Friday, March 07, 2008


As all of the candidates babble about health care reform, out in San Francisco a hospital of vital importance to working and poor people is being transformed into something that will not serve their needs.

St. Luke's founding mission was to provide medical care to anyone in need and it has in fact served multitudes of poor and uninsured people in its 136 year history.

Financially, not surprisingly it has been teetering on the edge for a long time.

But now, as reports the San Francisco Chronicle California Pacific Medical Center (CPMC) and Sutter Health, which runs St. Luke's, plans to close the hospital as an acute care institution within a few years, turning it into an outpatient hub. People suffering common acute illnesses such as heart attacks and pneumonia likely would be transferred elsewhere.

But where?

The new plan would leave a total of one hospital south of Market Street and a dozen to the north.

That's a plan.

"People will suffer," the chief of cardiology, Dr. Ed Kersh told the Chronicle. "The day after St. Luke's closes, someone having a heart attack south of Market will have no place to go for acute or continuing care - if he or she is lucky enough to survive."

The Coalition for San Francisco Neighborhoods urged CPMC and Sutter Health to keep all aspects, including the Acute Care Facilities, the Emergency Room, and the Ninth and Tenth Floor open and staffed to its fullest capacity to continue its critical and most needed of services to the most destitute and those in need in the southern and southeastern neighborhoods in San Francisco.

The Coalition was joined by Outer Mission Residents Association(OMRA). Steven R. Currier (OMRA)President of the OMRA Board and former member of the St. Luke's Foundation Board wrote:

"I want to express our concerns with the possible closure of certain departments at St. Luke’s Hospital. To give you a little history, I was a Board member of the St. Luke’s Foundation for seven years."

...The CPMC Board of Directors President’s disregard for the low income, the disenfranchised, and the immigrant community is an insult to this community and to those who serve this community."

As I know from being part of St. Luke’s and the Sutter Group for many years, St. Luke’s Hospital cares for more of these people in their “charity care program” than any other hospital in the Bay Area except for S.F. General Hospital. It is also insulting to many members of OMRA that were either born at St Luke’s,been treated there, or use this hospital for many emergency services, neo-natal services, cardiovascular services, and therapy services.The Board’s arrogance in this matter is quite demeaning to this community and it slaps the other cheek of those very people that need these services."

Well, maybe in the wake of the outcry from the public about this the plan is changing.

A "blue ribbon" panel of public officials and private medical experts is being formed to develop a plan for the future of St. Luke's.

Currier urged, "...the “Blue Ribbon Panel”to look at ways to keep all aspects of St. Luke’s Hospital,the oldest hospital in San Francisco, open to the southernmost area of the City."

The panel’s says its goal is to develop a viable plan for an acute care hospital and outpatient services at California Pacific Medical Center’s St. Luke’s campus, which complements and is supported by CPMC’s current institutional plan for all its campuses.

This is all fine and dandy. However, I don't know about you, but I don't exactly trust "blue ribbon" panels all that much to act on behalf of regular folks.

And apparently neither do the people of the area. After the panel was announced a fancy news conference, they gathered for one of their own. The group gathered at City Hall and said they want medical care that is available to the largely non-white and low-income people who live in the Mission, Excelsior and BayView neighborhoods and they don't trust Sutter.

Supervisor Tom Ammiano whose district includes St. Luke's said it simply: "I have never known Sutter to tell the truth. They don't know what truth is. They just know that profit is."

The blog
Happening Here reports that union members were out in force for this gathering. In addition to the nurses, United Healthcare Workers passed out a statement from its leader Sal Rosselli responding to CPMC's announced committee:

"For years, doctors, nurses, caregivers, elected officials, patients and community leaders have asked Sutter officials to commit to save St. Luke's, and they've hedged and dodged the entire time, changing their position over and over again. Now, they've been dragged to the table kicking and screaming, but they still can't say plainly that they're committing to keep St. Luke's open as a full service, acute care hospital.

"Sutter could save St. Luke's today by signing a legally binding memorandum of agreement to keep the hospital open and fully functioning. The Sutter Corporation reported $587 million in profits last year alone. They have more than enough funds to maintain and improve the hospital. The question is whether or not they have the will to protect the health of San Franciscans by keeping St. Luke's open.

"Fundamentally, we believe San Francisco would be better served by an open and accountable public process to determine the city's healthcare needs and ensure that all of Sutter's reorganization plans meet them in order to win city approval."

This sort of thing happens all over the country and the Oread Daily has reported on it before. Health care reform has to be more than talk and it has to be more than sitting down at the table with health insurance companies (and their buddies) and making them happy. Health care reform won't come until the giant corporations which run our health care system are directly confronted and told what they are going to do.

The time to ask the money bags currently running the system is long past.

In fact, it never was.

The following is from the San Francisco Bay View.

We must keep St. Luke’s alive
by Theodora Mays

As my blurred eyes opened, my head feeling woozy from the anesthesia, I focused on a red-faced doctor whose eyes were filled with tears. He started talking to me, something about the baby's heart rate dropping and a machine for three hours. My thoughts slowly started coming back to me and I remembered being rushed into a room and a big plastic object being placed over my nose. The tragic loss of my baby on that night, so many years ago, rushed back to me as I heard about the possible loss of St. Luke's Hospital in San Francisco.

For the last 130 years, St. Luke's Hospital, located at Mission and Cesar Chavez, has provided medical care to poor people and people of color. The hospital's closure is part of the recent string of attacks on poor communities from rich investors, where corporations move services from poor, underserved communities, to richer white areas of the city.

The California Pacific Medical Center (CPMC) plans on "replacing" St. Luke's with a series of ambulatory care centers. These centers would be in Stonestown, Potrero Hill and the Excelsior districts and cannot eliminate the need for an inpatient hospital nor will they be directly accessible to St. Luke's most needy patients. St. Luke's is the only private hospital on the east side of the city. The only other accessible hospital is San Francisco General Hospital, which is already overburdened.

If St. Luke's closes, one half of San Francisco will be left with only one hospital, San Francisco General. It is not easy to get from South of Market to North of Market.

Can you imagine having a heart attack in Bayview Hunters Point or the Excelsior District and trying to get across town in rush hour traffic, especially if San Francisco General is not accepting ambulances?

Last year, St. Luke's emergency room served 28,000 people - and 7,000 of these visits were critical. San Francisco General Hospital cannot handle this number of additional visits.

"You cannot have an emergency room without intensive care facilities or an operating room. All that is there is a shell intended to deceive the public into believing that an emergency room remains," said Bonnie Castillo, RN, director of the California Nurses Association, Sutter Division. Sutter, whose headquarters are in Sacramento, is the umbrella corporation that runs all the big private hospitals in San Francisco, as well as in much of the rest of the state.

Bonnie Castillo further proclaimed, "We will challenge Sutter with every means we can to preserve this critically needed hospital and the emergency care services at St. Luke's."

Hearing about the challenge to save St. Luke's, my mind kept wandering back to that night - to the blurred faces of my doctor and husband and the sounds of their muffled voices that seemed to keep saying something about "three hours on a machine." I struggled to mumble to my husband for him to call our Bishop, thinking we had three hours to reach out to him for prayer. Then I was jarred with the realization that the three hours had already passed and our baby was dead.

Had there not been a hospital accessible to me when I went into labor, the end could have been far more tragic - both my baby and I could be dead. I kept thinking about this when I heard of the mothers and children leading a Candlelight Vigil marking the closure of the key pediatric unit at St. Luke's Hospital on Feb. 13. Many families and women with high-risk pregnancies will be deeply affected by this closure.

Jane Sandoval, a registered nurse at St. Luke's, agrees: "Sutter is degrading patient care by closing unit after unit at St. Luke's. Do they expect women with high-risk pregnancies to take a cross-town bus? They are abandoning the families who depend on this hospital."

During the past two years, the CPMC has already closed or is "about to close" several services, including the psychiatric inpatient unit, occupational and physical therapy, the workers compensation unit and the neonatal intensive care and pediatric floor.

Imagining the crowds of women gathering at Valencia and Cesar Chavez with burning candles and remembering my own experience of losing a child, I know that we have to save these hospitals. We must keep St. Luke's alive.

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