The most important political race in the state this year is one you know nothing about.
The five elected directors of the Maricopa Integrated Health System toil in unpaid anonymity. Yet their actions will determine the future of Arizona's only public hospital at a critical time.
And that's not hyperbole: The Maricopa Medical Center is struggling to keep its accreditation, yet one slate of candidates running wants to put the district on an extreme diet. Republican bigwigs paint this as an issue of fiscal responsibility, but to me, it looks instead like one of those penny-wise, pound-foolish nightmares.
Maricopa Integrated Health System
At a time when emergency rooms across the state are packed, cutting services at the county hospital would surely result in catastrophe.
And even though you probably have no idea what's at stake, insiders are buzzing. Three former state legislators, as well as the former directors of both the county and the state health departments, have thrown their hats into the ring. Rob Carey, best known as Grant Woods' top aide during Woods' tenure as attorney general, is also a candidate — and prominent GOP lobbyist Stan Barnes is actually running his executive assistant for a seat. Even Sheriff Joe Arpaio is making a cameo: He's made robo-calls and has been the guest of honor for at least one fundraiser.
As it turns out, most of the big names are lined up to stop the Republican-sponsored slate. Believe it or not, even the big Republican names are lined up to stop the Republican slate. That's how out of touch the party has become.
The health district race is actually one of the weirdest, most chaotic ones we'll have this fall. And that's why I'm so worried.
Is anyone out there paying enough attention to this circus to know what they're voting for?
Four years ago, the Maricopa County Board of Supervisors spun off its neglected hospital district, making it a standalone entity rather than just another program under the supervisors' wing. County voters then elected a five-member panel to run it.
Overall, the panel has done a good job shoring up the district's financials, and the hospital is now in much better shape than it was when the Supes handed it off.
We could undo that with this election.
I first started paying attention to this race when I learned that Sheriff Joe and his evil little Igor, County Attorney Andrew Thomas, had endorsed some candidates for it. That seemed odd.
Then I read in the Arizona Republic that the Maricopa County Republican Party had endorsed a slate of five candidates without bothering to send out questionnaires or contact the Republican incumbents. As the Republic noted, two respected former GOP state legislators, Sue Gerard and Greg Patterson, also were running, yet the party hadn't bothered to contact them, either.
I don't know either of the two board members running for re-election. But I do know that Gerard and Patterson are not candidates to be taken lightly. Patterson writes the most influential blog in town, www.espressopundit.com. And Sue Gerard is the former director of the state health department — as well as that rare politician who's respected across the partisan divide. Gerard tangled with Governor Janet Napolitano while running the health department and ultimately resigned from her post, but you still can't find anyone in town who has a bad word to say about her. By all accounts, she's a straight shooter and a real professional.
So why would the GOP endorse a slate without even talking to Gerard or Patterson? It made no sense to me.
That's when I found out about Mike Albertson.
Albertson isn't on the ballot, though he might as well be. A GOP activist who's donated more than $4,000 to Republican causes in the past two years, he's shepherded this Republican "slate" through the details of running for office . . . and helped secure those party endorsements, too.
Albertson says he got involved because the county Republican Party wanted to make sure it had a candidate in every race. "I don't have any interest in the hospital," he insisted. "The issue is, you've got to get good people running boards."
But the truth is more complicated.
Albertson isn't just a party loyalist. He's also a former hospital executive — most recently at Sun Health — and current hospital consultant. In November, his two-person consulting firm bid on a $60,000 contract for the health district. When they didn't get it, Albertson lodged a formal protest.
Albertson insists that his failed bid has nothing to do with his interest in the healthcare district. But an e-mail Albertson sent to his slate of candidates in January raises serious questions about whether he really wants to help the medical center or destroy it.
The e-mail, with a subject line of "good story," linked to a recent New York Times story about hard times at the public hospital in Atlanta. As the Times reported, that city's safety net hospital has fallen into "financial crisis."
The story was an interesting one — and Atlanta's Grady Memorial Hospital does share some problems with the Maricopa Integrated Health System. It can't compete with private hospitals in the area, so it has a hard time attracting paying clients. But its poor neighbors need its care, now more than ever.
The problem is how Albertson framed it.
In his e-mail, he seemed to be boasting about how he'd helped to cause Grady's "financial crisis." I'm not kidding.
"This is a good article that mirrors many issues at Maricopa Integrated," Albertson wrote. "I can share with you specific strategies we employed in 2002 to cripple Grady's political monopolization of the Atlanta market . . . which you can see was successful in the article below."
The hospital is in financial crisis, and Albertson is boasting about strategies he used to undercut it?
As Albertson admitted to me last week, he worked for a private hospital in Atlanta in 2002. And, yes, that hospital worked to "cripple" the public hospital's political monopoly. Albertson seemed offended that I would suggest that he's trying to "cripple" the medical center here: "We were trying to cripple the political monopolization, not the hospital."
Okay, but the problem is that Albertson is not running a slate to take over a private hospital and guide the aforementioned crippling. Instead, he's fielding his slate to run the public hospital, even as he's boasting about how he helped put another public hospital into crisis. That's scary.
On the phone, Albertson doesn't come off as malevolent, but he is clearly a fiscal conservative who doesn't believe the government should subsidize a hospital — never mind that the government really subsidizes all healthcare to an alarming extent.
He frames the issue in terms of cronyism. He talks about lawyers giving money to board members — and then getting a contract for legal services. He rails about the GOP-connected firm, High Ground, being paid to lobby the Legislature. (He doesn't think a public hospital should have lobbyists.) And while the current board would like to see a plan for a new facility, or an upgrade to the giant complex at Roosevelt and 24th streets, to attract more paying customers, Albertson sees that as just an excuse to raise taxes.
These are the talking points echoed in his slate's campaign materials.
The weird thing is, most of the political insiders I talked to don't even know who Mike Albertson is. Some of them, like Sue Gerard, told me that they got involved simply because they were concerned by the GOP-backed candidates' inexperience with healthcare.
"I think there's a lack of understanding about what a hospital does, and how it makes money," Gerard told me. "The hospital could become self-sufficient, but instead they want to starve the beast, thinking that solves the problem."
Dr. Jonathan Weisbuch is the former head of the county public health department. He's also a candidate for the board this year — a Democrat worried about what he's hearing from the GOP slate.
"The hardest thing about this race is to get people to understand that this vote is more important, at least to those who live near the poverty line, than their vote for president this year," he says. "This is going to affect their families directly."
Without the proper funding and a knowledgeable board of directors, Weisbuch suggests, the board could lose its accreditation in a matter of months. (In fact, it's been teetering near the brink for a while now — which suggests Weisbuch is not an alarmist.) That means no reimbursement for Medicaid patients, or those on the AHCCCS health insurance plan.
And if that happens, the county hospital would surely have to close its doors.
The Mike Albertsons of this world may not see that as a huge problem. But with emergency rooms already overcrowded and no private hospital wanting to take on the poorest customers, it would be, unquestionably.
Albertson defends his team of outsiders as saving the county from insiders, looking to cash in: "If you can't get honest people — John and Jane Doe — to run, you're going to get people who are there because they have special interests."
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SHOW ME HOW
But what Mike Albertson doesn't get is that the notion of "crippling" the public hospital here also qualifies as a special interest. And it's the special interest that could prove most damaging in the long run — to our quality of life and the bottom line. It's much cheaper to serve poor customers at the medical center than to force them to get all treatment at various emergency rooms. The taxpayer always ends up paying the piper, whether at public or private hospitals. The question is how to set up the smartest system. Under a model without the medical center, I have no doubt we'd pay more in the long run.
And who's to say what'll happen if the Official Republican Slate gets elected? Albertson won't be the only guy vying for their ear. I'm more concerned about the system's influence on a group of neophytes, who won't even realize they're being had, than on an old pro like Sue Gerard.
Mike Albertson and the Maricopa County Republican Party are backing Rex Altree, Colette Rosati, Harlan Stratton, Elbert Bicknell, and Todd Hansen. You may want to scrawl those names on a slip of paper to take to the polling booth. Then vote for anyone else running.