San Francisco General Hospital Turns Away Private-Pay Patients, Citing ‘Safety-Net’ Mission, Finances
While "scrambling" for an "infusion" of city money to "stave off service cuts," San Francisco General Hospital has stopped treating patients with private insurance in order to return to its "core mission" of caring for the indigent, the San Francisco Chronicle reports. In a "controversial and seemingly paradoxical policy" supported by San Francisco Department of Public Health Director Dr. Mitch Katz, San Francisco General is "encouraging" private-pay patients to seek care elsewhere so that the hospital can serve "exclusively as a safety net" for the poor and uninsured. Katz's position is based on the "economic fact" that, given declining reimbursements, privately insured patients cost more to treat than their insurers are willing to pay. Therefore, according to the Chronicle, instead of spending money to process private insurance claims, the hospital is turning away privately insured and even Medicare patients. In addition, the Chronicle reports that Katz is also "fend[ing] off" efforts to purchase new equipment and amenities, which would "attract paying patients." Katz said, "[W]ith decreases in Medicare, Medi-Cal and from private payers, hospitals are not making their expenses. We're no different ... but our obligation is to take care of poor people."
Doctors, however, say the new policy "threatens" San Francisco General's "reputation as an elite medical institution." The Chronicle reports that for years, the hospital "has attracted outstanding physicians largely on prestige alone," despite the fact that its typical provider salary is 20% below the national average and the Bay Area's "notoriously expensive housing market." Dr. Phil Hopewell, UCSF liaison to San Francisco General, said, "We are not in a position to grant pay raises. If we lose [physicians], we're not going to be able to recruit replacements." Noting that few hospitals are covering their expenses given declining reimbursements across the board, Katz said, "Doctors tell me that I am sending away dollars. But I am sending away both dollars and expenses." Katz added, "For many doctors, this year has reached a breaking point. We are skating on the edge, and we can't afford to lose people or dollars." The hospital is hoping to increase doctors' salaries with additional funding from the city; the Board of Supervisors is considering a request for $5.2 million in additional funds to raise physicians' salaries 1.5%. The hospital's current contract with the city is valued at $54 million for the next fiscal year. While the board is considering the request for additional funding, the hospital is "vying" against other programs for the estimated $8 million to $15 million the city has available (Russell, San Francisco Chronicle, 6/18).This is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.