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February 2002

The Truth About the IJ, Sabin & MGH

By Norman Carrigg, MD

In 2000, Margaret Sabin moved from Steamboat Springs to Marin to take over as CEO of the two Sacramento-based Sutter Health Marin operations. Both Marin General and Novato Community Hospitals very much needed the attention she gives them. A Sabin January 13 Marin Independent Journal editorial accolade focusing on MGH deserves amplification.

The IJ mentioned a "political firestorm" which the daily did not describe further. Sabin had attempted to combine emergency room services of both hospitals under the direction of a Novato ER physician who also happened to be on the NCH board. It didn't fly, but MGH ER function improved enormously during the year 2001. Basically, the same MGH ER doctors are in place. The staffing is better thanks to Sabin with encouragement from the elected Healthcare District board. The hospital pharmacy did not dispense drugs to ER patients seen at night. Their only recourse was to pick up medication or whatever at Walgreen's 24-hour San Rafael pharmacy. Dr. William Rothman and Dr. Larry Bedard took this on as personal crusades and this thoughtless policy came to an end. Patients now go home with enough medication to cover them until they can get medications from their regular pharmacies.

The IJ editorial noted that it is "admirable" that Sabin has attended Marin Healthcare District board meetings. She actually makes cameo appearances, which are better than none at all. If the five elected directors who serve without remuneration stay for entire meetings, is it unreasonable to ask Sabin to do likewise?

The IJ told its readers that Marin Healthcare District board meetings, "sadly have a history of amounting to verbal target practice with MGH's management as the bulls-eye." That vintage IJ description in no way fits the current board of five professionals, four of whom are strong consumer advocates. The elected board's duty is to represent the interests of its constituents, the district residents (all of Marin except Novato). Sabin is a Sutter health employee, not a MGH employee, who represents the interests of the hospital chain. Disagreements are unavoidable.

Sadly, the elected board, for the most part, has little power. The board lost it in 1985 when five elected directors (Mary Carpou, Dr. Grace Goebel d'Esmond, Dr. Peter Eisenberg, Jeanine Gisvold and Don McCrea-Hendricks) leased the hospital for 30 years to a shell corporation headed by the hospital administrator, Henry J. Buhrmann, and the hospital attorney, Quentin Cook. Both were public employees who assumed identical positions in the privatized hospital late 1985 when "$10,871,410 in operating capital" was transferred to the shell corporation. A 1985 Marin County Supervisor, Gary Giacomini, described the lease as "the biggest theft of government property in Marin's history." The IJ was mum.

Late in 1985, Marin County residents awakened to the fact that they no longer controlled the hospital their tax money built. Pre-lease, the hospital spent a fortune on IJ display ads unrelated to the impending lease. Robert Weil, the IJ publisher, was delighted to be placed on the MGH Foundation board. Media coverage was nil. Meanwhile, in Contra Costa County, the legendary Dean Lesher, publisher of the Contra Costa Times, covered an attempt to privatize Mt. Diablo Hospital so well that it did not happen.

The lessee (now Sutter Health) has the right to siphon profits with no requirement that they be returned. Over the years, millions of patient revenue dollars have made one-way trips out of MGH. It is perfectly legal for a non-profit to siphon profits to a for-profit. Most people are unaware of this, but Sutter Health caught on long ago.

An outrageous lease was made worse early 1996 after MGH became a Sutter Health hospital. At the behest of Henry J. Buhrmann, it took only three district board votes (Dr. Larry Bedard, Valerie Bergmann and Suzanna Coxhead) for MGH to join Sutter's "obligated group." Obligations include Sutter's right to siphon hospital funds whenever there are funds in excess of those needed for 14 days operation. More frightening, MGH became a guarantor of Sutter's massive aggregate debt. Bedard and Bergmann are history; Coxhead still is a member of the elected board. The night of the vote, the IJ was sound asleep in Ignacio. The public did not know and there was no public reaction.

November 1996 was a victory month for residents of the hospital district. The nationally-known consumer advocate Sylvia Siegel was elected to the board and Linda Remy was swept in with her. What with Dr. Diana Parnell already on the board, consumer advocates were in the majority for the first time ever. Remy and Siegel are history. There now are three consumer advocates in addition to Parnell: Esther Blau, RN, Dr. Lawrence Arnstein and Dr. John Severinghaus.

In 1997, the district board made an honest but unsuccessful effort to modify the 1985 lease by negotiation. So in 1997 it was necessary to sue in Sacramento Superior Court to void the lease, based on violating Section 1090 of the California Government Code. The code prohibits government employees, which Buhrmann and Cook were in 1985, from making contracts to benefit themselves. The suit still is in progress. What happened in 1985 is not in dispute, but a preliminary ruling that the statute of limitations has expired is. The suit is at the appellate level on this issue. By case law, there is no statute for public property. I expect the district to prevail.

The IJ appropriately has complained about the high legal costs of the suit. Sutter managed to complicate a simple lawsuit with frivolous motions and sideshows which has sopped up excessive patient revenue for both sides.

The IJ describes a "current unconstructive relationship between the hospital and the district board." I have been following the district board since 1974. The current board is the best of the lot. The IJ assertion is nonsense. The five unpaid directors work hard doing an enormous job of informing themselves about such things as emergency services and seismic upgrades and intervening in ways that show their deep concern for the public. Consider, by contrast, inert boards of the past composed chiefly of management sycophants.

 

 

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