Join Our Fight Against Overpriced Healthcare

The Del Norte Healthcare District is an elected public agency in Del Norte County, California. The following content was approved by unanimous vote of the District's Board of Directors.

Join Our Fight Against Overpriced Healthcare

                        

The Del Norte Healthcare District is on a mission. After repeated requests for help from our residents and visitors, we are fighting high priced healthcare and incomprehensible medical bills.

The public brought us stories of brief doctor visits followed by $2,000 doctor bills, colonoscopy charges of $6,000, and hospital bills exceeding $10,000 for minor surgery performed in Crescent City. Nationwide, roughly $3.5 trillion is spent yearly on healthcare--more than $10,000 per person, every year. Now, the Healthcare District is comparing charges at local and out of area facilities to help patients find cost-effective care.

Why are rising healthcare costs important? Because we all pay for it--whether by larger “out of pocket” costs, lower wages (to make up for the higher cost for employers to provide healthcare coverage), higher taxes (to pay for government sponsored health programs) and more “job outsourcing” (where employers send jobs out of state or overseas to avoid high priced healthcare at home).

Why are healthcare costs out of control? In part, because the prices charged to patients are often a closely guarded secret. Although the “list price” of tests and procedures (called “chargemaster” rates) is published by hospital systems, the real price you pay (the “negotiated rate”) is only known to hospital systems and insurance companies.

How can we find out the real prices charged for healthcare? With two documents:

(1)   Your itemized bill (hospitals generally mail out a summary bill but not an itemized bill unless you specifically request it).

(2)   Your insurance company or Medicare Explanation of Benefits (which will show both the fee charged by the hospital or provider and the amount approved by the insurer).

How can you help tackle the problem of high-priced healthcare? By providing the Del Norte Healthcare District with a copy of your itemized bill and Explanation of Benefits. We will add your data (anonymously) to our growing list of healthcare prices charged by doctors, hospitals, and testing facilities—local and out of area. And we will publish the result and post the data on our website.

If you would like to help by sharing your bills and insurance statements, just email them to the Healthcare District at dnhcd@delnortehealth.com or drop off at our office in the Wellness Center on 550 E. Washington Blvd., suite 400, from 8 am to 12 noon weekdays. If you prefer to remain anonymous, simply remove your identifying information. If you would like us to review your charges and follow up with you, please provide your contact information, which we will not release to anyone.

As always, feel free to contact the Del Norte Healthcare District with your healthcare related ideas, or attend our monthly meetings held the fourth Tuesday of each month (except December when we meet on the 17^th), 6:30 pm at the Wellness Center on 550 E. Washington Blvd., Crescent City. Executive Secretary Hendricks Doris Hendricks is also available by phone at (707) 464-9494.

Visit us on the web at http://delnortehealthcare.com/

We look forward to hearing from you!

Del Norte Healthcare District Board of Directors,

Elizabeth Austen Kevin Caldwell, M.D. Gregory Duncan, M.D.

Dohn Henion, Esq. Michael Young

Who Profits From Non-Profit Hospitals?

If you are concerned with rising healthcare costs and lack of transparency in our health care system, a proposal before the California legislature will help address those problems.

Here is the background. Last year, representatives from the Del Norte County Board of Supervisors, City Council of Crescent City, and Del Norte Healthcare District asked California Assemblyman Jim Wood for help regarding increasing healthcare costs.

Although rising healthcare costs are a national concern, Del Norte County is particularly impacted because one healthcare system, Sutter Health, operates the county’s only hospital, ER, MRI, and CT scanner, where prices are much higher compared to facilities outside our county.

Because the California Attorney General is currently suing Sutter Health for alleged price fixing, restraint of trade, and conspiracy to create and maintain a monopoly, we understand this year is not the best time to introduce healthcare legislation which may overlap the Attorney General’s lawsuit. Instead, Dr. Wood and his staff proposed legislation to address the lack of transparency among non-profit hospitals, which provide charity care and community benefit in exchange for their tax exemptions.

The numbers are huge—billions of potential tax dollars are not paid by healthcare corporations, like Sutter Health, which operate as tax exempt charities. At the same time, a recent study found that non-profit healthcare systems charge much more for hospital care than “for -profit” systems.[1]

Are the billions of dollars in tax exemptions enjoyed by non-profit hospitals justified by the charity care which those corporations provide? The Del Norte Healthcare District is working on that question. We asked Sutter to explain how they are calculating the millions of dollars in charity care and community benefit they claim to be providing. Sutter Health would not answer our inquiry, other than to state “costs [for charity care] are computed on a relationship of costs to charges.”[2] What does that mean—“relationship of costs to charges”? 

Assemblyman Wood’s legislation, if passed, would provide much needed transparency to “non-profit” hospital systems. AB 204 authorizes the state to develop regulations standardizing the calculation and reporting of community benefits, and requires hospitals to report their community benefits plans on their web sites. In short, AB 204 would shed light on whether or not healthcare systems are deserving of their tax exemptions.

The Del Norte County Board of Supervisors and the Del Norte Healthcare District have voted unanimously to support Dr. Wood’s AB 204 legislation. The City Council of Crescent City will discuss AB 204 at an upcoming meeting.

You can support AB 204 by contacting Assemblyman Jim Wood at his website https://a02.asmdc.org or at his Sacramento office: Assemblyman Jim Wood, State Capitol, P.O. Box 942849, Sacramento, CA 94249-0002, or by phone at (916) 319-2002.

Sincerely,

Directors of the Del Norte Healthcare District

Elizabeth Austen, Kevin Caldwell, Greg Duncan, Dohn Henion, and Mike Young 

 

[1] “Average Hospital Expenses Per Inpatient Day Across 50 States” Amy Ellison, Becker’s Hospital Review, Jan. 4, 2019

[2] Letter from Sutter Coast Hospital CEO Mitch Hanna to Del Norte Healthcare District, received Jan. 2019

New Urgent Care Clinic Open in Crescent City

Redwood Urgent Care

286 M St., highway 101 south, Crescent City (707) 460-1919

Del Norte county patients needing walk-in treatment for most medical conditions now have an affordable option--Redwood Urgent Care at 286 M St. (off highway 101 south near Safeway). Experienced providers treat everything from colds, flu, rashes, and minor infections to sports injuries and lacerations--for as little as $99 a visit for cash patients ($50 for follow up visits). Open daily until 6:30 p.m., Redwood Urgent Care accepts most major health insurance plans, including Medicare. (Currently not contracted with Medi-Cal/Partnership Health Plan) Additional services include: x-ray ($75), asthma treatment, and laboratory testing for bladder infections, sore throat, diabetes and minor gynecological problems. (note: for life threatening conditions such as stroke, chest pain, head injury, severe burns, etc., please call 911 or go to your nearest emergency room. Redwood Urgent Care does not offer chronic care such as pain management, workplace injury treatment, or psychiatric care. Please visit redwoodurgentcare.com for more information)

Provider spotlight: Lynn Szabo, PA-C Many local patients already know Lynn Szabo, a physician assistant with 31 years of patient care experience. Lynn received her medical training from Duke University, then moved west to practice in a rural setting. Her medical expertise includes treatment of nearly all common conditions including respiratory, abdominal, bladder, skin and joint disorders. From closure of lacerations to treatment of headaches, Lynn Szabo brings compassionate, skilled care to our local patients.

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There are two healthcare boards in Del Norte--One elected by voters and the other appointed by Sutter Health

There are two healthcare boards in Del Norte--One elected by voters and the other appointed by Sutter Health

If you are interested in quality, affordable healthcare, the Del Norte Healthcare District would like your input. The Healthcare District is a five person board elected by county voters to address local healthcare needs. We constructed the clinic building on the corner of Washington Blvd. and Northcrest Drive, where medical and dental services are provided through Open Door Clinics. We are in the process of expanding our campus to include additional dental capacity, affordable MRI, and a visiting specialist clinic and possible surgery center, so residents can receive care at reasonable prices without leaving the area. The current Healthcare District Board members are Kevin Caldwell, Shellie Babich, Dwayne Reichlin, Terry McNamara and Greg Duncan. Incoming Board members are Mike Young, Dohn Henion, and Elizabeth Austen. We hold open public meetings, usually on the fourth Tuesday of each month at 6:30 p.m. Our meeting times, agendas and minutes are posted on the Del Norte County web site at http://www.co.del-norte.ca.us/ The other health care related board in Del Norte County operates Sutter Coast Hospital. Current Sutter Coast Board members are hospital CEO Mitch Hanna, Sutter Health executive Grant Davies, Scott Feller, Mojgan Arshi, John Jacobson, David Itzen, Ken Hall, Clarke Moore, Thomas Polidore, Warren Rehwaldt, David Wilson, David Gibbs, and Ron Sandler. Other than the hospital Chief of Staff, Sutter Coast Board members are appointed by Sutter Health in Sacramento. Sutter Health has the power to remove all the appointed Sutter Coast Board members at any time, without cause. Sutter Health also requires the Sutter Coast Board to be loyal to Sutter Health.  The Sutter Coast Hospital Board meetings are closed to the public. No observers are allowed. No meeting notes are released. Sutter Health officials have required the Sutter Coast Board members to sign confidentiality agreements, restricting hospital board members from answering questions or notifying the public of decisions made in the hospital board room. Sutter Health and the Sutter Coast Board refuse to release hospital meeting notes and financial records, despite requests for those records from the City Council of Crescent City and the Board of Supervisors of Del Norte County. In 2011, the Sutter Coast Board voted (behind closed doors) to dissolve itself and transfer hospital ownership to a Sutter Health corporation in the Bay Area. Dr. Kevin Caldwell was on the hospital Board at that time and was the only hospital Board member to vote against the transfer of ownership. Widespread local opposition to the transfer of ownership prompted the Sutter Coast Board to reverse itself and continue local hospital ownership. The Sutter Coast Hospital Board also voted (behind closed doors) to triple fees on Medicare patients, close half of the acute care hospital beds, and place limits on how long patients can stay at Sutter Coast Hospital. Dr. Greg Duncan was on the hospital Board at that time and cast the only “no” vote to Sutter’s plans. But due to the efforts of numerous elected officials and thousands of residents, once again Sutter’s closed door plans were stopped. For the past three years, the Sutter Coast Board approved an ER doctor corporation which bills patients “out of network” for emergency room treatment (costing patients more “out of pocket” dollars). Once again, the Del Norte Healthcare District Board, City Council of Crescent City, and Del Norte County Board of Supervisors joined forces to oppose the “out of network” ER billing. Curry County commissioners also voted to oppose the billing practices at the Sutter Coast ER. And again, community opposition to Sutter Coast was successful-- Sutter Coast Hospital recently announced the end of “out of network” ER doctor billing for most insurance plans. The Del Norte Healthcare District Board invites you to join us on the 4th Tuesday of each month at 6:30 pm in our conference room in the clinic building on Washington Blvd. and Northcrest Drive. Visit our website at www.delnortehealthcare.org, email us at dnhcd@delnortehealth.com or call us at 707-464-9494 from 8 am to 12 noon weekdays. The Healthcare District Board thanks all the local officials and residents who have supported our goal of accessible, affordable healthcare. Let’s keep the momentum going! Written and approved by the Del Norte Healthcare District Board of Directors. Previously published in The Del Norte Triplicate, available at : Click to link to Del Norte Triplicate

From Crescent City to National Media – our History with Sutter Health by Kevin Caldwell, M.D.

My relationship with Sutter Health began in 1988, when I was Chief of Staff and a Board Member of Sutter Coast Hospital in Crescent City, CA. At that time, our community enjoyed a positive relationship with Sutter Health, which advertised itself as “Community Based, Not for Profit.”

But in 2010, Sutter Health executives decided it was time to end their former relationship with communities across California. Sutter began dissolving local hospital boards and moving hospital ownership to distant corporations entirely controlled by Sutter Health.

In 2010, I was again Chief of Staff and a Board Member at Sutter Coast Hospital. Behind the closed doors of the Hospital Board Room, it was clear that Sutter Health executives had decided that dissolving our local Hospital Board, and moving hospital ownership to San Francisco, was in Sutter’s best interest. Less clear to me was that Sutter’s plan was in the best interest of our community. I was also concerned that Sutter Health had started implementing patient care policies at Sutter Coast Hospital without any input from the hospital doctors. Sutter Coast no longer seemed “Community Based.” Ultimately, the Joint Commission, (which certifies hospitals), cited Sutter for misconduct regarding its patient care policies.

Thanks to overwhelming community support, we derailed Sutter Health’s plan to dissolve local ownership of Sutter Coast Hospital. Today, Sutter Coast is the only community owned and governed hospital in the entire Sutter system. According to hospital CEO Mitch Hanna, “There are absolutely no plans to regionalize at this time or in the foreseeable future.”

I remain profoundly grateful to our community and its elected leaders who stood together to stop Sutter Health.

Today, our focus is on health care costs. Any patient, employer, or insurer who pays for health care knows the impact of Sutter’s charges on budgets. Sutter is facing multiple lawsuits over its business practices, including allegations by the California Attorney General that Sutter officials violated antitrust law as they raised prices and funneled the profits into executive salaries:

https://www.usatoday.com/story/news/nation/2018/03/30/sutter-health-lawsuitcalifornia-hospital-consolidation/474742002/

Less well known is that in a separate antitrust lawsuit, Sutter officials intentionally destroyed 192 boxes of evidence: http://sacramento.cbslocal.com/2017/11/21/sutter-health-destroys-evidence/

This year, Sutter Health’s charges were featured in the LA Times. The article includes some of our community’s concerns with Sutter Health: https://www.latimes.com/business/la-fi-sutter-health-prices-20180515-story.html

If you would like to see more accessible, affordable health care, here is how you can help: (1) Share your concerns and ideas with me, or the Del Norte Healthcare District, at dnhcd@delnortehealth.com, or by calling (707) 464-9494. The Healthcare District’s open public meetings are held at 6:30 p.m. on the fourth Tuesday of each month at the Wellness Center at 550 E. Washington Blvd., suite 400.

(2) Share your hospital bills. You can request an itemized hospital bill from Sutter Coast by calling (707) 464-8511 and asking for the billing department. Because Sutter officials meet behind closed doors, and are refusing to release hospital meeting records and finances, your hospital bills help us learn about Sutter’s charges.

(3) Talk to Sutter Coast Hospital Board members, most of whom live in our community, and some of whom have stated they want to represent the community’s interests. A list of Hospital Board Members is found in the main lobby of Sutter Coast Hospital.

(4) Contact your elected representatives. Report your concerns with outrageous heath care charges, and demand an end to tax exempt status for organizations like Sutter, which operate behind closed doors.

Please share this article with your friends, post on social media, and contact me if you would like to join our volunteer effort to expand and improve health care in our community.

Kevin Caldwell, M.D.

Redwood Medical Offices

Crescent City, California

(707) 465-5566

Report: Del Norte Healthcare District Meeting with Sutter Coast Hospital Board of Directors

The following report was approved by the Del Norte Healthcare District Board:



Inside the Hospital Board Room—With Unexpected Guests from Sutter Health

Sutter Health's conduct in Crescent City is key to understanding how it created a healthcare monopoly in northern California Last month, after offering to work with Sutter Coast Hospital to provide quality, affordable healthcare, Dr. Kevin Caldwell and I met with the hospital Board of Directors. The meeting was positive. When I asked the hospital Board who they represent--Sutter Health or our community--several Board members stated they represent the community. The Sutter Health executives on the Board--hospital CEO Mitch Hanna and regional CEO Grant Davies--did not answer the question. The question of representation is key to understanding the conflict which Sutter Health brought to our community, and to the creation of Sutter's monopoly. What is good for Sutter Health is not always good for communities. A brief history: In 2011, behind closed doors, Sutter Health tried to take ownership of Sutter Coast Hospital. Is transferring hospital ownership to Sutter Health good for our community? In 2013, in an effort to collect more fees from Medicare patients, Sutter Health tried to downsize Sutter Coast into a Critical Access facility. Are higher fees and fewer beds good for our community? Sutter Health claimed transfer of ownership and Critical Access were a financial necessity. One Sutter executive threatened to close the hospital if Sutter's plans were not enacted (I still have the audio recording and meeting record). But after Sutter Coast posted millions in profits, without transfer of ownership or Critical Access, Sutter's dire financial claims were proven false. Dr. Caldwell and I asked the hospital Board to reassure the community that transfer of ownership and Critical Access are off the table.  Now for the unexpected guests at our recent meeting: After the introductions of everyone present. I noticed a speaker phone in front of my chair, but no one had announced their presence. I asked if anyone was on the line. To my surprise, two attorneys from Sutter Health were listening in. I asked the Sutter Health attorneys who they represented--Sutter Health or Sutter Coast Hospital. The attorneys declined to answer, stating it was Sutter Health policy to not disclose the nature of their legal representation to private parties. But Dr. Caldwell and I are not "private parties." We are members of a California Special District, elected to represent our constituents, attending the meeting in an official capacity. I believe the Sutter attorneys did not want to discuss their legal representation because Sutter Health's attorneys played an important role in the creation of their healthcare monopoly. Normally, one attorney does not advise two parties during a change of property ownership. Nevertheless, during Sutter Health's statewide hospital merger known as "Regionalization," Sutter Health attorneys advised hospital Boards to transfer hospital ownership to Sutter Health. Sutter Coast Hospital (a separate corporation from Sutter Health) did not have its own independent lawyer. Without their own attorney, how could a community Board make an informed decision about hospital ownership? In 2012, I was a Board member of Sutter Coast Hospital. At that time, a Sutter Health attorney confirmed he represented Sutter Health--not Sutter Coast Hospital.  I was troubled by the fact that Sutter Health was using its executives and attorneys to convince the Sutter Coast Board to dissolve itself and transfer hospital ownership to Sutter Health's regional corporation. I thought Sutter Coast should have its own attorney, as described in the hospital bylaws. Nevertheless, Sutter Health was using its salaried attorney-executive to transfer ownership of Sutter Coast to Sutter Health.  It appears Sutter Health used its own attorneys to transfer ownership and control of its statewide affiliated hospitals to Sutter Health's regional corporations. Sutter Health's merger coincided with higher prices to consumers and vast increases in executive pay. Are higher prices and higher executive pay good for communities? Today, thanks to thousands of local residents who opposed Sutter's Regionalization plan, Sutter Coast remains the only locally owned and governed hospital in the Sutter Health system.  Feel free to forward this letter to interested parties, and post on social media. We will keep you up to date with future newsletters, and please visit our website at delnortehealthcare.org. Sincerely, Gregory J. Duncan, M.D. Chair, Del Norte Healthcare District

New York Times article - The Company Behind Many Surprise Emergency Room Bills

 Link:
New York Times article -The Company Behind Many Surprise Emergency Room Bills