Coastal Voices: Regionalizing Sutter
Coast hazardous for rural area
Written by Catherine
Wiley April 10, 2013 05:36 pm
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Sutter Coast Hospital provides health care services to Del
Norte and Curry counties, both of which are designated by the federal
government as Medically Underserved Areas by Population (MUAP) as well as
Health Professional Shortage Areas (HPSA).
“So what?” one might ask. Well, those designations mean
that our area residents and visitors have fewer choices in medical providers
and more limited access to health facilities compared to adequately served
areas. However, those same area providers and facilities benefit from
financial reimbursement incentives intended to expand and enhance direct
service provision.
The MUAP designation is based on the percentage of the
population below poverty levels; percentage of the population 65 and over;
infant mortality rates; and the ratio of primary care physicians to the
population. (That, by the way, does not reflect seasonal tourism influxes and
their health care needs.) Del Norte
County was designated in 1991, and Curry County was designated in 2001. While
the data used for establishing the designations are of interest and intended
to be assistive, they are truly inadequate in assessing or measuring
comprehensive, qualitative, holistic health care needs.
So, we are rural, remote, poor, designated as medically
underserved, and many of us are old.
We also have virtually no public transportation; excessive
costs for private transportation; one (and only one) north/south highway —
which has failures and closures on an annual basis; one small, expensive and
limited airport; dependence on life flights for emergencies (costing
thousands of dollars); and, we are in a tsunami area that could be
devastated/destroyed by any number of potential earthquakes.
What we deserve, and need, is not just a given number of
medical providers and/or facilities. We must have the right of access to
local, quality, comprehensive health care provided by culturally competent
individuals. The majority of residents in our communities do not have the
means, public or private, to be with ill/injured family members outside of
our immediate area. The significance for each of us, particularly the
cultural importance, of being with family; welcoming new life and honoring
elders, cannot be overstated. The
direct benefits of support from family and friends during illness/injury have
been documented physically, financially, psychologically, and emotionally.
The indirect benefits are immeasurable.
Based on these facts, virtually every hospital now has
“rooming-in,” directly in the patient’s room, or housing for family /patient
support members, at very low cost, in near-by facilities.
The primary issue seems apparent. None of us can afford
the risk of Sutter Health’s attempt to regionalize Sutter Coast Hospital, or
designate it as a Critical Access hospital.
The outcomes would include the reduction of hospital bed capacity by
50 percent, and require them to maintain an average length of hospital stay
to be less than four days. It would also eliminate the current requirement to
have a physician on duty in the emergency room, as well as having a general
surgeon and intensive care specialist on call.
I know I am “old school,” having passed my Board
exams back in the day when being in the medical profession included caring,
dedication and service; and, local hospitals were involved with and cared for
their communities.
Now, we have “non-profit” hospital business chains where
executive salaries and net profit margins exceed many of those in major,
profit-making businesses.
Perhaps the question that should be put to the Sutter
Coast Hospital Board of Directors is, just who and/or what interests do you
represent? Under their proposals for regionalization or Critical Access
designation, will the Board or Sutter executives be paying for patient and
family air transport and room and board?
According to the Time magazine Special Report, “Why
Medical Bills are Killing Us”, 3/4/13, “… outpatient emergency room care
averages an operating profit margin of 15% and nonemergency outpatient care
averages 35%. On the other hand, inpatient care has a margin of just 2%.” If
those figures aren’t clear enough profit incentive for Sutter Health’s desire
to reduce access to local care, perhaps their CEO’s salary is an answer. According to the same comprehensive
and well researched Time article, “… Sutter Health (is) a dominant nonprofit
Northern California chain whose CEO made $5,241,305 in 2011.
”When health service provision and access are already
determined to be inadequate, it is unconscionable to consider further
limitations, especially if based on profit margins and executive salaries,
rather than the essential needs and rights of those of us here in Curry and
Del Norte Counties.
Please get involved with this potential threat to the
health and well being of our communities. Contact your elected officials,
and/or learn more on http://crescentcityhospital.blogspot.com/ .
Catherine Wiley is a retired California registered nurse
practioner who lives in Curry County.
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