SAN FRANCISCO: Health Budget Irks Providers, Patients

      Angry that the city's health department plans to cut health care spending while the economy is booming, San Francisco health providers and patients packed Tuesday's standing-room-only hearing for the Health Commission to express their dismay over the proposed FY 2000-2001 budget, the San Francisco Chronicle reports. The $841 million budget includes cost-savings proposals such as cutting 21 psychiatric beds and closing the pharmacy at S.F. General Hospital and shutting the Potrero Hill Health Center. Although the budget cuts costs by $22 million, health officials indicated that the department will still be running an $18 million deficit. Dr. Mitchell Katz, head of the health department, defended the proposals, arguing that the cuts were necessary because of inflation, lower reimbursement for state and federal grants and the increasing number of non-paying patients. He said the department is facing a $14 million shortage because of state and federal cutbacks, coupled with a $4.5 million increase in the cost to treat the poor and uninsured (Squatriglia/Curiel, 2/9). Some workers will be reassigned and some patients will need to travel farther for services under the plan. And Katz said that if the city does not approve $18 million to cover the deficit, he will need to cut staff and services (Torassa, San Francisco Examiner, 2/9).

Pinning It On the Poor?
      The plan to cut 21 psychiatric beds drew the most ire, as critics argued that the move would "weaken a fragile mental health care system." The city plans to rent hotel rooms for mentally ill patients who are too healthy for hospitalization but not healthy enough to be on their own. Katz said the $900,000 cost for renting the rooms will save $3 million in hospital costs. Dr. Mark Leary, deputy chief of S.F. General's psychiatry department, said, "We will be leaving our patients to fend for themselves in an environment increasingly unresponsive to their needs." Critics also blasted the proposal to close the hospital's pharmacy since many of the city's Medi-Cal and indigent patients rely on those services. Potrero Hill Health Center employees will be folded into the staff at S.F. General and the clinic building will be sold for $1.5 million. Health care providers charged that the department was "balancing its budget on the backs of the poor." In a letter to the commission, UCSF Dr. Robert Okin wrote, "We believe that the budget as it stands is a very risky gamble, both clinically and fiscally." Critics urged the health commissioners to reject to proposals, which must also be approved by the Board of Supervisors (San Francisco Chronicle, 2/9).