OPINION For 136 years St. Luke’s Hospital has been a San Francisco landmark, serving the underserved communities in the southern half of the city.
Now St. Luke’s needs San Francisco’s help.
The hospital’s owner, Sutter Health, has embarked on a stealth strategy to close St. Luke’s, shuttering units one by one and gradually shifting personnel to facilities in wealthier neighborhoods — and their more upscale pool of patients.
This process is called medical redlining, or institutional racism, and it’s not just morally wrong — it’s contrary to the values that unite San Francisco.
Latino and African American patients accounted for 54 percent of the 23,000 emergency visits to St. Luke’s in 2005. This compares with only 8 percent at Sutter’s favored California Pacific Medical Center facilities across town. Similarly, 40 percent of hospital patients at St. Luke’s are Latino, versus only 1 percent at the CPMC site. There are 1,300 children born each year at St. Luke’s, most of them to families from the Mission, Bayview–Hunters Point, the Excelsior, and surrounding communities.
If St. Luke’s closes, where will these patients go? What will they do?
Some of them will head to San Francisco General Hospital, which is already struggling with too many patients and uncertain funding.
Sutter says it will treat the rest of these patients at its other facilities — all at least a 30-minute drive or a much longer bus ride away.
In reality, many patients will simply forego medical treatment. A recent study in the Journal of the American Medical Association found that for lower-income patients, "traveling across town to access better resources or health care facilities is often beyond their means."
In this context, Sutter’s latest cuts to the neonatal intensive care and pediatrics units are especially cruel. Since the only private hospital serving the southern half of the city is in danger of closing, many of these families with sick babies and children will not seek or receive the medical attention they need until a crisis arrives.
All this, to improve on Sutter’s 2006 profits of $587 million.
The good news is that it’s not too late to save St. Luke’s.
Sutter’s actions have sparked a community outcry. Registered nurses from the facility went on strike in October and continue to insist that Sutter stop bleeding the hospital dry. Doctors, patients, and public health groups have actively protested and organized against the chain, and the city’s Health Commission is considering its options.
Sup. Sophie Maxwell recently introduced groundbreaking legislation to require a health impact review of all new permits granted to medical facilities. This would force Sutter to present an institutional master plan before moving forward with its proposed facility on Cathedral Hill and to justify this expensive new project in terms of what is best for the citywide public health infrastructure.
On a parallel track, Sup. Ross Mirkarimi is proposing a resolution to give the Board of Supervisors more influence over Sutter’s plans and to direct the city attorney to explore legal options to counter Sutter’s medical redlining.
As the cuts at St. Luke’s continue, patients suffer — and so does the city’s health care safety net. It is time for San Franciscans to join together and save this city icon. *
Zenei Cortez, RN, is a member of the Council of Presidents of the California Nurses Association.