Governance

By Archimedes "Archie" Ramirez, MD

Public oversight of Marin General Hospital without micromanaging

My position is, and has been for a long time, that:

The Marin Healthcare District should have the same powers that Sutter has had.

The District must reserve to itself ALL powers that Sutter reserves to itself. No more, no less.

A global search and replace within the current subsidiary board's articles and bylaws, replacing Sutter with the District, will suffice.

As with Sutter,

1. These powers include approving members to a day to day operating and/or advisory board.

2. A professional Administrator of the Hospital recruited and paid by the District, with that CEO accountable to the District, i.e., the public (taxpayers and patients)rather than private interests.

3. A newly formed MGH operating Board would advise the professional Administrator regarding day to day hospital operations.

4. The District Board would set major policy and hold the CEO responsible for quality of care, pricing of services, and the financial soundness of the hospital, with an emphasis on and rewards for providing high quality of care.

5. The Subsidiary Board could not change its bylaws or articles of incorporation or enter into major financial obligations without District Board approval.

Unlike Sutter:

1. The new operating board would conduct itself in accord with the Brown Act, which contrary to what you may have heard, permits private meetings for competitive issues, while assuring accountability and transparency for the public/taxpayers/owners of MGH.

2. No one sitting on the operating board would be permitted to have conflicts, i.e., no more financial interests, direct or indirect, in MGH.

3. The Hospital would be operated to promote the health and welfare of District residents rather than Sutter's financial health.

It is that simple.

By simply replacing the District with Sutter as the sole member of MGH Inc, we can avoid the District Board majority's wasteful expenditures of attorney and consultant fees - to the tune of well over a half million dollars - to waste a year talking about governance.

The present majority of the District Board wants to give away more power than I believe is sound. They want the District to have less control than Sutter had. This includes giving up control over hiring, firing and setting the salary and performance standards of the CEO - such that failure to perform could not be immediately known or remedied.

The present majority does not want transparency and accountability. They do not want the Brown Act to apply to the operating board. They want to allow people with financial conflicts to sit on the operating board as has been the case under Sutter management, and as shown by their approval of the present advisory Board nominees (precurser to the operating board) that has four obviously conflicted members representing several of the medical groups that have always been conflicted.

The present Board majority wants "behind closed doors" governance of MGH so that large groups of financially conflicted doctors with lucrative contracts with MGH can continue to control the show.

That has sadly translated into keeping UCSF out of any role at MGH because the contracted doctors at MGH don't want any competition, despite that fact that we are facing severe physician shortages in Marin.

That is not right and not best for the patients and the community; UCSF would bring its great reputation and many good services to Marin patients.

Hopefully this position paper will finally put an end to false statements made regarding my position, and end ridiculous charge that I want to "micromanage" the hospital.

Stop listening to people who use "shock doctrine" tactics intended to create fear among District residents.

Yours for better healthcare at our publicly owned Marin General Hospital.

Archimedes Ramirez, M.D.