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 a recent decision to phase down and finally close the doors of Doctors Medical Center (DMC) in San Pablo by April 21.
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.
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.
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.
There is very little chance that last-ditch efforts 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. 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 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.
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
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.
We have to figure out as a community how to get the medical care we need, we deserve and is our right.
Jovanka Beckles is a member of the Richmond City Council.