Wednesday, November 13, 1996
MERGER:
Opponents believe privatization will strip public institution’s
beneficial qualities in favor of profitBy Phillip Carter
Daily Bruin Staff
With the UC Board of Regents set to vote on a merger of UC San
Francisco and Stanford medical centers today, opponents launched a
last-minute media assault this week to prevent the proposed
privatization.
Supporters of the move appear to have a solid, but
unenthusiastic, majority going into this week’s meeting beginning
Thursday. In July, the regents voted 14-10 to set up an independent
corporation to govern the new mega-hospital.
And just this past week, the push to merge the two hospitals
received an added boost when a panel of experts hired by the
regents gave the merger a green light, saying the UC could benefit
from the proposed consolidation.
That report, authored primarily by San Francisco investment
banker Warren Hellman, described the merger as "a sound business
decision," despite a potential slowdown in growth for the UCSF
Medical Center.
Yet, despite this seemingly overwhelming wall of support, merger
opponents have continued to fight in public and behind closed doors
against the combination of UCSF and Stanford hospitals. Just this
week, the Coalition to Stop the Sale of the UC Med Centers ran a
full-page advertisement in the New York Times condemning the
regents and blasting the "privatization" of UCSF.
"Teaching, research and community service are not profit
centers," the advertisement reads. "But they are absolutely
necessary. To preserve them, we must preserve UCSF."
Many of the merger’s staunchest opponents come from within UCSF
itself, particularly the faculty of its School of Medicine.
"UCSF is a world-class research institution precisely because it
is public and because of the close relationship between the bedside
and the laboratory," said Dr. Stanton Glantz, a professor at UCSF’s
medical school. "In a private, corporate setting, the agenda
revolves around money."
Indeed, UCSF Chancellor Joseph Martin resigned last week to
become dean of Harvard’s Faculty of Medicine. While Martin was
instrumental in setting up the merger, it was widely believed in
the UC system that he did not want to be a part of the post-merger
mega-hospital.
However, Martin left on a positive note, calling the proposed
consolidation "one of the most important and influential mergers in
the history of academic medicine."
The opposition to the proposed deal revolves largely around the
two issues of patient care and research. Traditionally, teaching
hospitals, such as UCLA and UCSF, have treated a larger percentage
of poor patients than their private competitors.
Teaching hospitals, also known as "academic medical centers,"
also form the backbone of the medical research community. Their
size, funding and large numbers of patients facilitate all
varieties of research, from basic science to clinical treatment
trials.
With the increasing pressure from the public and UC system to
turn a profit, university teaching hospitals have been pressed to
cut back both their poor-patient care and research while looking
for ways to earn money.
The merger with Stanford also came at the time UCSF needed a way
to increase its share of the medical market in San Francisco, where
Stanford is already the largest medical provider in town.
Opponents say that the merger would take away from the
public-service mission of these teaching hospitals only to provide
the basic research most corporations are reluctant to pursue on
their own.
"Public institutions should serve the public interest," said Dr.
Vishwanath Lingappa, professor of physiology and medicine at UCSF.
"Privatizing UCSF could direct its research away from free
scientific inquiry toward serving the corporate bottom line, a
tragic betrayal of the mission of academic medical research."
Ironically, it is the impetus to maintain this high-cost
research that has UC officials scrambling for a way to turn their
university hospitals into profitable places.
In the past two years, UC medical centers have taken devastating
cuts in federal Medicare and direct-research funding. Additionally,
state funding for the UC as a whole  and medical education in
particular  has not increased enough to keep pace with the
schools’ needs.
UC officials have argued to the Board of Regents and the public
that mergers  like the one at UCSF and the recent acquisition
of Santa Monica Hospital by UCLA Â were necessary if the UC
hoped to survive in an increasingly cutthroat world of
medicine.
As managed-care entities like Kaiser and Blue Cross become
competitive, UC Vice President for Clinical Services William
Gurtner and others argue that UC hospitals must become even more
aggressive. Not only do university hospitals need to turn a profit,
but they need to turn a profit and make enough to fund their
research and treatment of indigent patients.
But for the opponents of the merger with Stanford, this fiscal
imperative meant little when weighed against the needs of their
patients.
"The issue isn’t downsizing, but downgrading," said Dr. Warren
Gold, a medical professor at UCSF. "It is difficult to imagine how
a great public academic medical center like UCSF can compete
directly in a for-profit health care system and not compromise its
ethical standards."