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MARIN COUNTY'S NEWS MONTHLY - FREE PRESS
(415)868-1600 - (415)868-0502(fax) - P.O. Box 31, Bolinas, CA, 94924

July, 2007



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Uncertain Future For Marin General
By Norman Carrigg, MD

The Five elected Marin Healthcare District directors who oversee the lease of Marin General Hospital have a plate full of problems this summer. The Greenbrae hospital, owned by district residents (all of Marin except Novato), was privatized with a 30-year lease in 1985. Since early 1996, the lessee has been Sutter Health, the Sacramento-based hospital chain.
First of all, MGH under Sutter has had patient care problems. It almost lost its Medicare reimbursement because of deficiencies and was on probation. The hospital is chronically understaffed and as a RN on a medical floor pointed out to me "dangerously understaffed" at times.

Can the Healthcare District intervene when patient care is unsatisfactory? No. The lease does not permit this. Somehow the hospital has to get back under community control and activists, including me, have been working on this for years.

Sutter, lets face it, is a poster child for corporate greed. It has the right to sweep funds out of the hospital any time there is more money in the bank than is needed for 14 days hospital operation.

Law requires seismic upgrade of the hospital and Sutter did not want to pay for it. So Sutter sued the district board demanding that the board pay for the upgrade. In turn, the board countersued. At this point the board chairman then, Dr. John Severinghaus, agreed to Sutter's demand to negotiate secretly. Board member Sharon Jackson joined him.

That left three board members who were not permitted to be involved.

Sutter got exactly what Sutter wanted. Sutter will leave MGH in 2009 or early 2010 at which time MGH will return to community control.

What lies ahead?
Sutter already operates a Terra Linda outpatient facility competing for lucrative patients with MGH. Sutter recently purchased Marin Square, an unprofitable shopping mall, which will be the site of another Sutter outpatient facility. Sutter says it plans to enlarge Novato Community Hospital, basically a boutique hospital, which does not offer all services and plans 95 more offices to encourage doctors to practice next to NCH.

MGH when returned to community control as the county's only full service hospital could be in great financial difficulty. Seismic upgrade or a replacement wing will be required. The hospital's west wing requires no upgrade but the central and east wings do or a replacement wing will be required.

Almost certainly, it will be necessary to pass a general obligation bond. Not apt to be easy when one considers that 40% of Marin's population now belongs to Kaiser.

Will the public get back a shell of a hospital? In 1985 it was a profitable full-service hospital when its CEO Henry J. Buhrmann and the hospital lawyer, Quentin Cook, formed a shell MGH corporation and then transferred millions of dollars of public property to the privatized hospital, a hospital that has operated secretly ever since under the terms of the lease written by Buhrmann and Cook.

Yes, the public was scammed. Gary Giacomini, then a county supervisor, called it the "biggest theft of public property in Marin's history."

In November 2006 the district board significantly changed. Two of the five members are holdovers whose terms expire November 2008: Sharon Jackson, a Sutter supporter, and Dr. Archimedes Ramirez, a practicing neurosurgeon. Dr. James Clever and Jennifer Rienks were elected for the first time. Dr. Larry Bedard was elected for the second time. Bedard's first term ended in November 1996 when he was recalled chiefly because of conflict of interest. He was an emergency room physician member of the ER group that had a contract with MGH. Subsequently the Marin ER group asked Bedard to depart and he practiced thereafter at other hospitals.

Bedard now publicly calls for sale ore lease of MGH and calls its board "dysfunctional." Well, it does have one dysfunctional member-Bedard.

Dr. Harry Neuwirth and Bedard co-orchestrated a petition presented at the June 12 district board meeting: "We... respectfully ask the Marin Healthcare District to put a plan on the November 2007 ballot to sell or lease Marin General Hospital to a competent and proven hospital management group."

How can that be done with a lessee in place?

Mercifully, there are cooler heads on the district board. Currently a strategic analysis by Kurt Salmon Associates is underway and should be available by August. With objective outside professional advice, the decision-making process for the board may be easier and some seemingly formidable problems can be tackled one at a time.


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