Wednesday, December 28, 2005

Squirrels and Other Rodents

I have this Camellia I’ve pampered all year, it has dark green foliage and huge deep red flowers with yellow stamens. I have it in a pot in front of the living room window. I repotted it, fertilized it and loved it all year; it has huge buds, which promise to bloom in late winter early spring. The other day I looked out the living room window and the red of the petals had started to show. A squirrel ran down the Oak tree and up the camellia it pulled off a flower bud like it was picking an apple and sat on the edge of the terra cotta pot and took a huge bite. I started waving my hands and stomping my feet in the window. The squirrel turned his head slowly toward me and stuck up his middle finger.

So what about the medical center’s favorite fury friend, Dave Kears? Dave runs the Alameda County Healthcare Services Agency. So complex and confusing are the county’s budget battles and bureaucratic labyrinths that those charged with serving the county’s poor spend most of their time serving Dave Kears and fighting other organizations they should be working with, for cash and turf. Sure we have some great services but they all operate in a vacuum instead of cooperating to provide the best care. Closing the medical center and looting Measure “A” funds are top priorities for the secret squirrel: he needs more cash for brain-dead billboards, consultants and committees.

With winter here and the new executives distracted by operational issues and settling labor contracts, opportunity knocks. Kears can’t take money outright but he can attack the medical center’s credibility and bottom line. It’s a shell game; Alameda County Healthcare Services Agency makes consultants rich, gives fat contracts to political suck ups and leaves the poor, sick and confused. For years the agency has been trying and failing to get county residents enrolled in Healthy Families, a program which gives low-income families MediCal (state paid health insurance.) Tons of county residents qualify but don’t get the services because of the daunting and bureaucratic application process, and the complete and total ineptitude of Alameda County’s Health Care Service Agency.

So of course Healthy Families has flopped but Kears knows how to turn personal failure into opportunity! Kears has now mandated the cumbersome and overwhelming state application, the 1-E-Application for financial eligibility, be used at the medical center. This electronic application can then go directly to the state’s computer, decreasing the time needed to get MediCal. They haven’t worked out the technical details like software compatibility with the state, necessary middleware or how to convert all archived paper applications to the new electronic format, but in theory it’s a great idea. In practice in order for the medical center to get the MediCal a patient desperately needs and deserves, the medical center must get detailed information about the whole family. So Highland’s overworked, underpaid and under resourced eligibility clerks now have to get a translator to explain to the patient that they need their mother’s bank account records for the medical center to get them the coverage they need to get dialysis.

Imposing this application on the medical center increases the time and complexity of each financial screen and because of the huge amount of information required, it decreases the success rate for the same reason. Kears is no dummy he conceded this might be difficult so he threw the medical center some “chump change” for a couple extra, temporary, non-union clerks. See Dave’s not looking for success, he doesn’t care about the county’s poor or sick; he cares about his beloved bureaucracy. Kears plans to shift blame for Alameda County’s failure to get families the state health coverage they deserve, onto the medical center.

Monday, December 26, 2005


"My friend Daniel celebrates Hanukkah. I celebrate..... sea lions."

Emma Rose Nomura Fisher (4 years old)

Thursday, December 15, 2005


‘Tis the season to withdraw from alcohol, overdose, breakdown, or my personal favorite overeat. Don’t laugh over eating, or dietary indiscretion as we call professionals call it, lands lots of people up in the hospital. It’s the fat and salt that tips you right over into heart failure.

Isn’t that a great emphismism, dietary indiscretion, it sounds like you slept with a Danish, when actually all you did is wake up late and finish off the left over turkey, dressing, and three pies. Americans have so much wealth and so little happiness. We have so much stuff and so little security; we all need a warm safe place to go where we can be cared for.

So the hospital has filled up with people, trying to get well, to get warm or to get the help they need to die with dignity and comfort. Fear of illness and the cost of illness has become a disease onto itself here in the U.S. So people come to the hospital so sick and so frightened, and so shocked and grateful for the care we give them. The holidays provides a huge opportunity to help to heal and to comfort, it also gives those of us lucky enough to work at the medical center an up close and personal view of how hard our country has become.

The medical center, in spite of staff shortages, broken equipment, consultants, turnarounds, somersaults and frontal attacks on revenue by the Sheriff and other sundry politicians, remains a warm place. We try to give patients what they need to get well and to care for each other and patients understand that we have very few resources with which to help them but that we will do all we can with what we have.

Lassiter Alert

That’s right, Wright’s out and about thanking staff for working so hard. He gets big points for noticing the hospital has filled up and backed up with really sick people. I appreciate the support, apparently he’s working days and nights while his dogs chew up his new California home. Wright Lassiter III comes from Texas where you can by a small town for what a two-bedroom house in Monclair costs you. Still, in the pit of my stomach I have a deep uneasy feeling about Mr. Lassiter. He’s nice, he’s smart he’s positive and hard working but he’s from Texas, which begs the inevitable and ominous question: is he a Dallas Cowboys fan? I can’t stand the Cowboys!