It's just another example, another feather in the cap for how Gavin Newsom has
saved the day with California Healthcare. So there's a story locally about a birthing
center in Ti Larry County. Adventist Health to Larry has closed its maternity ward.
So I think this must be in or near the city of Tilarry.
To Larry County's expectant mothers, says the story in GV wire have one less
place to receive maternity care. As of Thursday, a drop into Larry County's
birthrate and the number of planned births at Adventist Health to Larry led the decision
to close the maternity ward, a hospital official set after the close, mothers
wanting to deliver their baby in a hospital will have to go to Visalia,
Redley, or Hanford. Adventist hopes to be able to reopen again through local
partnerships with health advocacy groups clinics, said Kiyoshi Tomono, a Partnership and well
Being executive at Adventist Health Central California Network. But closing the department follows a
trend in California of maternity wards shutting down because of lack of demand. Hospital.
Births have declined by sixty percent over the past year at Adventist Health to
Larry, and the hospital can no longer sustain these services, said Tomno.
This decline in births at Adventist Health to Larry aligns with a significant drop in
the birth rate into Larry County and a significant decrease in births in California.
More to Larry mothers are relying on the emergency department. After the hospital closed
in twenty seventeen, Ogyan's got in the habit of not sending their patients to
then to Larry Regional Medical Center, said Heather van Housen, patient care executive
for Central California Network of Adventist Health. Berths at the hospital came nearly all
from mothers going into the emergency department, which Van Housen said is less safe
then having a planned birth. In twenty twenty two, the hospital provided services
for twenty berths. By twenty twenty four, that number had decreased to eight.
If you want to do things and do things well, you need to
have to do more than five a month, said Van Housen, who added
that the ideal number was closer to fifty. The hospital network explored a partnership
with healthcare clinic Altura Centers for Health to work with ogyn doctors in connecting them
in their patients with Adventist Health. Maternity wards closing all over California, Hilary
is hardly the only hospital to close its maternity ward. Matthew Beeler, the
chief strategy officer with American Advanced Management, the health system taking over operations for
Madera Community Hospital, said the company is holding off opening the maternity ward at
that hospital because of few planned berths. In the past decade, nearly fifty
California hospitals have closed maternity wards. Calmatters reported half of those closings came in
the last four years. The trend in Florida, where the state's legislature this
year enacted a law allowing doctors to deliver babies via c section outside of hospitals.
According to the Kaiser Family Foundation, the idea was to lower costs and
give pregnant women a homeier birthing atmosphere. Now, the thing is there is
it's not like Central California, though, has homere you know, birthing center
atmospheres for people. So what's going on here? I suspect what's happening here
is part of this bigger problem with medical and the way that Democrats and Gavin
Newsom have sort of managed the entire system of healthcare for lower income people in
California where basically we have this problem. We have a lot of lower income
people who need health care and can't afford it themselves. So how do you
do it? And basically what Newsom has done is he has doubled down,
tripled down, quadrupled down, quintupled down on medical as medical as the blanket
solution for everyone in California who needs healthcare, extending and extending and extending and
extending medical eligibility. And I think Democrats in general, not just in California,
but nationwide. Democrats in general have realized Medicaid is super popular. Medicaid
expansion, the expansion of Medicaid eligibility that happened under Obamacare, has been a
very popular aspect of Obamacare. It gives you coverage, It gives you some
kind of baseline coverage, and Democrats love it. Democrats also like using it
as a political cudgel against Republicans. You all remember when David D. Valadeo
lost his seat in Congress for two year stretch. How TJ. Cox beat
him for one two year cycle? How did he do it? David Valadeo
voted to repeal Obamacare early in the Trump years, and Valadeo was able to
run on and TJ. Cox rather was able to run on. David Valadeo
voted to take away medical coverage from, however, many tens of thousand,
hundreds of thousands of people who live in his district. That's simple fact of
the matter is that Obamacare expanded hugely the pool of people eligible for Medicaid in
California. That's medical So Democrats really like it, and Gavin Newsom comes into
office. He comes into office with these grandiose promises about he's going to have
universal single payer California healthcare, and he's blowing that trumpet before or he comes
into office. Oh, I'm gonna have universal health care coverage. Then he
comes into office and all of a sudden is hit by all the lobbyists from
all the insurance companies, and magically, suddenly, all of a sudden changes
his tune. The insurance companies do not want to be run out of business
in California, so what do they do? Well, they convince Gavin Newsom,
hey, instead of pushing for a single payer system, why don't you
instead just keep expanding medical eligibility until every single person in California is covered.
So that's what Newsom has done. He expands and expands and expands and expands
medical eligibility. And the deck of cards that is medical just keeps getting taller
and taller and taller and taller. And I say it's a deck of cards
because we can't afford to cover all all of these people. It's not working.
The insurance reimbursements that providers get from taking care of medical patients isn't enough
to cover the cost of care. You're losing money on medical patients. It's
not even a question of breaking even. You're losing money on medical patients very
often, for very many different kinds of fields of health care. And maybe,
you know, maybe for if you have one specific thing that you're doing
that you can set up your clinic and you're you can set things up,
so it's that you know, you're turning through x number of patients per hour
doing this service at this reimbursement rate on average, and you're averaging this many
dollars per hour, and your costs for your nurse practitioner or your doctor whatever
are lower. Okay, maybe there are some people who can make money on
some things, but in general, the imbursement rates for medical are so low
that doctors, that hospitals, that clinics are losing money taking medical patients.
The only people making money off medical are federally qualified health clinics. And why
are they making money Well, because they have a bunch of federal subsidization.
That's the only way it works is if they get a big infusion of federal
cash on top of the state funded reimbursements from medical. So this financial unsustainability
of medical is leading to problems of yes, you have medical coverage, but
where do you go for care? You have medical coverage, but where are
you going to actually get your healthcare? In Madeira, where's your hospital?
Oh, it went out of business. Madera Community Hospital went out of business.
Why did it go out of business, Well, it went out of
business because the overwhelming bulk of their patients are medical patients. They don't have
the same portfolio of investments that Valley Children's has, which, by the way,
we can talk about Valley Children's later on in the show. They don't
have the same portfolio of investments and they don't have the same kind of philanthropic
support that Valley Children's has. So as a result, Madera community, they're
taking care of all these medical patients, all these medical patients, and they're
losing money on Eventually, the hospital just became a financially unsustainable venture and it
went out of business. And there are other hospitals around California facing if not
quite as dire, maybe they're not quite shut down, but there are other
hospitals in California facing the same difficulty. Now for us, you know,
we right to life, I mean, we dealt with this in the area
of prenatal and maternity care. Okay, so what are we seeing in the
city of Fresno the dynamics of medical And by the way, Gavin Newsom has
ramped up this unsustainability of medical by basically we're adding more and more and more
people who are eligible for medical benefits without being able really to increase the pot
of money from the state to reimburse providers for taking care of medical beneficiaries.
And guess what, Gavin Newsom just added another humongous Gavinusom in the state legislature
added another humongous population of people who are now eligible for medical illegal aliens.
Everyone under a certain income threshold is eligible for medical regardless of your immigration status.
Right you can see the billboard. I've seen the billboard driving south on
the ninety nine in Spanish declaring, you know, I forget, I forget
the actual phrase it did, no s importa status the emigression. I can't
I can't remember exactly what the phrase is in Spanish, but it's loudly proclaiming
you're eligible for medical regardless of your immigration status. So that's the situation.
So Gavin Newsom's adding in another huge population of people into medical. Meanwhile,
the state is facing a seven three billion, however you want to slice the
math budget deficit. Now, it seems like there are some other factors that
may be in place specifically with this, with this maternity ward at Adventist Health
to Larry, Adventist Health Larry closed its maternity ward. Part of it seems
to be so many mothers are just going to the er to deliver rather than
going through the normal procedures at the maternity ward at Adventist and so basically they
were like well, if we can't sustain this ward, if we don't have
people going there, but why are people going to the emergency department to deliver
their babies? Well, very often what's happening. I think the dynamics of
what's happening is you have more and more women who are on medical and you
have fewer and fewer options for clinics or docs or nurse practitioners who are willing
to take medical patients because they lose money. And this vicious cycle gets worse
and worse and worse where fewer docs want to take more and more patients.
So if the first appointment, if you realize you're pregnant, and your first
appointment you can get is like two months out, two and a half months
out, you might not come. Especially if you're kind of in a chaotic
like home situation or something, you might not come. It's over twenty percent
of women in South Fresno who get no prenatal care at all before they deliver
their baby. The first time they see a doc for their pregnancy is when
they crash the ober At community or at Saint Agnes and apparently at Adventist into
Larry, which is how most of these women are given birth. They're given
birth by just they're pregnant, they haven't seen a doctor the whole pregnancy,
seemingly, or that they haven't had any kind of consistent care over the course
of their pregnancy, and they're crashing the maternity er right when they're about to
deliver. So this is just yet another example of where and I'm not saying
there's an easy answer here, but we're just doubling and tripling and quadrupling down
on the medical solution for everyone's healthcare. And I just don't I don't see
how this is sustainable. When we return, we'll talk about Gavin Newsom's broken
promises about single payer health care. That is next on the John Girardi Show.
Story about the birthing center in to Larry being closed down. Adventist Health
to Larry at its birthing center and it decided to close down for lack of
demand. All these women are going to the er to deliver their babies.
And I'm connecting this to the broader problem of medical in California that Gavin Newsom
has just decided that medical and expanding medical eligibility to basically everyone to cover up
all the holes of all the different populations in California that didn't have health insurance.
Gavin Newsom's just decided, Oh, I'll just expand medical eligibility and then
I'm done. I've accomplished single payer healthcare now, or excuse me, I've
accomplished the goal of universal healthcare, specifically, not single payer, which is
what Newsome campaigned on in twenty eighteen. In twenty eighteen, when Newsom's running
for governor, he said, oh, oh, Democrat politicians always talk the
talk about single pair and then when it comes time to deliver, they always
kick the can down the road. I'm not gonna do that. And then
he proceeded to do precisely that. So let me talk about that, about
this broken promise by Newsom of about single payer health care. Now, let
me just be clear. I am not saying single payer health care is good.
I am not saying single payer health care does not come with enormous risks,
dangers, as well as enormous cost. Okay, it would require a
massive tax increase. It would. It's a massive, massive undertaking. But
there is a certain kind of internal coherence to it that does not exist with
Gavin Newsom's let's just expand medical strategy. All Right, Gavin Newsom is basically
in this position, this awkward position, where he he he can't. He
feels as though he just cannot increase taxes that much more on Californians. We're
already the most overtaxed state in the Union. He is incredibly reliant on a
very small percentage of the California population whose tax revenue is propping up the whole
system. If they all move, this whole thing becomes unsustainable, or if
they move their assets out of California, or whatever happens, this whole thing
becomes unsustainable. He's basically reliant on about one hundred thousand super high income taxpayers,
you know, maybe high investment income, high whatever income, whose capital
gains taxes and income taxes are sustaining the whole shebang. And frankly, we
might be at the point where Newsom has already ticked them off so much that
we are now in unsustained ability mode. I mean, the state budget this
year is looking like it's gonna have a seventy three billion dollar deficit. Now
that we're out of this La La land we were living in where in twenty
twenty two we had a budget surplus, and Newsom was like, oh,
happy days are here to stay. No, we had a surplus because we
had a huge infusion of COVID cash from the federal government. That was not
the norm. That was the deviation the last two years of running deficits.
That's the norm, much to Jerry Dyer's chagrin, because of course, in
twenty twenty two, when we had a surplus, that's when Gavin Newsom promised
him, Oh, yeah, we'll give Fresno two hundred and fifty million dollars
for downtown revitalization efforts. Here's the first fifty million. And then twenty twenty
three, Ah, we have a deficit. Sorry, I'm not going to
give you the second installment. Twenty twenty four, Ah, we have another
budget deficit. I'm not going to give you the second installment this year either.
So now we're two years behind and guess what, Jerry, I don't
think that money's ever coming all right anyway, So again I'm not I'm saying
single payer healthcare is crazy expensive and would require some kind of tax increase,
and the argument in favor of doing that is, well, the healthcare system
in general is so expensive that yes, you would increase taxes, but you're
cutting all kinds of costs as far as the actual provision of healthcare. So
it's sort of a reshifting of costs towards the wealthiest one percent. And the
problem is that, well, the wealthiest one percent have agency, and maybe
they will move if you do this to them. So I think Newsom came
to this conclusion, especially given that the people he most needs to keep happy
if he wants them to raise funds for him to run for president, they
didn't really want this. Okay, the ultra super wealthy whose money he needs
to run for president in twenty twenty eight, they probably weren't crazy about this
either. And the insurance companies. Now, what do we mean by single
payer universal healthcare. Well, in healthcare ecosystem you have payers, providers,
patients. The provider is the doc or the nurse practitioner providing the service.
The patient is the patient, the payer is the insurance company. So that
is kind of the circle of life for the practice of medicine. The patient
has some form of insurance from either an insurance plan he pays for himself or
that his employer pays for as part of his compensation. So the health insurance
company gets those premiums, the provider provides the care to the patient, and
the payer gives money to the provider. So that's the circle of life patient
payer provider. In California, we have multiple payers, all different kinds of
private companies quasi private, public and medical and medicare and other kinds of government
health insurance, so we have multiple payers. Single payer healthcare means you eliminate
all the payers except for one, and that one payer then controls everything with
a provision of care, and there's a certain kind of internal coherence to it.
It eliminates all the cost It eliminates a lot of costs, but it
also has problems that now the state is completely controlling the practice of medicine.
But it does also accomplish universal coverage in a way that's sustainable. It's taking
all the tax revenue from the super wealthy people, taking tax revenue from everybody
to sustain this system that's caring for everybody, rich and poor like, so
it has a kind of financial sustainability. The problem is it's at the expense
of a massive increase in the taxes on wealthy people, and Newsome just wasn't
willing to go that far. So instead, what has he done, He's
just increased medical eligibility. We maintain our situation of multiple payers in the market.
Medical just becomes a bigger and bigger and bigger. Well. It has
more and more and more beneficiaries that it covers, but it's not getting more
and more and more money pay The patients aren't paying premiums, are aren't paying
premiums into medical that are sustaining this thing Medical. The money Medical gets to
pay payers has to come from tax payers, and our taxes haven't grown commensurate
with the additional number of people who are medical eligible, especially now that we've
added illegal aliens to that list. So Newsome opted for, i think,
the easier option so that he could say, oh, yeah, so I've
done it. Everyone in California's covered. But he did so in a way
that's just financially unsustainable. And that's why we're seeing the problems we're seeing of
hospitals going under, of maternity wards, closing of huge percentages of women not
getting any prenatal care. It's because Newsom has just doubled, tripled, quadrupled
down on this fundamentally unsustainable system for providing healthcare coverage for Californians. All Right,
when we return, another hit piece on Valley Children's Hospital, I dig
into it. That is next on the John Girardi Show. We've had this
huge spate of hit pieces against Valley Children's Hospital over the last two months or
so. Basically, all these hit pieces to say Valley Children's is giving way
too much money to its CEO, Todd Cuntrapak, and to its executives,
that its executive compensation is too high relative to the size of the hospital,
et cetera. And this a lot of some of the focus of this is
coming from Gary Brettefeld and Miguel Arius, who particularly tried to call out Lisa
smit Camp. Lisa Smithcamp sits on one of the boards at Valley Children's Hospital,
and Brettefeld and Arius took the time out to sort of say, well,
she should you know, she's on this board of directors. This is
so inappropriate that they're spending so much on executive compensation when this is a children's
hospital, a charitable hospital that relies on philanthropic support and grant support like this
seems inappropriate. They called for investigations into whether Valley Children's was misusing medical money
for all this executive compensation, and I have pushed back on that, and
I think all of these criticisms I think are misguided and incorrect. For one
thing, the attacks on Lisa Smitcamp, I think, in particular are misguided.
The Valley Children's has more than one board of directors for sort of more
than one on departments or wings of the hospital, and the particular board that
Lisa Smithcamp is on, like I know other people on that board, it's
not a board that is concerned with executive compensation. They don't review approve executive
compensation. That's just not it's more of a it just does not have anything
to do with executive compensation decisions. So Lisa Smithcamp has no oversight for that.
That's not within her domain. Also, I think the allegation that there
could be misuse of medical funding for executive compensation for Value Children's, I think
that is just very very implausible. What the medical funding the Value Children's receives
is in exchange for services. Okay, you provide care for a patient who
is a medical beneficiary, you get reimbursed by medical. As I was describing
in the last segment, medical does not reimburse Well, it's like the least
you know, from a pure dollars and cents perspective, if you see a
patient walk through the door with private insurance, you're like, yes, if
you see a patient walking through the door with medical again, this is just
purely from a dollars and cents perspective, you say, ah, darn it.
Why because medical just it has a limited pool of money taxpayer money to
fund reimbursements for medical and the pool of people who are now medical eligible is
just getting bigger and bigger and bigger. Funding for medical is not growing commensurate
with that pool of people, so medical reimburses poorly. Medical is also administratively
a nightmare to deal with, and you're probably in many cases, Valley Children's
is losing money on its medical patients, which, by the way, is
about seventy percent of its patient pop. So to argue that medical funding might
have somehow inappropriately funded executive compensation the medical funding that Valued Children's get, they
lose money on most of their medical transactions. Okay, yes, in the
aggregate over the course of a whole year. The number that the total amount
of money that Value Children's receives from medical looks like a very big, impressive
number, right, I don't know what the number is, but let's let's
don't I don't even know if this is correct scale wise. Let's say that
Value Children's gets one hundred million dollars per year from medical Well, Value Children's
probably spent one hundred and twenty million dollars in costs to get that one hundred
million dollars in reimbursement. Okay, Now again I don't know if those numbers
are even close to the right scale. But you see what I'm saying.
Whatever they're getting from medical funding at Valley Children's, it's probably they're either barely
breaking even or losing money. So the idea that it's medical funding that's you
know, allowing that that's goosing their executive compensation to higher and higher levels,
that allows Todd Suntrapak to make you know, a huge bonus in a year,
and blah blah blah blah blah. No, that's not what's happening.
That's not how it works. That that doesn't make sense. As far as
the financial picture of Value Children's. The reason why Value Children's is able to
be sustainable financially is not because they're getting money hand over fists from medical.
Nobody's getting money hand over fists from medical. The reason they're financially sustainable is
because they have a very successful portfolio of investments and they have really strong palanthropic
support. That's why they're still doing well. And I guess the people who
are complaining about Valued Children's having a large portfolio of successful investments, I would
ask them, well, what would you rather have a hospital that's working,
that's open, that's still taking care of kids at a really high level,
that has a big portfolio of successful investments that help fund this operation, Or
would you rather have Mederic Community Hospital, which is serving a similar as so
far as socioeconomically, a similar patient demographic. Okay, about seventy percent of
Valued Children's patients are medical patients. You're losing money on your medical patients.
Maderic Community was probably a similar percentage. The only difference is Valley Children's is
open and Mederic Community ain't, so which is better? And also Valued Children
Yes, they're paying their executives a lot, but here they are in this
very difficult market. It's a more difficult market than San Diego. It's more
difficult market to make things work. There's a much poorer community doing as good
a job as big time children's hospitals in big time, much more higher socioeconomic
parts of the state. Like, yeah, there should be good executive compensation,
and a lot of this is the be looking, you know, not
understanding how stuff was lined up, as far as we had two years worth
a bonus in one year or this or that. Basically my assessment of it
is, I just don't think that the executive compensation that Value Children's is providing.
I just don't think it's that excessive. I think a lot of especially
when you're not just focusing on Centrapac, but other executives at the hospital.
A lot of these people have been there for thirty years and are really good,
are really successful, and you don't just reset their pay scial because just
for some arbitrary reason, ah, we're paying them. No, these are
great people doing a great job. They've been there for decades. Keep paying
them well. So we now have this story from the increasingly irrelevant Fresno Bee,
and the Bee seems to have sort of established itself as we are going
to be the attack dogs against Valley Children's, which, fortunately for Valley Children's,
the Bee is becoming less and less significant on the local stage. It
is. I think it's only being printed like three days a week. Now
are coming up soon it'll only be printed like three days a week. So
here's the story. As Valley Children's give back enough, Valley Children's Hospital,
the largest pediatric hospital in central California, reinvested the lowest amount of money into
its region when compared to the nation's other largest nonprofit children's hospitals that have the
same tax exempts charitable status. A Fresno b analysis found the be examined the
amount of Valid Children's reported spending on what the IRS considers community benefit, such
as free medical care provided to certain patients. Well, it says provided certain
patients, but that's the TYPO. Located in Madera County, maybe get an
editor. Located in Madera County, Valley Children's is the sixteenth largest children's hospital
in the US, with three hundred and fifty eight beds. When compared to
the nation's fifteen larger such hospitals, Valley Children's came in last in how much
it gives back to the community as a percentage of total expenses, And it
wasn't close. Now it has to do with a few things. One is
the kind of giving that's in this one bracket of spending as opposed to other
kinds of charitableivings. There's also the problem of every kid in California is medical
eligible, and up to now that has not been the case with A California
adults and b non California kids at non California hospitals. So basically what this
category of quote community giving a lot of what falls into that bucket is basically
providing free health care for people who don't have insurance. Valley Children's doesn't do
that as much because every kid in California's got medical eligibility, so the amount
of money that they're going to put into free healthcare is smaller than would be
the case at I don't know a children's hospital. The Scottish Right Hospital in
Dallas, Texas, where my dad did his fellowship. It's a children's hospital
in Dallas, Well Scottish Right in Texas. They don't have the same level
of Medicaid coverage for kids in Texas. They probably do more free healthcare provision
for kids than Valley Children's does, not because they're taking more poor kids or
because they're so much more generous. Scottish right would take Medicaid coverage. You
know, they would take Medicaid coverage too if they could get it. So
even this, it just seems like it's kind of a phony, blooney story
by the Bee where they have to acknowledge later on that yeah, Children's has
stuff in other categories of giving, not just specifically there. You know,
they're in a different situation from say, again a hospital in Texas or even
hospitals in Fresno that take adult patients. They are more adult patients that don't
have coverage, So you know, Saint Agnes is able to put more into
that bucket of giving because they have more of these adult patients who don't have
coverage that they're just providing care to for free. So I guess it.
I'm this whole story about the Fresno B It just astonishes me, this myopic
obsession with it on the part of again the increasingly irrelevant Fresno B and other
people. I just think this is like, unquestionably the one hospital that is
operating at the absolute highest level, and this is the one that we're targeting
for this big campaign to discredit it. I just find it bizarre. When
we return, I warn my listeners about the biggest scam this upcoming election season
and every upcoming election season, signing petitions. Don't do it. Next on
the John Girardi Show, this is a public service announcement for all you folks
out there, especially you see who maybe sometimes don't catch on to these various
scam attempts. So I was going through some tweets from Rand Paul, and
Rand Paul in the US Senate has been the chief foe of Anthony Fauci and
has been I think one of the members of Congress most critical of him and
most critical in examining his conduct over the course of COVID in a way that
I think was admirable. And I think that's a good role for Rand Paul,
given that he's a physician, and you know, he had a particular
interest in this, and he had a series of tweets about stuff with Fauci,
and this says, sign my petition to hold Fauci accountable, which made
me roll my eyes. Let me explain this to all of you. Don't
sign petitions. I'm not talking about like a petition to get like a California
ballot initiative qualified, which where it's like an official state form for adding your
signe. I'm not talking about that. Don't sign online petitions. All you
seniors who get angry about spam phone calls, spam political texts, spam mail,
you're the ones who probably are signing these petitions. Don't sign online petitions.
The only point of a politician asking you sign this petition to build the
wall, sign this petition to take down Crooked Joe, sign this petition to
tell doctor Fauci he's a son of a gun. The only point of those
petitions is to get your email address and your cell phone number so that politicians
can send you campaign ads. That's the only points. So don't sign online
political petitions. That'll do it for John Jurardy Show. See you next time
on Power Talk