Tuesday, July 01, 2008

UT: Full Airing, Please

The San Diego Union-Tribune
Monday, June 30, 2008, Page B6

Full airing, please
Palomar Pomerado pact shouldn’t be hidden

The publicly owned Palomar Pomerado Health District wants the best of both worlds. It wants to keep contracts hidden from the public to protect trade secrets that arguably could be useful to a private hospital group seeking to compete with the district, which serves San Marcos, Escondido, Poway, Ramona, parts of Rancho Bernardo and Rancho Penasquitos and other areas.

Yet the district enjoys the taxing and bonding authority of a public agency. Most recently, in 2004, voters passed Proposition BB, a $496 million bond measure to fund expansion and improvement of district facilities, including a state-of-art hospital now under construction in Escondido. As a result, property owners are paying an additional $17.75 for every $100,000 in assessed valuation annually for 30 years.

The fundamental fact that Palomar Pomerado is owned and partially funded by taxpayers trumps all arguments about why it should be allowed to keep contracts secret.

The issue has come to a head over efforts by some district residents to see details of a Palomar Pomerado contract with Kaiser Permanente guaranteeing a certain number of beds in the new hospital to patients insured by Kaiser, in return for unspecified payments from the health insurer. The district has released a copy of its contract with Kaiser, but the document is so heavily redacted that it is impossible to glean details.

In addition, top Palomar Pomerado officials implausibly deny that a guarantee exists, though unredacted sections contain the words “capacity guarantee,” “guaranteed bed” and more. Almost surreally, the officials insist that skeptics among the public and inquiring journalists are taking the words out of context. That context, they note, apparently unaware of the irony, is in the portions of the contract they redacted.

One top official, while insisting there is no guarantee, did at least acknowledge that the contract does provide Kaiser with a “certainty” of available beds in exchange for a fixed payment. [Compare: " a fixed payment for bed availability guarantees", PPH2WallSt103007.pdf , discussed in my blog entry of April 26, 2008]

District taxpayers have every right to question whether the deal with Kaiser is good for residents, and whether it might have affected voters’ thinking during the Proposition BB campaign. But the Kaiser contract is really just a symbol in the bigger, and essential, discussion of the importance of open government.

The revenue, expenses and contracts of Palomar Pomerado - and all public hospital districts - should be subject to detailed public review, just as are those of counties, cities, school districts and other government entities. That is one way elected officials are held accountable and waste or corruption detected. Sunlight and fresh air are the best disinfectants.

District officials point to sections of the Health and Safety Code that they say give them the right to make secret deals. Our reading leads us to conclude otherwise. If the law is-ambiguous, the Legislature should change it in favor of taxpayers and their right to monitor how government manages their money and resources.

In the meantime, we call on the Palomar Pomerado trustees to do the right thing and expose the details of Kaiser bed guarantee to the air and the light.


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