Guest OpEd: Health Care Should be the Number-One Priority

April 20th, 2009

Guest OpEd: Health Care Should be the Number-One Priority

By Christopher G. Dawes and Martha H. Marsh — Palo Alto Weekly,

The decision by Stanford University to withdraw its application to the City of Palo Alto to expand Stanford Shopping Center underscores the urgent message we have been trying to convey in dozens of public meetings over the past two years — the future of health care in our community is at stake and must be our number-one priority.

It is time to refocus the discussion on the critical issue of health care, without the distractions and complications of the proposed expansion of the shopping center.

Stanford Hospital & Clinics and Lucile Packard Children’s Hospital have been working diligently with the city since 2006 to seek approval to meet state-mandated earthquake-safety standards, modernize and replace Eisenhower-era medical and laboratory facilities, and assure adequate capacity to meet the needs of our community. Throughout this process, we have taken every opportunity to inform and educate Palo Altans about the challenges we face in caring for you, your children and families, and your neighbors.

We need to focus on urgent health care needs. For example, the Emergency Department that serves both hospitals was built for less than half the patient volume it currently sees daily, and both hospitals are frequently full. This means that patients seen in the Emergency Department for life-threatening illnesses or injuries may need to wait many hours for admission to the hospitals because there are literally no beds available.

It sometimes means that ambulances must be re-directed to other hospitals that do not offer Stanford’s level of care or which may take much longer to reach when even minutes can make the difference between full recovery and permanent disability — even between life and death.

The city’s evaluation of the proposed Renewal Project should be based on its most significant community benefit — the ongoing provision of superior health care services to Palo Alto and nearby communities. Two-thirds of Palo Alto adults and children who required hospitalization in 2007 turned to us for care. The hospitals provided more than $220 million in uncompensated costs of medical services and charity care in 2007 alone.

Our ability to continue to provide these vital community benefits faces enormous challenges from the current economic environment and from the requirement to comply with state-mandated earthquake-safety requirements by 2013, even as we hope for an extension to 2015.

Before starting construction, we must also complete a lengthy and extensive review by the California Office of Statewide Health Planning and Development (OSHPD). Time is of the essence, yet today the project is fully a year behind in the release of a draft environmental impact report, which was originally expected in June 2008.

Potential significant environmental impacts of the project will be identified as required by the California Environmental Quality Act. We have always acknowledged the hospitals’ responsibility to include all feasible and reasonable mitigation measures in our projects to address such impacts. However, above and beyond mitigation measures, the city has been generating an ever-expanding list of items it desires to be included as “community benefits” in a development agreement or as “requirements” to be put in a zoning change.

This expanding list would impose on the hospitals millions of dollars in costs for items that are not related to health care or the impacts of the projects themselves. It comes at a time of tremendous economic pressure, when the hospitals are facing higher financing costs, greater difficulty in raising private donations, and the need to increase care to those who cannot afford to pay for the medical services they need or may be uninsured due to having lost their jobs.

It is essential for all involved in these discussions and for our community to understand that the hospitals each have sole responsibility for the costs of their respective projects. It is not possible to add substantial costs for items not related to medical care or the impacts of the projects without placing the hospitals’ future — and the future of services everyone in our communities relies upon — in significant financial jeopardy.

We intend to bring to the city a comprehensive proposal and engage in good faith negotiations in the near future. It is our belief that together we can make progress toward the goal of formal City Council action by early 2010.

Construction of the Renewal Project will bring a projected $18 million in taxes and fees to the City of Palo Alto and will lead to creation of approximately 2,200 new jobs at a time when health care is the among the most stable and promising sectors in the economy. This is a stimulus package we are proud to be able to provide to Palo Alto in addition to high-quality medical care and one that others facing the closure of hospitals would certainly wish were available to their communities.

This year marks the 50th anniversary of the move by the Stanford School of Medicine and the hospital from San Francisco to Palo Alto and 90 years since the Stanford Home for Convalescent Children was established. From the beginning and in each era, the city and the medical center together have met challenges in a manner that has provided generations of Palo Altans with the highest quality health care available anywhere.

We owe it to our community to work together to reach fair and reasonable solutions that will allow us to maintain the services we provide today and build on a legacy that will enhance life here and benefit people everywhere.