Medical Group Comes Out Against Measure O

Expressing strong support for the local public hospital safety net, the Ventura County Medical Assn. announced Wednesday its opposition to Measure O, which would wrest $260 million in tobacco settlement money from county government and give it to private hospitals.

The governing board of the 350-doctor association voted Tuesday evening to urge voters to reject the Nov. 7 ballot measure after deciding that some settlement money should go to the county’s public hospital and clinic system to care for poor or uninsured patients.

“The safety net is very important,” said association President-elect Max Stearns, an Oxnard urologist. “Measure O does put some money in the appropriate place. These funds should be used for patient care. But a significant portion should be used to support the safety net in place in Ventura County, especially for indigent patients.”

The medical association’s decision came after months of debate within the organization.

Some doctors favored Measure O, written by Community Memorial Hospital in Ventura, because it would ensure that an estimated $10 million a year for 25 years would be used for health care and could not be siphoned off by county officials for others purposes.

But many other physicians thought the measure went too far by shutting out the county hospital, and by distributing money based on a formula that apparently helps only some of the county’s seven private general hospitals.

“We’re concerned that Measure O locks in monies that appear to be going basically to three hospitals--Community Memorial, Los Robles and Simi Valley--for a 25-year period,” Stearns said. “That seems unwise in this ever-changing medical environment. And there certainly is a feeling that those three hospitals sharing money in perpetuity is not the best thing for patients in Ventura County.”

Community Memorial spokesman Mark Barnhill said the association position is no surprise because most members are affiliated with the county-run Ventura County Medical Center. Nor do association members make up a majority of doctors in this county, he said.

“It’s my understanding that the association is predominantly made up of physicians associated with the county hospital,” he said. “So it’s not surprising that they would parrot the county’s position on the measure. In a larger context, there are physicians throughout the county who strongly support this thing.”

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Mary Carr, executive director of the association, said Barnhill is wrong, and that only 15% of members are on the staff at the county medical center.

“The VCMA’s position on Measure O represents our concerns for all patients and physicians throughout Ventura County. The decision was not influenced by a small segment of our members.”

Barnhill said he also thinks it is untrue that only three hospitals would benefit from Measure O. All seven local private general hospitals are eligible based on their treatment of uninsured patients, he said. To qualify, a hospital would have to report bad debts for at least 360 patient days during one year.

St. John’s Regional Medical Center in Oxnard, which provides more free care to patients than any other local private hospital, would qualify, Barnhill said.

“We don’t think St. John’s has said that [it won’t],” he said. “It’s been our assumption that they would qualify.”

Charles Padilla, administrator at St. John’s in Oxnard, said through a spokeswoman that the hospital is in the process of correcting and resubmitting the number of uninsured patients it reports to the state. He did not say whether he thinks St. John’s would qualify for Measure O funding.

The St. John’s hospital board has not taken a position on Measure O, except to say that it favors the sharing of tobacco settlement funds between “public and private health-care providers.”

David Maron, a spokesman for a coalition opposing Measure O, applauded the medical association’s position.

“Certainly [we’re] glad to see that more and more organizations are realizing the dangers of this initiative, that it is not reaching out to all elements of the county,” Maron said.

Dr. Marie Kuffner, president of the California Medical Assn., attended the local medical society meeting Tuesday evening and said she came away convinced that Measure O is not the way to go in distributing tobacco funds.

“As an individual who understands these issues,” she said, “I think this initiative is too narrowly drawn for too long of a period of time. This is a narrowly contrived formula that serves certain portions of the health-care community but not the entire community. This initiative would leave so many out. It’s going to pay bad debts, but that’s only a small bite of the apple.”

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The state medical association helped bring the lawsuit that led to the tobacco settlement, and it always intended that the money repay those who have borne the cost of caring for patients with smoking-related diseases, Kuffner said.

“The public system paid the bill for many of those patients,” she said. “That’s the reason CMA was way out front pushing this lawsuit, to put those monies back into health care.”

In a brief position statement, the Ventura County Medical Assn. said its position is that the settlement money “should be implemented as it was first intended; to be spent entirely on direct patient care.”

That should be accomplished, the association said, in four ways:

* By allocating a fixed percentage of the money to private hospitals for care they provided without compensation;

* By allocating another portion to the county hospital and clinic system;

* By paying private physicians who provide uncompensated care for their work;

* By appointing medical association members to an oversight board to ensure the settlement money is used as intended, and to ensure that current factors are used to decide how the money is spent.

Because Measure O does not cover all those bases, the association said it was encouraging a “No” vote on Measure O.

The association’s statement was adopted Tuesday evening after the Board of Governors submitted it to about 70 members at a meeting in Oxnard. After discussion, the statement was amended to strengthen it from refusing to endorse Measure O to encouraging voters to reject it, Carr said.

A key point by members was that it was not fair that Community Memorial and Los Robles would get a healthy chunk of the $10-million annual payment, Stearns said.

“The impetus was that many physicians feel that Community and Los Robles do not provide as much charitable care as some of the other hospitals do,” he said.

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Measure O does not, in fact, reimburse private hospitals for charitable care to the poor, but for bad debts by any patient, according to an analysis by the county counsel’s office.

While the medical association officially opposed Measure O, Stearns said some members were critical of the county Board of Supervisors for spending the first $3 million the county received to pay a debt instead of on medical care.

“Our position is that the Board of Supervisors has not done what we would ideally want them to do,” he said.

But a recent commitment by the board to spend the remaining $257 million on health care reassured his association that the county would spend the money in the right place, Stearns said.

FYI

To access an online discussion about Measure O, visit https://www.latimes.com/editions/ventura.