Fixing our County's Healthcare System

By Jim Price

My plan for improving our County's healthcare system focuses on bringing accountable leadership to our County's Medical Center, saving taxpayers millions of dollars by better preparing our County for the future, and bringing awareness of and educating people for, well paying healthcare jobs.

We are all aware of the concerns about the effect that our baby boomers will have on our country's social security system. This is such a big issue that it has captured national attention. Just as important is the effect that baby boomers are going to have on our public and private healthcare systems. In the coming years millions upon millions of seniors will be in need of healthcare on an increasing basis as they age and need their health attended to. Our current healthcare system is not prepared to handle this. While others are arguing about the kind of healthcare system we should all have, our County leaders should be making sure that what we have now works.

A plan must be put in place so that we may successfully overcome the monumental challenges ahead. This plan must take into account that all levels of government will play a role in the success or failure of our healthcare system and that all levels of government must begin working together now in order to have any chance at success. There are three issues that are vital to the success of our County's public hospitals. I have a plan that will protect and improve the quality of Alameda County's healthcare system, and it can be used as a guide to help public hospitals throughout our State.

Our state legislature recently passed a law mandating that all hospitals, both public and private, must meet new seismic standards by the year 2013. That is only 7 years from now. For many of the hospitals in our state, the cost of the retrofit is more than the cost to replace the existing structures.

This situation places our public healthcare system in a frightening predicament. Construction companies have become increasingly wary of bidding on County contracts. With private and public hospitals now competing for these contractors, work on our public hospitals is taking a backseat to private hospital. When projects in the public sector run into new costs or require changes, a long drawn out process ensues and projects go through a new round of bidding. This causes delays and can mean a change in who's doing the work. In the private sector this bureaucracy doesn't exist. Projects go through risk assessments and contingency plans are adopted. New costs can be signed off on. It's no surprise that construction companies are hesitant to bid on the public jobs. And it should be no surprise that our public hospitals are left in a situation where they are begging for a contractor.

My plan for creating a viable County healthcare system capable of serving our community and the masses of new patients calls for establishing new guidelines that will encourage construction companies to bid on public jobs. We must remove the unnecessary obstacles if we are to get the mandated work done by the 2013 deadline and at a reasonable cost to taxpayers.

As our baby boom generation begins to use healthcare facilities with growing frequency, who will be there to provide the care? The average age of a healthcare worker is 47 years old. When we think about healthcare workers we may think of doctors, nurses, and pharmacists. We already know that we have a shortage of nurses. If we think a little harder we might think of x-ray technicians and nursing assistants. In fact, there are many other positions, all of them required, in order to provide comprehensive healthcare. One example is a position called a Clinical Lab Scientist. In California alone, there is a need for 700 new Clinical Lab Scientists each year. Yet our state is producing, on average, only 70 people each year. These are good jobs that pay about 80 thousand dollars a year. So how are we filling the other 630 jobs? We are bringing in talent from other areas. We need to do more to enable local residents to receive the training needed to become eligible for these jobs.

We must do a better job marketing the great opportunities in healthcare. We must do a better job preparing people for these opportunities. My plan calls for helping Alameda County residents to qualify for these jobs. Accomplishing this will start in the high schools to create awareness and interest in healthcare as a career. My plan will bring the private and public sectors together, plus industry and education together, to develop the right strategies for creating awareness, provide the training needed for careers in healthcare, and for funding the effort. Career options that allow people to live a quality life in California are becoming more and more elusive. Good jobs in our healthcare industry can help. These jobs can help more Alameda County residents own their own home. These jobs can help Alameda County residents stay in California, living their California dream.

The Alameda County Medical Center is our County's healthcare safety net. Tens of thousands of people each year depend on this organization of hospitals and clinics for their healthcare needs. Nearly 25% of the County's yearly budget goes towards funding this public healthcare system. There are many caring and qualified individuals at the Medical Center who work hard each day under very adverse conditions to provide quality healthcare to the public. There are administrators doing their best to grapple with the ever-present financial challenges that persist at the Medical Center. On top of it all is the Medical Center's Board of Trustees, which governs the Medical Center.

This Board of Trustees was created in 1998 by our County's Board of Supervisors. It was decided, rightfully I might add, that the County's healthcare system required more attention than the Supervisors were providing. While the creation of this board provided the Supervisors a way to distance themselves from what many considered a failing healthcare system, it failed to create the authority and the accountability that is really needed.

The Board of Trustees consists of up to ten members, all volunteers, who are appointed by the County Board of Supervisors. These individuals come from many walks of life. Some are doctors, some are executives, some are consultants and some are retired. All are well intentioned, giving what time they can spare to overseeing our County's healthcare system. After observing this Board of Trustees in action for the past year, and cultivating relationships with the people on the ground doing the work at the Medical Center, I am convinced that the Board lacks accountability and real authority. Unless this changes we are never going to lift the Medical Center up from the hole that it's currently in.

Our County's Sheriff's Department has an operating budget of $239 million dollars and is overseen by the County Sheriff, an elected official, accountable to the voters. The County's District Attorney's office has an operating budget of about $48 million dollars and is overseen by the District Attorney, an elected official who is accountable to the voters. Why is it then that our County's Medical Center, the overwhelming recipient of a public healthcare budget of $547.8 million dollars, is not overseen by anyone accountable to the voters?

Should the public be entrusting our healthcare safety net to a group of volunteers? Should the public be allowing this group of volunteers to decide how millions upon millions of public dollars are used? And while well intentioned, should we seriously expect individuals with other jobs and careers, to commit the time and energy needed to ensure our County's healthcare system is viable and comprehensive?

I believe the answer to these questions is no. A better solution is to discontinue this huge bureaucracy that lacks accountability and implement a better model. The model that I have in mind is to create a smaller, five seat elected Board of Trustees. One seat for each Supervisory district, accountable to the voters. I have discussed this idea with County Sheriff Charles Plummer and he thinks it is an excellent idea. I have discussed this with Medical Center employees and union leaders and they think it is an excellent idea. And I have talked with other members of the community and they think it is an excellent idea.

We can give our County's healthcare system a real chance to succeed. We can give voters the right that they deserve, to choose who is running this half billion-dollar a year organization. We can attract qualified individuals who are able to invest 100% of their time into improving efficiency, attending to operational infrastructure, fixing a billing system that is losing about $10 million a year in real revenue, and making this a healthcare system that works. We can create the accountability that the voters deserve and that is so desperately needed if we are to turn our County healthcare system around.

The alternative is to continue with the status quo of huge deficits, taxpayer bailouts, mismanagement, a lack of trust between employees, and the current Board of Trustees, and the closing of more County hospitals and clinics.

If I am elected to be your County Supervisor, the status quo will not be on my healthcare agenda. I will be focusing on providing solutions to these important issues. I will make sure our public hospitals can compete with private hospitals in attracting contractors to do the work mandated by the state. I will make sure we are training more Californians for careers in healthcare in order to meet the growing demand. And I will create accountability and authority where currently none exists, by giving voters the final say on who leads and who doesn't.

Accomplishing these things will give our County's healthcare system the chance it needs to succeed and to provide the high quality healthcare that everyone deserves.