East Palo Alto Mayor Ruben Abrica, San Mateo County Supervisor David Canepa and local healthcare workers gathered on Saturday at the Palo Alto Downtown Library to collect signatures for a ballot initiative that would cap Stanford Hospital bills to 15 percent above the cost of treatment, plus quality improvement costs.

The initiative would also require a medical facility that exceeds the 15 percent charge limit to refund patients for the difference.

Stanford Hospital spokesperson Patrick Bartosch called the initiative “unconstitutional and invalid if enacted.”

Linda Cornell, a 37-year Stanford Hospital veteran, union member and Patient Unit secretary, said supporters plan to garner the 2,400 votes necessary to put the initiative on the Nov. 6 ballot. The initiative is sponsored by the Service Employees International Union United Healthcare Workers West Political Issues Committee (SEIU-UHW).

Advocates cited high medical bills at Stanford Hospital as a primary reason for the initiative. Comparing the charges a patient could expect from receiving care for chest pain at different Bay Area hospitals, Cornell said that Stanford’s medical care would be most expensive.  

“Your average [cost] for chest pain [at Stanford Hospital] would be more than $77,000. If you went to UCSF [hospital] your charges would be around $53,000. That’s a $24,000 difference and that all lands on the patient’s shoulders,” Cornell said. “We don’t want to keep Stanford from making profits, but we don’t [want] them to keep gouging patients either.”

A Caesarean section costs an average of $107,296 at UCSF and $249,376 at Stanford. Joint replacements cost $110,698 at UCSF and $167,904 at Stanford, according to the healthcare workers’ union.

Bartosch said the initiative “would impose substantial and burdensome administrative and related costs” if enacted.

“If each city in our country were to adapt similar measures, the entire U.S. health care system would be in jeopardy,” he said.

“A lot of time, people don’t even see their hospital bills because it’s all paid by insurance. They don’t even know what they’re being charged,” Cornell said.

Cornell attributed this lack of oversight as the reason for exorbitant prices.

“If the hospital can do it and get away with it, they do it,” she said.

Bartosch asserted that Stanford’s higher rates correlated with higher-quality care.

“All hospital charges reflect the various levels and complexities of care provided by these health care organizations,” he said. “At Stanford Health Care, we are committed to providing the best value for our patients and community.”

Abrica, however, framed the issue in civic terms.

“For public or private institutions to create so much profit and not share it … to me, that’s not democracy,” he said.

He said he was shocked by the size of the hospital’s endowment. “For a non-profit corporation to have $700 million of liquid assets and just be sitting on them…it’s just not right,” he said.

A fact sheet sponsored by the healthcare workers’ union noted that Stanford Hospital often charges up to seven times the state average for services.

“The disparity in cost, to be quite frank with you, is unheard of,” Canepa said. “When an institution has made it very, very clear that they have policies in place that don’t reflect what’s right for the community and the workers within the institution, that’s when we stand up. The responsibility is clearly to stand with our working men … and women.”

According to the union fact sheet, the 15 percent profit margin is based off of “the reasonable costs of direct patient care for each patient, and a pro rata amount of certain quality improvement costs, such as for updated medical equipment or electronic medical records.”

Stanford Hospital’s safety record was also attacked at the petition signing event. The healthcare union sponsoring the ballot initiative, collecting data from OSHPD and Medicare, noted that Stanford Hospital had one of California’s worst infection rates, prompting three Medicare fines in as many years. The Center for Medicare and Medicaid Services (CMS) placed Stanford’s Hospital in the bottom quartile nationally for preventing the spread of hospital infections such as C. difficile and staph. Both UCSF and the San Francisco general hospital scored higher.

“My hope is that with this initiative the hospitals really focus on patient outcome. Let’s invest in our patients. Lets invest in our workers,” Canepa said.

Canepa voiced concerns on behalf of average Palo Alto residents.

“Palo Alto is not full of billionaires,” he said. “There are a lot of them, but it’s not full of billionaires. It’s full of working class people who are working at your cafe, people who are working in the hospital.”

Contact Nicholas Midler at midler ‘at’ stanford.edu.