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By David Olson 

Daily Planet correspondent 

East Bay hospitals are not living up to their obligations to take care of low-income and uninsured patients, speakers at a Wednesday night forum said. 

Both nonprofit and for profit hospitals were accused of negligence by participants, including California Attorney General Bill Lockyer, public health officials and a man who has had to wait months for vitally important eye care. 

“This is a topic that is of life and death,” U.S. Rep. Barbara Lee, D-Oakland, told the crowd gathered inside Resurrection Lutheran Church near Lake Merritt. “It’s a shame we have to talk about charity care during a time of economic boom in this country.” 

“Charity care” is the free health care that hospitals are supposed to provide the poor and uninsured. Nationally, nonprofit hospitals devote an average of 3 percent of its revenues to charity care, according to several speakers.  

In Alameda County, hospitals on average spend less than 1 percent of revenues on charity care, said Sal Rosselli, president of Local 250 of the Service Employees International Union. That union represents workers at Alta Bates Medical Center in Berkeley and other hospitals. 

Rosselli said hospitals should be required to either increase their charity care or should help fund public hospitals and clinics.  

“Hospitals – whether for profit or nonprofit – have an obligation to serve the communities they’re located in,” Rosselli said. 

Spending on charity care has been declining for the past several years, said Julio Mateo, an attorney and health-care consultant. Yet nonprofit hospital chains such as Sutter – which owns Alta Bates and is the East Bay’s largest hospital group – receive generous tax exemptions in exchange for taking care of the poor. 

The low charity care spending shows that hospitals “are not keeping their end of the bargain,” he said. 

Mateo cited a 1996 study in the journal Health Affairs that found that a fifth of California non-profit hospitals spend less money on charity care and bad debt – which in general terms is money that hospitals cannot collect from non-indigent patients – than they receive in tax subsidies. 

In 1999, Alta Bates and Summit combined, provided more than $48 million in community benefit programs, 

serving more than 176,000 people, according to spokesperson Carolyn Kemp.  

“At private not-for-profit hospitals, most charity care is delivered through the emergency department. The Alta Bates and Summit Emergency Departments treat all patients, regardless of their ability to pay. In increasing numbers people use the Emergency Department as their source for primary care. Yet, the Emergency Department is the least effective and most expensive way to provide that care,” Kemp said in a prepared statement. “Our goal is to provide programs and services such as the Ethnic Health Institute, Health Ministry/ Parish Nurse Program, Asthma Management Resource Center and Diabetes Center to help people better manage their health and receive preventive and primary care in the appropriate setting.” 

Kemp added that the Hospital supports Assemblywoman Dion Aroner, D-Berkeley, and other state legislators in addressing the increasing need to provide primary and preventive care.  

Lee said she supports either federal legislation or stiffer federal rules to require a certain level of charity care. 

San Francisco hospitals are no more generous than East Bay ones, said Dr. Mitchell Katz, director of the San Francisco Department of Public Health. There, too, hospitals on average spend less than 1 percent of their revenues on charity care. The only exception is St. Luke’s Hospital, which, as an independent institution, has stronger links to the community, he said; St. Luke’s spends about 3 percent of its revenue on charity care. But, Katz noted, Sutter is trying to purchase St. Luke’s, and that makes city officials worry that the amount of money spent on charity care there will decline.  

San Francisco General Hospital is an option for the poor, but it is overcrowded, Katz said. So is Highland General Hospital in Oakland, said Roger Peeks, Highland’s interim chief executive officer. People sometimes spend days in the emergency room waiting for care at Highland and wait months to receive an appointment at a clinic, he said. 

Lamont Stewart, 50, a homeless man from Berkeley, said he suffers from glaucoma and burst blood vessels behind his eyes. Stewart said first tried to make an appointment at Highland in October but only recently was given a slot, for Feb. 6. 

"My vision and my life are almost on hold," he said. 

Hospitals would like to spend more money on charity care, said Rebecca Rozen, regional vice president for the Hospital Council, which represents hospitals in northern and central California. But it is difficult to do so because hospitals increasingly face financial problems as a result of state and federal cutbacks on reimbursement for patient care, she said. Almost two-thirds of hospitals are not profitable, Rozen said. 

In addition, she said, hospitals provide other types of “community benefit,” including health education, training of nurses and community grants. 

Lockyer said hospital mergers and consolidations have made the problem worse. According to experts, between 50 and 125 of California’s approximately 450 hospitals may close during the next five years, Lockyer said. 

Wednesday’s hearing was set up by Aroner, but she was not able to attend her own event. She was stranded in Sacramento because of legislative debate over how to deal with the electricity crisis. Lee acted as the moderator in her stead.