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June 8, 2024 38 mins
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It's just another example, another featherin 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. AdventistHealth to Larry has closed its maternity ward.

So I think this must be inor near the city of Tilarry.
To Larry County's expectant mothers, saysthe story in GV wire have one less
place to receive maternity care. Asof Thursday, a drop into Larry County's
birthrate and the number of planned birthsat Adventist Health to Larry led the decision
to close the maternity ward, ahospital official set after the close, mothers

wanting to deliver their baby in ahospital will have to go to Visalia,
Redley, or Hanford. Adventist hopesto 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 CaliforniaNetwork. But closing the department follows a

trend in California of maternity wards shuttingdown because of lack of demand. Hospital.
Births have declined by sixty percent overthe past year at Adventist Health to
Larry, and the hospital can nolonger sustain these services, said Tomno.
This decline in births at Adventist Healthto Larry aligns with a significant drop in
the birth rate into Larry County anda significant decrease in births in California.

More to Larry mothers are relying onthe emergency department. After the hospital closed
in twenty seventeen, Ogyan's got inthe 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. Intwenty twenty two, the hospital provided services
for twenty berths. By twenty twentyfour, that number had decreased to eight.
If you want to do things anddo things well, you need to
have to do more than five amonth, said Van Housen, who added
that the ideal number was closer tofifty. The hospital network explored a partnership

with healthcare clinic Altura Centers for Healthto 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 closeits maternity ward. Matthew Beeler, the
chief strategy officer with American Advanced Management, the health system taking over operations for
Madera Community Hospital, said the companyis 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 trendin Florida, where the state's legislature this
year enacted a law allowing doctors todeliver 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 goingon here? I suspect what's happening here

is part of this bigger problem withmedical and the way that Democrats and Gavin
Newsom have sort of managed the entiresystem 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'tafford it themselves. So how do you

do it? And basically what Newsomhas done is he has doubled down,
tripled down, quadrupled down, quintupleddown on medical as medical as the blanket
solution for everyone in California who needshealthcare, extending and extending and extending and
extending medical eligibility. And I thinkDemocrats in general, not just in California,

but nationwide. Democrats in general haverealized Medicaid is super popular. Medicaid
expansion, the expansion of Medicaid eligibilitythat happened under Obamacare, has been a
very popular aspect of Obamacare. Itgives you coverage, It gives you some
kind of baseline coverage, and Democratslove 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 twoyear stretch. How TJ. Cox beat
him for one two year cycle?How did he do it? David Valadeo
voted to repeal Obamacare early in theTrump years, and Valadeo was able to

run on and TJ. Cox ratherwas able to run on. David Valadeo
voted to take away medical coverage from, however, many tens of thousand,
hundreds of thousands of people who livein his district. That's simple fact of
the matter is that Obamacare expanded hugelythe pool of people eligible for Medicaid in

California. That's medical So Democrats reallylike it, and Gavin Newsom comes into
office. He comes into office withthese grandiose promises about he's going to have
universal single payer California healthcare, andhe's blowing that trumpet before or he comes

into office. Oh, I'm gonnahave universal health care coverage. Then he
comes into office and all of asudden is hit by all the lobbyists from
all the insurance companies, and magically, suddenly, all of a sudden changes
his tune. The insurance companies donot want to be run out of business
in California, so what do theydo? Well, they convince Gavin Newsom,

hey, instead of pushing for asingle payer system, why don't you
instead just keep expanding medical eligibility untilevery 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 ofcards 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 allall of these people. It's not working.
The insurance reimbursements that providers get fromtaking 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 kindsof fields of health care. And maybe,

you know, maybe for if youhave one specific thing that you're doing
that you can set up your clinicand you're you can set things up,
so it's that you know, you'returning through x number of patients per hour
doing this service at this reimbursement rateon average, and you're averaging this many
dollars per hour, and your costsfor your nurse practitioner or your doctor whatever
are lower. Okay, maybe thereare some people who can make money on

some things, but in general,the imbursement rates for medical are so low
that doctors, that hospitals, thatclinics are losing money taking medical patients.
The only people making money off medicalare federally qualified health clinics. And why
are they making money Well, becausethey have a bunch of federal subsidization.

That's the only way it works isif they get a big infusion of federal
cash on top of the state fundedreimbursements from medical. So this financial unsustainability
of medical is leading to problems ofyes, 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 theirpatients are medical patients. They don't have
the same portfolio of investments that ValleyChildren's has, which, by the way,
we can talk about Valley Children's lateron in the show. They don't

have the same portfolio of investments andthey don't have the same kind of philanthropic
support that Valley Children's has. Soas 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 hospitaljust became a financially unsustainable venture and it

went out of business. And thereare other hospitals around California facing if not
quite as dire, maybe they're notquite 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 medicalAnd by the way, Gavin Newsom has
ramped up this unsustainability of medical bybasically we're adding more and more and more
people who are eligible for medical benefitswithout being able really to increase the pot

of money from the state to reimburseproviders for taking care of medical beneficiaries.
And guess what, Gavin Newsom justadded another humongous Gavinusom in the state legislature
added another humongous population of people whoare now eligible for medical illegal aliens.

Everyone under a certain income threshold iseligible 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, nos importa status the emigression. I can't
I can't remember exactly what the phraseis in Spanish, but it's loudly proclaiming
you're eligible for medical regardless of yourimmigration status. So that's the situation.

So Gavin Newsom's adding in another hugepopulation of people into medical. Meanwhile,
the state is facing a seven threebillion, however you want to slice the
math budget deficit. Now, itseems 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 closedits maternity ward. Part of it seems
to be so many mothers are justgoing to the er to deliver rather than
going through the normal procedures at thematernity ward at Adventist and so basically they

were like well, if we can'tsustain this ward, if we don't have
people going there, but why arepeople going to the emergency department to deliver
their babies? Well, very oftenwhat's happening. I think the dynamics of
what's happening is you have more andmore women who are on medical and you

have fewer and fewer options for clinicsor docs or nurse practitioners who are willing
to take medical patients because they losemoney. And this vicious cycle gets worse
and worse and worse where fewer docswant to take more and more patients.
So if the first appointment, ifyou realize you're pregnant, and your first

appointment you can get is like twomonths 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, youmight not come. It's over twenty percent
of women in South Fresno who getno prenatal care at all before they deliver

their baby. The first time theysee a doc for their pregnancy is when
they crash the ober At community orat Saint Agnes and apparently at Adventist into
Larry, which is how most ofthese women are given birth. They're given

birth by just they're pregnant, theyhaven't seen a doctor the whole pregnancy,
seemingly, or that they haven't hadany kind of consistent care over the course
of their pregnancy, and they're crashingthe maternity er right when they're about to
deliver. So this is just yetanother example of where and I'm not saying

there's an easy answer here, butwe'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 wereturn, 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 toLarry being closed down. Adventist Health
to Larry at its birthing center andit decided to close down for lack of
demand. All these women are goingto the er to deliver their babies.
And I'm connecting this to the broaderproblem of medical in California that Gavin Newsom

has just decided that medical and expandingmedical eligibility to basically everyone to cover up
all the holes of all the differentpopulations 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 payerhealthcare 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 whenit 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 aboutsingle payer health care. Now, let
me just be clear. I amnot saying single payer health care is good.
I am not saying single payer healthcare 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 internalcoherence 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 increasetaxes that much more on Californians. We're

already the most overtaxed state in theUnion. He is incredibly reliant on a
very small percentage of the California populationwhose 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 onabout one hundred thousand super high income taxpayers,
you know, maybe high investment income, high whatever income, whose capital
gains taxes and income taxes are sustainingthe whole shebang. And frankly, we

might be at the point where Newsomhas 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 havea seventy three billion dollar deficit. Now
that we're out of this La Laland 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 cashfrom the federal government. That was not
the norm. That was the deviationthe last two years of running deficits.
That's the norm, much to JerryDyer's chagrin, because of course, in
twenty twenty two, when we hada surplus, that's when Gavin Newsom promised
him, Oh, yeah, we'llgive Fresno two hundred and fifty million dollars
for downtown revitalization efforts. Here's thefirst fifty million. And then twenty twenty

three, Ah, we have adeficit. Sorry, I'm not going to
give you the second installment. Twentytwenty four, Ah, we have another
budget deficit. I'm not going togive you the second installment this year either.
So now we're two years behind andguess what, Jerry, I don't
think that money's ever coming all rightanyway, So again I'm not I'm saying
single payer healthcare is crazy expensive andwould require some kind of tax increase,

and the argument in favor of doingthat 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 faras the actual provision of healthcare. So
it's sort of a reshifting of coststowards the wealthiest one percent. And the
problem is that, well, thewealthiest one percent have agency, and maybe
they will move if you do thisto them. So I think Newsom came

to this conclusion, especially given thatthe people he most needs to keep happy
if he wants them to raise fundsfor 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 twentyeight, they probably weren't crazy about this

either. And the insurance companies.Now, what do we mean by single
payer universal healthcare. Well, inhealthcare ecosystem you have payers, providers,
patients. The provider is the docor the nurse practitioner providing the service.

The patient is the patient, thepayer is the insurance company. So that
is kind of the circle of lifefor the practice of medicine. The patient
has some form of insurance from eitheran insurance plan he pays for himself or
that his employer pays for as partof his compensation. So the health insurance

company gets those premiums, the providerprovides 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, wehave multiple payers, all different kinds of
private companies quasi private, public andmedical and medicare and other kinds of government

health insurance, so we have multiplepayers. 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'sa certain kind of internal coherence to it.
It eliminates all the cost It eliminatesa lot of costs, but it

also has problems that now the stateis completely controlling the practice of medicine.
But it does also accomplish universal coveragein a way that's sustainable. It's taking
all the tax revenue from the superwealthy people, taking tax revenue from everybody
to sustain this system that's caring foreverybody, 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 taxeson wealthy people, and Newsome just wasn't
willing to go that far. Soinstead, what has he done, He's
just increased medical eligibility. We maintainour situation of multiple payers in the market.
Medical just becomes a bigger and biggerand bigger. Well. It has

more and more and more beneficiaries thatit covers, but it's not getting more
and more and more money pay Thepatients aren't paying premiums, are aren't paying
premiums into medical that are sustaining thisthing Medical. The money Medical gets to
pay payers has to come from taxpayers, and our taxes haven't grown commensurate
with the additional number of people whoare 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 couldsay, 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'swhy 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 becauseNewsom has just doubled, tripled, quadrupled
down on this fundamentally unsustainable system forproviding healthcare coverage for Californians. All Right,
when we return, another hit pieceon Valley Children's Hospital, I dig
into it. That is next onthe John Girardi Show. We've had this

huge spate of hit pieces against ValleyChildren's Hospital over the last two months or
so. Basically, all these hitpieces 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 highrelative to the size of the hospital,

et cetera. And this a lotof 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 onone of the boards at Valley Children's Hospital,
and Brettefeld and Arius took the timeout to sort of say, well,

she should you know, she's onthis board of directors. This is
so inappropriate that they're spending so muchon executive compensation when this is a children's
hospital, a charitable hospital that relieson philanthropic support and grant support like this
seems inappropriate. They called for investigationsinto whether Valley Children's was misusing medical money

for all this executive compensation, andI have pushed back on that, and
I think all of these criticisms Ithink 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 oneboard of directors for sort of more
than one on departments or wings ofthe hospital, and the particular board that

Lisa Smithcamp is on, like Iknow other people on that board, it's
not a board that is concerned withexecutive compensation. They don't review approve executive
compensation. That's just not it's moreof 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 forexecutive 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 getreimbursed by medical. As I was describing
in the last segment, medical doesnot reimburse Well, it's like the least
you know, from a pure dollarsand cents perspective, if you see a

patient walk through the door with privateinsurance, you're like, yes, if
you see a patient walking through thedoor with medical again, this is just
purely from a dollars and cents perspective, you say, ah, darn it.
Why because medical just it has alimited pool of money taxpayer money to
fund reimbursements for medical and the poolof 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, somedical reimburses poorly. Medical is also administratively
a nightmare to deal with, andyou'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 themedical funding that Valued Children's get, they
lose money on most of their medicaltransactions. Okay, yes, in the
aggregate over the course of a wholeyear. The number that the total amount
of money that Value Children's receives frommedical looks like a very big, impressive

number, right, I don't knowwhat the number is, but let's let's
don't I don't even know if thisis correct scale wise. Let's say that
Value Children's gets one hundred million dollarsper year from medical Well, Value Children's
probably spent one hundred and twenty milliondollars 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 atValley Children's, it's probably they're either barely
breaking even or losing money. Sothe idea that it's medical funding that's you

know, allowing that that's goosing theirexecutive compensation to higher and higher levels,
that allows Todd Suntrapak to make youknow, 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. Thatthat 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'regetting money hand over fists from medical.
Nobody's getting money hand over fists frommedical. The reason they're financially sustainable is
because they have a very successful portfolioof investments and they have really strong palanthropic
support. That's why they're still doingwell. And I guess the people who

are complaining about Valued Children's having alarge portfolio of successful investments, I would
ask them, well, what wouldyou rather have a hospital that's working,
that's open, that's still taking careof kids at a really high level,
that has a big portfolio of successfulinvestments 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 patientdemographic. 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, sowhich is better? And also Valued Children
Yes, they're paying their executives alot, but here they are in this
very difficult market. It's a moredifficult 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 hospitalsin big time, much more higher socioeconomic
parts of the state. Like,yeah, there should be good executive compensation,
and a lot of this is thebe looking, you know, not
understanding how stuff was lined up,as far as we had two years worth

a bonus in one year or thisor that. Basically my assessment of it
is, I just don't think thatthe 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 beenthere for thirty years and are really good,
are really successful, and you don'tjust 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 havethis story from the increasingly irrelevant Fresno Bee,

and the Bee seems to have sortof established itself as we are going
to be the attack dogs against ValleyChildren's, which, fortunately for Valley Children's,
the Bee is becoming less and lesssignificant on the local stage. It
is. I think it's only beingprinted like three days a week. Now
are coming up soon it'll only beprinted like three days a week. So

here's the story. As Valley Children'sgive 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'sother largest nonprofit children's hospitals that have the
same tax exempts charitable status. AFresno b analysis found the be examined the
amount of Valid Children's reported spending onwhat the IRS considers community benefit, such

as free medical care provided to certainpatients. 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 hundredand 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 asa percentage of total expenses, And it
wasn't close. Now it has todo with a few things. One is
the kind of giving that's in thisone bracket of spending as opposed to other
kinds of charitableivings. There's also theproblem of every kid in California is medical

eligible, and up to now thathas not been the case with A California
adults and b non California kids atnon California hospitals. So basically what this
category of quote community giving a lotof what falls into that bucket is basically

providing free health care for people whodon't have insurance. Valley Children's doesn't do
that as much because every kid inCalifornia's got medical eligibility, so the amount
of money that they're going to putinto free healthcare is smaller than would be

the case at I don't know achildren's hospital. The Scottish Right Hospital in
Dallas, Texas, where my daddid his fellowship. It's a children's hospital
in Dallas, Well Scottish Right inTexas. 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 coveragetoo if they could get it. So
even this, it just seems likeit's kind of a phony, blooney story

by the Bee where they have toacknowledge 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 havemore of these adult patients who don't have
coverage that they're just providing care tofor free. So I guess it.
I'm this whole story about the FresnoB It just astonishes me, this myopic
obsession with it on the part ofagain the increasingly irrelevant Fresno B and other

people. I just think this islike, 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 listenersabout the biggest scam this upcoming election season

and every upcoming election season, signingpetitions. Don't do it. Next on
the John Girardi Show, this isa public service announcement for all you folks
out there, especially you see whomaybe sometimes don't catch on to these various
scam attempts. So I was goingthrough some tweets from Rand Paul, and

Rand Paul in the US Senate hasbeen the chief foe of Anthony Fauci and
has been I think one of themembers of Congress most critical of him and
most critical in examining his conduct overthe course of COVID in a way that
I think was admirable. And Ithink that's a good role for Rand Paul,

given that he's a physician, andyou know, he had a particular
interest in this, and he hada series of tweets about stuff with Fauci,
and this says, sign my petitionto hold Fauci accountable, which made
me roll my eyes. Let meexplain this to all of you. Don't

sign petitions. I'm not talking aboutlike a petition to get like a California
ballot initiative qualified, which where it'slike 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 phonecalls, spam political texts, spam mail,

you're the ones who probably are signingthese petitions. Don't sign online petitions.
The only point of a politician askingyou sign this petition to build the
wall, sign this petition to takedown Crooked Joe, sign this petition to
tell doctor Fauci he's a son ofa gun. The only point of those

petitions is to get your email addressand your cell phone number so that politicians
can send you campaign ads. That'sthe only points. So don't sign online
political petitions. That'll do it forJohn Jurardy Show. See you next time
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