Bay Area Public Hospital Systems and Workers Sound Alarm, Urge Emergency Response to Looming Health Care Crisis
As state budget negotiations enter the final stretch, public hospital systems and workers urge California’s leaders to prevent needless patient suffering by providing critical financial support to California’s public hospital systems and to protect health care access for millions of patients
SACRAMENTO, CA — As negotiators finalize a budget for California, CEOs, doctors, nurses, and workers from all six Bay Area public hospital systems gathered at Zuckerberg San Francisco General Hospital, urging state leaders to support public hospital systems with $500 million in the state budget as an initial step to confront a preventable health care crisis.
California’s 17 public hospital systems, which provide health care regardless of a patient’s coverage status or ability to pay, face about $4 billion in annual losses. Nearly $3 billion comes from federal health care cuts imposed by H.R. 1, or the so-called One Big Beautiful Bill Act, and another $800 million in state cuts have been proposed by Governor Gavin Newsom. Without state support, public hospital systems will be forced to cut life-saving services that restrict health care access for their 3.7 million patients, resulting in more preventable illness, facility closures driving longer patient wait times and commutes for care, and higher costs we all pay.
“Public hospital systems can’t be left on their own to navigate a hostile federal government working to roll back the progress we’ve made towards a more affordable, equitable health care system,” said Dan Tsai, San Francisco Director of Health. “We know our state leaders care about protecting public health and we’re calling on them to go further. By fully stepping up for public hospital systems, they can prevent the rise of more preventable illness and death, facility closures driving longer patient wait times and commutes for care, and higher costs we all pay.”
“We operate the largest public hospital system in Northern California, which handles nearly half of local emergency rooms visits and 80% of trauma cases. Residents across Santa Clara County and the Bay Area count on our system to be there when an emergency strikes,” said Greta S. Hansen, Chief Operating Officer for the County of Santa Clara. “Without state action to protect public hospitals, access to life-saving care and the future of our emergency rooms remain at risk.”
“We cannot face this alone. If we are forced to cut services, they disappear. No one else is waiting to fill the gap,” said Dr. Chester J. “CJ” Kunnappilly, Chief Executive Officer of San Mateo Medical Center. “Other hospitals will not open a unit to treat burns or provide neonatal intensive care because public funding dried up. Once those services are gone, they are gone. That means less health care options available for all of us.”
H.R. 1 cuts $1 trillion from the nation’s health care over the next decade. The impact of these cuts in California will fall primarily on the communities relying on California’s health safety net, or Medi-Cal, which covers half of California’s children, one in five working Californians, and millions of seniors and people with disabilities.
Nearly 2 million Californians will lose their coverage through Medi-Cal next year because of H.R. 1. These patients will still need care. Many will still come to public hospital systems, which already provide more than a third of all Medi-Cal and uninsured care, and make the cost of uncompensated care grow dramatically.
“California is on a collision course and state leaders are running out of time to act. No hospital system can endure financial losses this large without being forced to cut services that restrict health care access for patients,” said Katie Rodriguez, Interim President and CEO of the California Association Public Hospitals and Health Systems. “We are on the front lines of a preventable health care crisis. How California’s leaders respond over the next couple weeks will decide how painful and deadly this crisis becomes.”
California’s public hospital systems, which include county-owned or affiliated systems and five University of California academic medical centers, comprise just 8% of the state’s hospitals overall. Yet, they operate 67% of the state’s burn beds, 32% of psychiatric beds, and 15% of neonatal intensive care beds while training half of all new doctors in hospitals.
“Public hospital systems are the backbone of health care in California and must be supported,” said Dr. Gabriel Ortiz, Chief Medical Officer at Zuckerberg San Francisco General Hospital. “With more than two-thirds of patients in Medi-Cal, Zuckerberg General anchors the health care safety net in our community. As the only Level 1 Trauma Center providing comprehensive, 24/7 emergency and psychiatric emergency care, we are also the foundation of care for all of San Francisco’s most critically ill and injured patients.”
“Public hospitals and safety-net providers already operate in an environment where Medi-Cal reimbursement falls short of the actual cost of care,” Dr. Josh Adler, Chief Clinical Officer, UCSF Health. “The federal Medi-Cal cuts will place additional strain on the health care systems that serve California’s most vulnerable communities.The Governor and the State Legislature must reinvest in public hospitals to protect access to care for the people who depend on Medi-Cal every day.”
“I see every day what happens when patients lose coverage and delay care,” said Dr. Sergio Urcuyo, Chief Medical Officer at Contra Costa Regional Medical Center and Health Centers. “The patient who comes in with an infection that should have been treated weeks ago. The diabetic foot wound that becomes an amputation because there was no follow-up care. The chest pain ignored for months that leads to a massive heart attack. These are not policy abstractions. They are the reality of what happens when people fall through the cracks and H.R. 1 creates more cracks than anything I have seen.”
“I became a physician because I really believe in the power of healthcare to uplift communities,” said Dr. Norman Archer, Regional Vice President, SEIU-CIR. “Right now, my patients are increasingly worried about the status of their health care and benefits for themselves and their kids. As their doctor, it’s hard to face the fact that our federal government doesn’t value their health or security. If California allows public hospitals to close, it will have a devastating impact on every aspect of our society. Keeping these critical training sites is the only way we can guarantee Californians will have the care they need when they need it.”
“Public hospitals across the state deal with absolutely everything under the sun. At SF General, we have a motto, ‘As Real As It Gets,’” said Kristin Vice President of San Francisco, SEIU Local 1021. “In spite of the heartless acts of the Trump Administration and the GOP-led congress, California must do everything it can to care for our people. Whether community members have Medi-Cal coverage or not – public hospitals must remain open. If California’s leaders want to prevent a healthcare disaster in Black and Brown communities across California, with massive job losses resulting in loss of care – the answer is simple: Fund our Public Hospitals Now!”
“What nurses know must be considered by Califonria’s leaders finalizing the state budget,” said
Terrance Fitzgerald Shaw, Chief Nursing Officer at Alameda Health System. “The sicker patients arrive, the longer it takes to care for them and the harder it becomes to provide care for everyone else. When funding is cut, the consequences are real for our patients. Staffing ratios are stretched thin, patients wait longer, patient conditions worsen, and health outcomes that should have been preventable become permanent.”
Today, 7.1% of Californians are uninsured – a record low. If state leaders do nothing and stand by while H.R. 1 is implemented, this figure will grow to 15%.