Sutter Coast Hospital out of Del Norte County

Please vote on Tuesday, November 8.  Your vote does make a difference!
Gregory J. Duncan, M.D. | | | 1200 Marshall St.
Crescent City, CA 95531

Monday, October 10, 2016

Healthcare and Coastal Development: Where Money Flows

Healthcare and Coastal Development: Where Money Flows 

Read below to learn how one elected official reportedly accepted gifts from Coastal developers. The same elected official also quietly met with Sutter Health executives, claiming to have been appointed by her fellow County Supervisors, as Sutter was trying to increase prices and cut beds at our region's only hospital.  

Introduction: L.A. Times article by Steve Lopez

Warning: The following LA Times article contains quotes from Supervisor Martha McClure containing extremely offensive language: 

Click here to read the LA Times article  or copy and paste the following into your browser search bar:

McClure's Connection to Sutter Health
According to the L.A Times article, the money trail between California Coastal Commissioners and coastal land developers includes our own Supervisor Martha McClure, an appointee to the Coastal Commission who is currently seeking her sixth term as County Supervisor.  When asked about possible financial conflicts of interest with coastal developers, McClure hurled a string of obscenities at the L.A. Times reporter. 

Why am I writing this?  Because McClure reacted similarly when Dr. Caldwell and I asked about her relationship with Sutter Health executives as they attempted to cut hospital beds and raise prices at our region's only hospital. 

Here is the background:

When I was on the Board of Directors of Sutter Coast Hospital, I discovered that Supervisor McClure had quietly started working with Sutter Health executives.  McClure claimed she was working with the Sutter "selection committee" under an official appointment by the County Board of Supervisors.  The committee was charged with selecting the consultant for the 2013 Sutter Coast Hospital study.

The problem with McClure's story is that there is no record of her having been appointed by the Board of Supervisors to work with Sutter.  Her appointment is not on any meeting Agenda, nor is it in any meeting minutes.  Three Supervisors could not remember Martha's supposed appointment.

When Dr. Caldwell and I asked Supervisor McClure about her claim to have been appointed to work with Sutter, she responded angrily, including a voicemail asking how I could question her authority, and an unprintable phrase she directed specifically at Dr. Caldwell.  

Just as in her L.A. Times interview, when confronted with evidence of apparent misconduct, McClure responded with four letter words and false accusations.  Her outburst aside, McClure produced no evidence to support her claim to have been appointed to work with Sutter by the Board of Supervisors.  Unable to back up her claim, she resigned from the Sutter selection committee.  (She resurfaced shortly thereafter, as a member of the Sutter/Camden committee, but this time serving "as an individual.")
According to the Triplicate, and substantiated by internal hospital records, the Sutter/Camden committee members, which included McClure, all voted for Critical Access designation at Sutter Coast.  Recall that Critical Access would have cut our acute care beds by 50% and tripled charges to Medicare patients.  Thankfully, widespread public opposition forced Sutter earlier this year to rescind its Critical Access application.

I understand these facts may come as a surprise.  I, along with longtime Democrat Drs. Kevin Caldwell, Donna Sund, and Mark Davis, supported Martha McClure for many years.  But knowing of her false claims, support for Critical Access, and pattern of inappropriate behavior, we can no longer support Martha McClure.  We endorse Lori Cowan for District 2 Supervisor.

The pattern with McClure is clear: when asked about apparent official misconduct, McClure uses emotional outbursts to divert attention from issues such as coastal development, possible influence peddling, and people's healthcare. 

As always, I appreciate receiving your questions and comments.   As a local resident and business owner, it would have been easier to stay silent.  But this story--a multi-billion dollar corporation and an elected official misleading the public while working to cut vital healthcare services and raise charges on our senior citizens-must be heard.

To hear a last week's comprehensive radio interview on our community struggle with Sutter Health, tune into KFUG radio with host Paul Critz at:

or copy and paste the following link into your browser:

"Our lives begin to end the day we become silent about things that matter"-- The Rev. Martin Luther King, Jr.

Friday, February 26, 2016

Sutter Coast 's Critical Access Application Withdrawn!

Conversation opened. 1 read message.

A Major Victory But Not an End to the Sutter Conflict

The Past:  On December 5, 2013, the Sutter Coast Hospital Board voted, over my objection, to downsize Sutter Coast to a Critical Access facility.

The Present:  This week, hospital CEO Mitch Hanna confirmed he had sent a request to the State of California, asking to withdraw Sutter Coast's Critical Access application.  Mr. Hanna also confirmed Sutter Coast registered multimillion dollar profits again in 2015, after Sutter's "independent study" and former CEO Linda Horn had foretold of heavy losses through 2018.  As so many in our community have told me, Sutter can cook its books any way they wish, because hospital Board meetings and financial records are kept secret.  At the same time, Sutter Coast is granted a "hardship" tax exemption, claiming they are a charity.

Thanks to your efforts, Sutter's decisions to move hospital ownership out of Del Norte County and to downsize to Critical Access, have been stopped for now. Sutter told us we could not stop them, that we had no voice, that our community just didn't understand.  You proved Sutter wrong.

The immediate threat of Critical Access designation has passed. However, Mr. Hanna made no promises that he would not implement Critical Access in the future.  Here is why I opposed Critical Access:

--huge increases in out of pocket costs to local Medicare patients

--closure of 50% of the acute care hospital beds

--restriction on how long patients may stay in the hospital

--mandatory patient transfers to outside hospitals

--nationwide, Critical Access hospitals have been shown to have higher death rates for patients with pneumonia, heart failure, heart attack, and following elective surgery.

The future:  My next focus will be on Sutter's high charges for care, which result from their statewide monopoly and high income needs of their multimillion dollar executives and attorneys. 

Sutter's high charges drive up your insurance premiums and harm our public employees, teachers, individuals, and small and large businesses.  Statewide, Sutter's charges have been found to be up to 60% over market averages, while its executive pay has skyrocketed. This injustice must end.  

Please send me your thoughts to, and tune in to a recent radio interview on KCIW, available by podcast, tablet, or smartphone at:


Gregory J. Duncan, M.D.
Diplomate, American Board of Orthopedic Surgery

Sunday, February 21, 2016

How Your Healthcare Dollars Are Paying Sutter's Executive Salaries

Introduction by Greg Duncan, M.D.

This newsletter tells the success story of how our community fought Sutter Health's efforts to downsize and take ownership of Sutter Coast Hospital.  Local attorney Bill Gray investigates Sutter's misconduct, exposes the harm Sutter has brought to our community and our state, and offers advice on how to bring justice to Sutter.  To learn more, please stop by my office on 1200 Marshall St., pick up fact sheets on how Sutter is increasing your healthcare costs, and join the more than 4,000 residents who have signed the petition opposing Sutter's plans.  To subscribe to this newsletter, please send me an email at   Read past newsletters at

Most of all, thank you for your support, ideas, and prayers.

Greg Duncan, M.D.
Diplomate, American Board of Orthopedic Surgery
1200 Marshall St., Crescent City, CA  95531
Myth Busting Sutter Health:
Community Benefit or Executive Greed?
by Bill K. Gray, Esq.

(originally published in the Anderson Valley Advertiser:
Sutter Health is a tax exempt public charity.  The tax code requires Sutter to operate solely for community benefit. Indeed, for decades Sutter Health served to manage community owned hospitals which were governed by community Boards of Directors. In 2010, Sutter Health's role changed when it implemented a statewide merger effort to transfer ownership of the community hospitals into large multi-hospital corporations.  Now, Sutter Health controls two massive "Divisions" containing nearly 40 hospitals and surgery centers.  The result?  Sutter Health's monopoly allows it to charge up to 60% more than market rates for healthcare.  Sutter executive salaries more than doubled during its merger.
Who pays Sutter's executives?  You do.  Whether in the form of higher health insurance premiums, lower wages (as more employer dollars are used for employee health insurance), or direct payment of Sutter's inflated charges for care, everyone in California is impacted by Sutter Health's monopoly.
Today, only one Sutter hospital in California remains locally owned--Sutter Coast Hospital ("SCH") in Crescent City.  This article tells the story of how our town fought off Sutter's attempts to transfer hospital ownership outside of our community.  We debunked Sutter's false claims, one by one, until Sutter agreed to leave us out of its two "Divisions."  We know Sutter Health will be back, but for now, SCH is locally owned and governed. 
Sutter employed four tactics in its takeover attempt:
(1)  Threats to close the hospital if the local hospital Board did not comply with Sutter's corporate plans.  For years, Sutter executives claimed SCH needed to transfer ownership to Sutter's regional corporation, and to downsize to a Critical Access facility (which would allow SCH to triple its charges to Medicare), in order to survive.  Sutter's threat to close the region's only hospital nearly worked.  In 2011, the Sutter Coast Hospital Board (which contains three highly compensated Sutter employees) voted to transfer hospital ownership to Sutter's multi-hospital corporation.  But protests from every elected body and thousands of residents, and talk of eminent domain against Sutter by the Del Norte Healthcare District, forced Sutter to put the merger on hold.
(2)  False claims of financial losses.  Former Sutter Coast CEO Linda Horn stated 2008 was the last year Sutter Coast was profitable.  Sutter's paid consultants (the Camden Group) predicted heavy losses from 2014 to 2018 unless the hospital converted to Critical Access. Now we know the truth: Sutter's claims were all myths.
IRS filings confirm Sutter Coast made over $7 million in profits combined in years 2009 and 2010. That's on top of many millions in profits from 1985 through 2008.  Sutter's predictions of losses from 2014 to 2018 are also proving false.  According to current hospital CEO Mitch Hanna, Sutter Coast generated a "healthy profit" in 2014.  How healthy?  $10.8 million in 2014, with similar profits predicted for 2015, when Mr. Hanna's annual salary was $840,000.  So, without downsizing to Critical Access, Sutter Coast's profits and Mr. Hanna's salary both appear quite "healthy."
But what of the health of our community?  In 2014, Sutter Coast transferred 872 patients out of our county for medical care.  Sutter Coast outsourced local hospital jobs to Sutter's regional service center, cut hospital staff, and has become a revolving door for physicians leaving the county.
(3) Secret meetings. Sutter claim:  "We act openly and truthfully in everything we do."  Here are some facts:  Sutter only released "select information" from its self-funded "independent" hospital study. Sutter muted the telephone lines during its internet-only public presentation of the study, so audience members could not hear questions from other participants.  Sutter holds closed Board rooms, dismissed a dissenting Director from the Board room, and censured our local hospital Chief of Staff for allegedly releasing Board meeting minutes, while providing no evidence to support the allegation. 
(4) Broken promises. Sutter, a public benefit company, has hosted no public meetings during their four your conflict with the community.  During a Town Hall meeting on February 17, 2015, Sutter Coast CEO Mitch Hanna, unable to answer many questions from the audience, stated he would return within 30 days to discuss hospital finances. One year later, Mr. Hanna has failed to appear.  Sutter Health executives also ignored official record requests from our city and county leaders. 
Sutter's tax exemption means our county, state and federal governments cannot collect hundreds of millions in yearly tax revenues which "for profit" companies must pay. Does Sutter deserves its tax exempt privilege and above market charges for health care?  You be the judge . . . . .
Sutter's violations of California law are too numerous to detail here.  If you would like to help address Sutter's misconduct and its impact on California healthcare costs, please join Dr. Duncan's team of volunteers by writing him at, and join our city and county leaders, who have already asked Attorney General Kamala Harris to investigate Sutter Health, by writing to:
The Honorable Kamala Harris
Attorney General of California
1300 "I" St.
Sacramento, CA  95814-2919

Tuesday, January 19, 2016

The Root of the Hospital Problem: A Sutter Coast Hospital Board Mired in Secrecy

In This Issue 
January 16, 2016
The Root of the Hospital Problem:  A Sutter Coast Hospital Board Mired in Secrecy
By Greg Duncan, M.D., with original email by Larry Eninger, M.D.
This article contains an internal hospital email written by my colleague Dr. Larry Eninger, providing a "behind the scenes" look at the conflict between our community and the Sutter Health appointees on our local hospital Board.  Dr. Eninger served on the Sutter Coast Hospital Conflict Resolution Committee, formed when hospital physicians opposed the Board's secret vote to transfer hospital ownership out of our community.   Local readers already know Dr. Eninger as a caring doctor with a wonderful staff in Crescent City and Brookings.  Less well known is his resume--retired Navy captain and flight surgeon, former Sutter Coast Chief of Staff and Director, and former staff physician at the Scripps clinic in La Jolla, California.  Dr. Eninger's  experience in multiple practice settings was a great asset to the committee.  For three years, he met with physicians and hospital Board members, studied the hospital bylaws changes written by a Sutter Health attorney in 2011, and offered his advice to resolve the Sutter conflict.
This week, Dr. Eninger resigned from the Conflict Resolution Committee.  His resignation email , sent to all members of the Sutter Coast Conflict Resolution Committee, follows:

(note: "Kevin" refers to Dr. Kevin Caldwell, who was advised by a hospital Board member that Dr. Caldwell could not release any committee information to anyone)
"Kevin, you don't need anybody's permission to share our communications. 
Anyone who thinks their words/actions should be kept secret should probably reconsider those words/actions.  I will certainly be perfectly candid if anyone cares enough to ask me what has transpired in our committee."
"I have been tight-lipped, but I fully understand your frustration.  All the secrecy is counterproductive.  Do some think they need to make decisions for the community without the community's knowledge because they are so much smarter than the lowly people who just wouldn't be able to understand their wisdom?  Or maybe they are ashamed of their actions and know that anyone with knowledge will recognize that those actions are indefensible?"
"I've tried for years to be understanding, but it's time to call a spade a spade.  It's convenient and comfortable to criticize Sutter Health, the big nebulous corporation in Sacramento, rather than our friends and neighbors.  But Sutter Health is not primarily responsible for the decline of Sutter Coast Hospital over the past few years.  Sure, they could have been more open and spoon-fed us with the negative aspects of their plans, but why should they?  They are a corporation whose Board is responsible for the success of that corporation.  Their primary concern is not Sutter Coast Hospital or our community.  That responsibility belongs to our local Sutter Coast Hospital Board."
"In defense of our Board, it is a tough job.  Nonetheless, it is our Board's responsibility to protect the interests of Sutter Coast Hospital, and by virtue of the hospital's charter, the local community.  Whether by ego, ignorance, ineptness, laziness, cowardice or combination thereof, our local Board has failed miserably in that responsibility."
"Some board members still believe that Sutter Coast Hospital is owned by Sutter Health.  They either don't understand their responsibility as Trustees of Sutter Coast Hospital or they choose to ignore it.  They weakened their powers, and thus their ability to meet their responsibilities, by accepting the Bylaws changes of 2011; they tried to give them away completely by voting for regionalization; and they voted for Critical Access, a designation that burdens our community.  Then when confronted with opposition they chose to spend hundreds of thousands of dollars on a carefully-orchestrated, dependent "study" carefully constructed & interpreted in the then-CEO's office to support their position before hunkering down behind a wall of secrecy.  They chose to ignore the physicians and community with whom they clearly (should) have common goals and instead listen to the lawyers of Sutter Health, a corporation whose goals are, although generally aligned with, not the same as those of Sutter Coast Hospital."
"Our Sutter Coast Hospital Board is at odds with our community - fighting us on behalf of Sutter Health.  Until the majority of our Board is once-again composed of community-focused individuals who are capable of independent thought, our efforts on the Conflict Resolution Committee are a waste of time.   I am truly sorry about the events of the past 4-5 years for all of us.  However, 4 years is enough of rehashing the facts and having them repeatedly ignored.  I had hoped to contribute to resolution of our conflict, but I hereby admit my failure to meaningfully do so and submit my resignation from this committee."
Larry Eninger, M.D.
How Can You Help?
If you support the goal of affordable, accessible healthcare, please join the more than 4,000 local residents who have signed the petition at my office on 1200 Marshall St., opposing Sutter Health's corporate plans; write a letter to the Del Norte Triplicate (P.O. Box 277, Crescent City, CA  95531) and join the statewide effort to compel Sutter Health to open its hidden books and records by asking Attorney General Kamala Harris to investigate Sutter Health's conduct and whether Sutter deserves a tax exemption:
The Honorable Kamala Harris
Attorney General of California
1300 "I" St.
Sacramento, CA  95814-2919

Gregory J. Duncan, M.D.
Diplomate, American Board of Orthopedic Surgery
Please post this letter on Facebook and forward to interested friends!
Gregory J. Duncan, M.D. | | | 1200 Marshall St.
Crescent City, CA 95531

Monday, January 4, 2016


by Roxie Hazard, Certified Radiologic Technologist
Here is a brief history on California's Healthcare Districts, and why our local Healthcare District is so important to our community:
In order to address healthcare shortages in rural areas, the California legislature approved the formation of local Hospital Districts, now called "Healthcare Districts." By law, Healthcare Districts have specified statutory rights, including the right of eminent domain, in order to provide appropriate healthcare for communities.  The Del Norte Healthcare District is governed by five elected county residents who, among other contributions, built the Del Norte Community Health Center, the largest clinic in Del Norte County, providing primary care, dentistry, and mental health services.
Four years ago, as part of Sutter Health's statewide hospital merger effort, the Sutter Coast Hospital Board voted (over the objection of Chief of Staff Dr. Kevin Caldwell) to dissolve itself and transfer ownership of Sutter Coast to a San Francisco based, multi-hospital corporation, entirely controlled by Sutter Health. Sutter excluded the hospital physicians, the Del Norte Healthcare District, and our community from its decision to transfer ownership of Sutter Coast Hospital out of Del Norte County.  In spite of widespread public concern, the Sutter Coast Board Chair refused to reconsider the Board's decision, stating, "the train has left the station."
Two years ago, the Sutter Coast Board voted (over the objection of Chief of Staff Dr. Greg Duncan) to implement "Critical Access" status, which, according to hospital CEO Mitch Hanna, would allow Sutter Coast to collect an additional $5 million a year from Medicare. However, Critical Access also required Sutter Coast to close half of its beds, and would greatly increase out of pocket costs to local Medicare patients. Whenever Sutter Coast was "full" under the 25 bed cap imposed by Critical Access, patients would be shipped to outside hospitals, at their expense.
In response to Sutter Coast's decisions, the Del Norte Healthcare District led an effort to stop Sutter Health's plans to take hospital ownership and to downsize Sutter Coast to a Critical Access facility.  Now, Sutter Coast states it has ended its effort to transfer hospital ownership out of Del Norte County, and has tabled its plans to downsize to Critical Access.
The problem is, the Sutter Coast Board has not made any binding promises--they have not withdrawn their Critical Access application and have not rescinded their vote to transfer hospital ownership out of our county, despite being asked to do so by the hospital physicians. The Sutter Coast Board has also refused to release their meeting records and financial data, and they continue to hold meetings closed to the public.
Q.  How can we bring better healthcare to our community?
A.  By supporting our locally elected Del Norte Healthcare District Board. 
Over 4,000 area residents have signed the petition at Dr. Duncan's office, opposing Sutter's corporate plans for Del Norte County.  Please stop by his office on 1200 Marshall St. and add your name to this list.  Our community, together with our Healthcare District, can improve local healthcare.
Our Healthcare District generally meets at 6:30 p.m. on the 4th Tuesday of each month, but with the holidays, the next meeting is scheduled for next Tuesday,
January 5th,  2016, at 6:30 p. m.  Meetings are open to the public, and are held at the Wellness Center, 550 Washington Blvd, Crescent City, CA 95531.  The phone number is:  (707) 464-9494, Monday through Friday, 8 am to 12 noon.
Please join me on Jan. 5, and the fourth Tuesday of each month, and bring your ideas and questions.  Together, we can make better healthcare in our region a reality. 

Roxie Hazard, CRT
Crescent City, CA