unrelated in the same building. if you want to bore yourselves, you can read through all of those studies. the evidence does not overwhelmingly support concentration of services. we do have a need for more services in the southeast. cpmc identified a set of zip codes, the primary st. luke's service area, that generates 85% of st. luke's discharges. you see a plan of these hospitals that is explicit segregation of patients based on ability to pay. i would think we would be beyond an argument about whether we believe in segregation. the plan is come a 10% private insurance. the justifies the hospital based on current utilization. 65% private insurance to other campuses, 10% medi-cal.

these are people from around the central city in the southeast going to st. luke's. if people from the southeast go to cathedral hill. that does not make sense. 40% of the emergency room cities -- visits come from around the st. luke's area. what happens there puts a burden on sf general hospital. the approach we're taking to davies we believe should be the approach to st. luke's. it works when there is a clinical anchor to generate investment. they are not designed as a permanent charity write-off. davies has a community-serving function and an anchor of clinical services. we believe that should be the approach to st. luke's, where they cluster services related to

some set of specialties for all the patients at st. luke's. i would like to turn it over -- i would like to share with you these other documents and turn it over to my colleague. >> good evening, commissioners. i attended city arts and technology high school. it is important to not only me, but community members and families that st. luke's remain open. i am medi-cal insurance. cpmc has put the attention on making this new hospital. i am making sure it is -- not making sure it is providing the services for the southeast part

of the city. how can you allow them to build that they are not paying attention to what the community needs? like the ceo of cpmc said, it has been around for 150 years. why not give the hospital would need to continue providing those services? thank you for listening to the community. >> good evening. my name is emily. i want to talk with you tonight about our concerns around the rising cost of health care. i have packets of information. pass these out. there should be enough. ok. we are ecstatic that it was said that the commitment to san francisco is to control rising health care costs. we are glad to hear that and we would like to hear specifically how they plan to do that. if you could put the first chart -- one of our concerns is that

the plans will result in increased costs for residents and workers as they gain an even larger share of the pie. in general, a recent article came out saying that northern telecom hospitals are charging higher rates for the same services provided at southern california hospitals. you can see here that on average, northern california hospitals are collecting 56% more in revenue per patient, per day. one of the driving forces in northern california is sutter health. as one of the largest hospital chains, with 24 hospitals, 5000 doctors that operate in 100 cities and towns, they are everywhere. they are a huge force. we know that sutter charges 37% more than the state average, which is concerning to us.

they are trying to control rising health care costs. we would like to see that number much lower. in contrast, a different companies charges 4% below the state average. we have two hospitals, two different systems, providing the same care, but at different rates. one of the questions we have is, with these beautiful, single- room patient rooms, it looks like a hotel. it looks really nice. it looks like a nice place to stay overnight. is that what we need? do we need luxury care? is that what the cost is so high? does that justify it? what does this translate to 4 san francisco? we are paying increased rates for employee health care benefits. we're having to pay for more expensive health plans.

sutter controls a huge portion of the market and they can dictate how much they will charge for services. this is not acceptable. the city of san francisco needs to be looking at these rates and how consumers are able to access to hospitals and doctors they want at affordable rates. this is 2007 market share. cpmc already controls about 1/3 of the market share. with this new, 550-bed hospital planned, what will that do to the rest of the market? they are dominating the market. what is that going to do to the rest of our rates? as a question of antitrust issues, how will this play out with one provider dominating the market? what will happen? there's a disproportionate share of beds in north of market. why are you adding more beds?

why? use of the split line? why would you need to add more luxury beds? it is such a close proximity of other hospitals. we want to mention that san francisco health care costs are already among the highest in the state. you can see on the start that the average price in the west bay, $35,225 as the average net revenue paid in 2009 for an in- patient day. we already know that we have the priciest areas around. what does this mean? how will the proposed plans affect our high costs? how was it proposing to control those costs? we asked the question, how can cpmc justify its non-profit status with the lowest percentage of medi-cal patience

and justify getting those millions of dollars in tax breaks? we urge the planning commission and health commission to consider some of these questions and we thank you for your time. >> our next speaker is carol. carol? >> good evening, commissioners. my name is carol. i have lived in the tenderloin for the past 20 years. this is our position about the proposal. for seniors in low-income families, we need a hospital to

serve us. the record of serving our residents is very poor. only 710 patient coming from tenderloin neighborhood. this is very small compared to the number of people who need affordable health care in tenderloin. our community needs access to affordable care. the hospital should open its doors to the community. how can we support this project when cpmc has a record in supporting our community? what we need is equal access to affordable health care.

we need cpmc to support the community. a community will not support this project if it does not serve the poor. i urge the commissioners not to approve this project unless cpmc agrees to sign a community benefit agreement. thank you very much. dori jimenez. >> good evening, commissioners. i am here today to express my position about the proposed cpmc hospital. our community lacks access to affordable health care. we're not sure that cpmc can do this. it has a very poor record in

serving the poor. the tenderloin needs a hospital that provides hospital care for our residents that are not available or accessible in this community. our community needs access to affordable care. our community cannot support this project unless it serves the poor. what we need is a project that is responsive to our needs. according to the department of public health, charity care report of 2009, cpmc's ratio of charity care, the patient revenue is very low, less than 1%. compared to the state average, it is 1.75%. what will happen to the elderly who really need help?

we, the community members, we deserve to be happy, healthy, and live longer so we can enjoy life with our family in our society. thank you very much. >> i will show you real quick. >> good evening, commissioners. i have lived in tenderloin for almost 25 years. i want to express my opposition to the proposal of cpmc hospital.

they do not plan to serve low- income patients. we in the community cannot accept this project, cpmc serves our needs. cpmc should increase access to all kinds of hospital care. it should be for seniors and low-income families. they should increase access to health care. if cpmc continues to operate for low-income families, it will be better. thank you, your honor. >> [reading names]

>> good evening, commissioners. i live in the tenderloin. i'm here to express my opposition to cpmc hospital that does not serve the community. in the tenderloin, lots of seniors and low-income people use medi-cal. less than 10% patients seen were under medi-cal. how can the community approve this hospital when they do not also, i understand that cpmc is a non-profit organization. that exempts them from paying taxes. they're one of the most profitable hospitals in the state. cpmc charges the most money for their services compared to other hospitals in san francisco. how can they be a nonprofit?

what we need is a project that is responsive to our needs. the tenderloin has the most real health care problems in the city. in 2007, more than twice the numbers of patients from knob hill were seen a than patients from the tenderloin. this does not make sense for us. the tenderloin has the highest need for health care in the city. we urged the commissioners not to approve this project without the community support. the tenderloin does not want this hospital unless cpmc opens its doors to our community. thank you. president olague: thank you. please come up to the mic if your name was called, in whatever order. >> good evening, commissioners.

i am a senior living in the tenderloin area for 25 years. i am here tonight to express my deep concern about the proposed cathedral hill hospital. we need a hospital that provides quality care and services to ensure that seniors and all people with disabilities and low-income families will have equal opportunities in health care. at this point, it is unclear that cpmc will accommodate seniors and low-income families from tenderloin, especially.

we want to make sure that medi- cal patients can use this cpmc facility. the tenderloin and central city residents will not support this project unless cpmc addresses our concerns. this will be no project without community support. thank you.

>> thank you. >> good evening, commissioners. i am a resident of tenderloin. i am here today to express my opposition about the proposed cpmc cathedral hill hospital. the proposed hospital must also serve the needs of the poorer because it is a non-profit. the ratio of charity care to patients is very low at .94%. i realize -- rely on my medi- cal. i went to cpmc emergency room to find a doctor specialist for my sickness. they found out i was on medi-cal and told me to go back to my

primary care doctor. no wonder cpmc has the lowest ratio, less than 10%. how can they explain this to the poor people like us, if they are in non-profit? the tenderloin community does not want this hospital on the cpmc provides their share of medi-cal care. we need a hospital that will except seniors and low-income families. we want to make sure that medi- cal patients can avail love the cpmc facilities. our community will not support this project, cpmc addresses our concerns. we demand that cpmc signed a benefit agreement for our

community. thank you. >> thank you. [reading names] [tone] >> hello. good evening, commissioners. i volunteer for a senior center. i am a resident for more than 10 years. cpmc's new hospital is not here to serve the community. it is for profit. i am an uninsured patient dependent on free clinics and charity care. i would not receive this care from cpmc. i'm sure of that. cpmc provides little charity care, despite making some much

in profit. -- so much in profit. we do not need hospital in the tenderloin that does not serve tenderloin people. what we need are more community- based clinics that are dedicated to serving our diverse population. centralizing hospital service does not make sense. hospital like cpmc are known to be hospital for the rich only, and for high profit. this will have an adverse affect of marginalizing the residents.

lastly, hospital that does not cater to economic realities of this population's constituency must rely on medi-cal programs will not serve the public. [tone] president olague: thank you. after the final bell, the two minutes are up. >> [reading names] >> good evening, commissioners. my name is gloria and i have lived in the tenderloin, for the past 20 years -- tenderloin for the past 20 years. i am here today to lead to know

that i am concerned about cpmc's plans for the hospital. i am a senior and under medi- cal. i rely on health services for low-income. cpmc plans to make this new luxury hospital and it gives me great concern. first of all, i will not be able to use the new cpmc hospital. currently, cpmc -- secondly, i would like to see my doctor. i feel that i deserve a hospital with quality health services.

great health care is not just for the rich. cpmc -- please do not approve this project without a complete plan for serving low-income patients like me. thank you very much. >> lorenzo. >> and good evening, commissioners. my name is lorenzo. my family lives in the tenderloin for six years already. i am here tonight to express my opposition about the proposed cpmc hospital. cpmc said a while ago it has poor performance when it comes to serving our residents. it has served more people

outside of san francisco. cpmc is one of the most profitable hospitals in san francisco, earning millions of dollars, but has the worst record in providing charity care, despite being a nonprofit hospital. cpmc's ratio is below the state average. in the pay your profile, it attests to this disparity. how can us, the residents, support this project, when cpmc, for the record, does not serve us? cpmc should keep act -- keep equal access to us, to the poro. the tenderloin community does not want this project, cpmc will open its doors to us.

all of you, honorable commissioners, we ask that you reject this project unless they support us. thank you. >> [reading names] >> my name is sue. i work in tenderloin community. tonight, we come here. we hope cpmc will provide the circus for the low-income families -- provide the service

for the low-income families. cpmc supports us, we would like to support cpmc. have a site in the tenderloin community. thank you. >> thank you for coming out, everyone. president olague: did you all want to stand up? >> thank you. our next speaker is paul. >> good evening, commissioners. my name is paul. i am of ukrainian descent. i am a resident here, of the city and county of san francisco.

i'm a client of jobs that cpmc has offered me. they offered me the services for free. i merely have to go to their door. i open it. considering they have offered me plenty of opportunities more than i have asked for, as well as what i have asked for, i support this expansion of cpmc. i support the new location. it could be a new location for myself and anyone in the surrounding areas. it could be convenient. more convenient. i do support the expansion of cpmc in this way.

it can expand all the trades simply building it, the medical facilities, the services that i have gotten, they have given the opportunities and let me too many doors, but i opened the myself. most of the time, that is what most of the world as told to do. we leave you to the door and you open it. that is the way my opportunities have come to me. i do support that in that you move forward with the expansion of cpmc. thank you very much. >> we have another senior.