News

Ballot measure seeks to curb health care costs

Workers file petitions in four cities, plan to do so in Palo Alto this week

Palo Alto voters may have a chance next year to put a cap on how much Stanford Health and other health care providers can charge patients for medical care under a ballot initiative being advanced by the health care union.

The Service Employees International Union-United Healthcare Workers West (SEIU-UHW), which represents about 93,000 employees, filed ballot initiatives last week in four Bay Area cities that have Stanford Health medical facilities: Emeryville, Livermore, Pleasanton and Redwood City. On Thursday, the union plans to do the same in Palo Alto, home of the network's flagship facility, Stanford University Medical Center.

Union spokesman Sean Wherley said the union decided to pursue the initiative in the five cities after learning that Stanford University Medical Center has been experiencing higher infection rates than other hospitals in the Bay Area while at the same time charging some of the highest rates for patient care. The union includes about 1,800 Stanford University Medical Center employees.

The measure would effectively bar Stanford from charging patients more than 15 percent above the actual cost of providing services. In a news release, the SEIU-UHW pointed to a report from the California Office of Statewide Health Planning and Development showing Stanford significantly exceeding the statewide average for various treatments.

For alcohol and drug abuse treatment, the statewide average was reportedly $27,621, according to the union. Stanford charged $100,557, more than both University of California, San Francisco ($76,230) and California Pacific Medical Center's St. Luke's Campus ($86,828), the union alleged, pointing to the data from the state agency.

The union also highlighted data showing that Stanford charges almost $60,000 more than the state average for treatment of kidney failures and more than $45,000 above the state average for chest pain treatment.

In addition, the union alleged that the medical center scored far worse in 2013 and 2014 than the national benchmark for patients acquiring Clostridium difficile, a contagious infection that causes severe diarrhea. Wherley told the Weekly the union is concerned about this combination of higher costs and poor quality at Stanford Health.

"Now that you have Stanford expanding into (the) East Bay, there's real concern that problems that exist in Palo Alto -- the overcharging and high infection rates -- will be brought to other communities," Wherley said.

In response to the union's announcement, Stanford Health released a statement saying that while it hasn't seen the ballot language, "we would be disappointed if these efforts moved forward."

"All hospital charges reflect the complexities of the national healthcare system as well as multiple other factors ranging from local and regional market conditions to the level of care being provided," Stanford's statement read. "We take this seriously and we certainly want to respond on behalf of our patients and the communities we serve once we see the proposed language."

The proposed ballot language states that the purpose of the ballot measure is to "provide for the orderly regulation of hospitals and other health facilities" by providing "minimum standards and regulations regarding their operation."

"The prices charged to patients and other payers have far-reaching effects on consumers purchasing health care services and insurance, as well as taxpayers supporting public and welfare programs," the ballot statement reads. "Investments in quality of care improvements can benefit patients and caregivers, and ultimately result in lower overall health costs."

If approved by the voters, the new cap would take effect on Jan. 1, 2019. It would require hospitals and clinics to calculate its health care costs and compile, for each patient, a list of information that includes the total amount received in payments; the "reasonable cost" of the provided care; and, where applicable, the amount by which the former has exceeded the latter.

The new law would require that payments made by patients to the hospital not exceed 115 percent of the "reasonable cost of direct patient care," unless the hospital successfully petitions the city's Administrative Services Department for a waiver. A waiver would only be granted if the city finds that requiring such a rate would be "confiscatory or otherwise unlawful as applied to that hospital, medical clinic or other provider."

Even if the city grants such a petition, the waiver would offer only limited leeway. The ballot language specifies that the city would only be able to adjust the "115 percent" number by the "lowest whole number such that the resultant acceptable payment amount would not be unlawful."

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Comments

10 people like this
Posted by only Stanford?
a resident of College Terrace
on Dec 19, 2017 at 8:44 pm

Would this ballot measure only apply to Stanford or to all hospitals? Is it even legal??


16 people like this
Posted by Peter Carpenter
a resident of Atherton
on Dec 20, 2017 at 6:50 am

Peter Carpenter is a registered user.

"Is it even legal??"

No - cities do not have the power to set prices for health care that is provided to others and prices for health care that they purchase for themselves/their employees are usually negotiated rather than set unilaterally by the city.


8 people like this
Posted by Yu Pei Kwoh
a resident of Crescent Park
on Dec 20, 2017 at 11:36 am

It is a fair and just proposal even though it is not realistic under the current welfare and healthcare system. I know for a fact that different patients pay different amounts for health care, not to mention those who do not have to pay anything. Therefore this proposal, if passed, will shed light on how much the fee-paying patients are subsidizing, without their consent, the non-paying patients.


8 people like this
Posted by Anon
a resident of Another Palo Alto neighborhood
on Dec 20, 2017 at 1:09 pm

I have no idea regarding the legality of such a ballot measure, but, there should be a way to found out what the actual cost of providing care is. I would urge everyone to read the following article, which I think pretty clearly identifies the gap between the top-line cost, what insurers pay, and, the cost of actually providing the care.

Web Link

How is it that less than $60K of actual cost treating a catastrophic illness becomes $356,884.42, which is then generously discounted to $285,507.58? (Even though insurers would only have paid $70-$80K?) Read the article!


2 people like this
Posted by Janr
a resident of Another Palo Alto neighborhood
on Dec 20, 2017 at 1:33 pm

My understanding was that the most difficult and complicated cases were referred or transferred to Stanford.


8 people like this
Posted by Anon
a resident of Another Palo Alto neighborhood
on Dec 20, 2017 at 2:14 pm

Janr:, "My understanding was that the most difficult and complicated cases were referred or transferred to Stanford."

To clarify, the NY Times article is about an incident at a different hospital, not Stanford, but, sure, many difficult and complicated cases go to hospitals like Stanford. And, that will surely show up in the actual cost of treatment. Why can't patients get access to the actual cost of treatment (from any hospital or clinic, not just Stanford)?


4 people like this
Posted by Doctor Pickpocket
a resident of Crescent Park
on Dec 20, 2017 at 5:52 pm

>> Why can't patients get access to the actual cost of treatment (from any hospital or clinic, not just Stanford)?

That is the question. That should be the goal. It might be one of the things that
could break the back of this national extortion medical mafia..

There are countless article, documentaries and books written about health care,
and no matter how well documented or what alternative ideas implemented
in other places or other countries or whatever the public wants or has complaints
about it is always the same ... nothing changes.


2 people like this
Posted by Doctor Pickpocket
a resident of Crescent Park
on Dec 20, 2017 at 5:58 pm

>> Stanford University Medical Center has been experiencing higher
>> infection rates than other hospitals in the Bay Area while at the
>> same time charging some of the highest rates for patient care.

More money for worse service ... higher costs for those who cannot
afford it ... a sickening trend that some here seem to extol with every
post, but don't let it make you so sick you need to see a doctor.

And how does anyone have the nerve to say that this is because
Stanford treats so many that do not pay. Typical Palo Alto Online
Forum nonsense.


5 people like this
Posted by SIEU tactics
a resident of Adobe-Meadow
on Jan 28, 2018 at 3:55 pm

Usual SIEU negotiating tactic. Nothing more.


6 people like this
Posted by Anon
a resident of Another Palo Alto neighborhood
on Jan 28, 2018 at 5:00 pm

Posted by SIEU tactics, a resident of Adobe-Meadow

>> Usual SIEU negotiating tactic. Nothing more.

Why can't patients get access to the actual cost of care from any hospital or clinic?

Web Link

It is called "transparency". If SEIU can establish that as a legal right, it will be worth trillions of dollars to all of us.


Sorry, but further commenting on this topic has been closed.

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