Richmond asks, ‘Who killed DMC?’

5
247

by Jovanka Beckles

A quarter of a million people in Richmond and West Contra Costa County, a majority people of color community, will be without a community hospital as a result of the decision made last Thursday to phase down and finally close the doors of Doctors Medical Center (DMC) in San Pablo by April 21, 2015. To not provide a full service hospital in West Contra Costa County is an example of environmental and institutional racism as experienced by predominantly poor people of color.

Doctors Medical Center
Doctors Medical Center

In large part due to the location of Chevron and other industries, West Contra Costa County has higher rates of cancer and asthma. These industries also pose a regular risk of explosion and release of dangerous chemicals. There should be a hospital nearby in case of an industrial accident, but the largest and most profitable industry, the Chevron Corp., refused to contribute to keep DMC open.

The remaining hospital in the area, Kaiser Richmond, does not serve indigent patients, has an emergency room too small to handle the volume of the area, and does not have the capability to handle strokes and heart attacks. The DMC emergency room closed to emergency services months ago. For most of the residents of Richmond, San Pablo and surrounding areas emergency care is between 15 and 20 miles away over clogged freeways. Already it appears that two or three people have died because they could not receive emergency care quickly enough.

The remaining hospital in the area, Kaiser Richmond, does not serve indigent patients, has an emergency room too small to handle the volume of the area, and does not have the capability to handle strokes and heart attacks.

But it’s not just an issue of emergency care. A community needs a hospital just as it needs its parks, police, libraries, schools and public transit. When people require treatment in a hospital, it is important that their parents, children and other members of the family and friends be able to visit. It is simply part of good medical care. People who need regular treatments, whether it’s for cancer or kidney problems, need a hospital that is convenient. The long travel distances to a hospital place an extra burden on poor people.

The decision to close DMC left a tiny ray of hope by postponing the closing for one week to hear from a group of DMC doctors and staff and a “hospital turnaround expert.” The turnaround expert claimed to have a plan, as well as support from a Chinese investor, that would allow it to turn DMC into a profitable private hospital. There is very little chance that this will save the hospital. One can only hope.

So who killed DMC?

First is our broken health care system. The problem with DMC was not how it was run. Whatever problems its management had, it provided service at lower cost than surrounding hospitals. The problem was “its patient mix” – DMC treated “too many” low income or indigent patients.

The problem with DMC was not how it was run. Whatever problems its management had, it provided service at lower cost than surrounding hospitals. The problem was “its patient mix” – DMC treated “too many” low income or indigent patients.

Payments from Medicare and Medical were too low to cover costs, so DMC lost money on every one of these patients. Simply put, DMC failed because it provided medical care to people who are already underserved. As a result, DMC had to be subsidized.

The county refused to do it. The state government refused to reclassify DMC so it could receive a special subsidy for caring for “target” patients, and came up with a paltry $3 million. Obamacare meant the hospital would benefit community members, but provide still more services at a loss to DMC.

Many community members tried to save Doctor’s Medical Center. As a result of pressure from the community, the Richmond Progressive Alliance and the California Nurses Association, the Richmond City Council was pressured to allocate $15 million to support DMC. Unfortunately, government leaders from other parts of the area turned their heads.

San Pablo contributed nothing more than to broker a deal to transfer land to the local casino. Neighboring cities Hercules, Pinole and El Cerrito were silent. A majority of the county supervisors based in the East County would not help. The Contra Costa Times ran a campaign for the closing.

The Contra Costa Times ran a campaign for the closing.

Other hospitals in the region should have contributed. While they are called “non-profit,” Kaiser, Sutter and other hospitals are enormously profitable and have ways to transfer money to management. They save a lot of money because of their “non-profit” status.

The existence of DMC actually saves them money by absorbing some of the indigent population they would otherwise have to treat. Yet they refused to join in the plan to keep DMC open.

There are a lot of institutions and individuals to blame for closing DMC, but in the end the main problem was that there were not enough political leaders willing to organize a campaign to force these institutions to save DMC.

This scenario is a case of classic institutional racism. Areas where people of color live are underserved supposedly not because of race, but because we are not wealthy and powerful. So we are left to “compete” on a playing field made more uneven by more health problems and less medical care.

In the end the main problem was that there were not enough political leaders willing to organize a campaign to force these institutions to save DMC. This scenario is a case of classic institutional racism.

Richmond City Councilmember Jovanka Beckles
Richmond City Councilmember Jovanka Beckles

We must have a hospital now. We have to figure out as a community how to get the medical care we need, we deserve and is our right.

Richmond City Council member Jovanka Beckles works as a mental health specialist for Contra Costa County. She was born in Panama City, where she grew up in a bilingual, multicultural household. Her parents moved to the United States in1972, and she has lived in Richmond for the last 13 years. She can be reached at Jovankabeckles@gmail.com.

 

5 COMMENTS

  1. I do not realize if there is a matter of exaggeration, or simply racism persists until the bitter end. I am waiting for the day when people will not be block by such meaningless and without importance criteria . I hope the problem will be solved as soon as possible.
    Anda

  2. I've never felt so unsafe in my entire life. I have lived all over this country; had immediate access to emergency/critical care. Now, here I am in my native city and should something serious befall me; I'd better be prayed up and hope that I get the care I need in a timely manner. This should never happen in a city that serves so many. If this is a racial or political issue; shame on the participants. Remember, what you give out, you get back.

  3. It is interesting that Chevron’s sister refinery in El Segundo, CA, which operates under the same regulatory requirements, does not have higher incidents of cancer. Where is the data that directly implicates Chevron in this? Where is the data that also explores the cause and effect of freeway traffic pollution, the Port Of Richmond, the Richmond dump, etc. It is easy to cast blame but much harder to get to true root cause of an issue and is often not done dueto politics or lack of initiative. It is also interesting that there is no discussion on any work by Chevron to make good both DMC and Richmond for direct impact of the 2012 incident.

  4. General trend: Big chains are taking over the hospital industry, and stand-alone hospitals are forced to merge into larger systems or close. As you noted, profit-driven systems (inc. so-called non-profits Sutter & KP) don't want to absorb hospitals that serve poor and Medicaid (MediCal) patients–MediCal has just about the lowest reimbursement rates in the U.S. Urban communities of color suffer from this trend, and so do some rural communities.

    Specific history: I'm told that 20-odd years ago, the Contra Costa Co. public system, Contra Costa Regional MC, actually wanted to merge with DMC (Brookside) but Brookside's docs opposed the deal then. Years later, once the hospital was in desperate condition, the county built its own clinic 2 blocks away, and then turned its back. Nobody knows you when you're down and out.

  5. Contra Costa County itself should have taken the west county facitility (DMC) under their wing. However, as stated in Board of Supes meetings, PENSION obligations for the country are so enormous, that there was no money to take the San Pablo campus under the county wing. Know, too, that Tea Party activists in El Sobrante lobbiedl hard for the hospitals' closure. Brookside (as it was known) had a 25 bed ER. So, when the really big industrial accident really happens (not just smoke that rises and goes away) or the really big earthquake happens . . where is all that triage and treatment going to happen? Kaiser? Not likely.

Leave a Reply