San Francisco Mayor Ed Lee spared the city's Public Health Department from cuts in his latest budget proposal, which benefited not just health care consumers, but also a lobbying group that consumer advocates say works against them.
According to memos obtained by The Bay Citizen through the city's sunshine ordinance, the department plans to spend $330,000 for the California Hospital Association to lobby on its behalf – by far the largest single recipient in the department's nearly $1 million lobbying budget.
The association aims “to provide strong and effective representation and advocacy to advance the interests of California hospitals, patients and communities,” according to its website, including issues related to the city's own hospital and health care system. But consumer and labor groups say the association often opposes efforts to improve care and increase patients’ rights.
“The California Hospital Association is the leading opponent of every single proposal to improve the quality of health care, expand access, control health care costs, to make hospitals seismically safe – take your pick,” said Chuck Idelson, spokesman for the California Nurses Association. He added that “it's a disgrace” that San Franciscans' tax dollars are going to pay the hospital association.
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But the Public Health Department says the association's lobbying efforts benefit the two public hospitals the city runs – Laguna Honda Hospital and Rehabilitation Center, which provides long-term care and recovery services to seniors and people with disabilities, and San Francisco General Hospital, which has a trauma center and employs 3,500 people.
Sue Currin, CEO of San Francisco General, said the association has played a key role in preserving government funding for vital services, including filing lawsuits to block state cuts.
“There is no way I could do that individually. You know how much it costs to go into legal battle with the state?” Currin said. “They do a lot of lobbying, but it’s on behalf of hospitals, and for a place like SF General, every dollar counts.”
At $1.7 billion, the Department of Public Health's budget is by far the largest of any city agency. More than $1.2 billion of that money comes from sources outside the city’s general fund, including state and federal health programs for low-income residents like Medi-Cal and Medicaid.
The department plans to spend $971,492 next year in annual dues to various trade and professional associations. Much of that money is slated for groups – such as the National Association of Public Hospitals and Health Systems – that have relatively uncontroversial opinions on budgetary and technical issues. But the largest share of that money – $330,000 – would go to the California Hospital Association and its regional and national affiliates, according to internal health department memos.
The association, which has a $20 million annual operating budget, regularly contributes to political campaigns. Between 2003 and 2010, it made $4.5 million in contributions to individual candidates, to the state's Republican and Democratic parties, and to a variety of initiative campaigns, according to the National Institute on Money in State Politics.
It recently joined United Healthcare and other insurance companies to form a group called Californians Against Higher Health Care Costs to fight a measure that would give the state's insurance commissioner the authority to reject health insurance rate increases.
The proposed initiative “creates more government bureaucracy and intrusive regulatory controls over people’s health,” the association's president, C. Duane Dauner, said in a statement.
“It’s about giving power to a regulator to have a say in whether rates go up. Why would San Francisco’s hospitals be against that?” said Jamie Court, president of Consumer Watchdog, which has submitted 800,000 signatures to the state to get the measure on the ballot. “I think San Franciscans deserve a refund.”
Jan Emerson-Shea, spokeswoman for the California Hospital Association, disagreed. “There’s a lot of benefits San Francisco’s hospitals get by belonging to these organizations," she said.