'No alternative,' Casper
tells Faculty Senate
BY JAMES ROBINSON
President Gerhard Casper
told the Faculty Senate last week that the decision to
dissolve UCSF Stanford Health Care was the most
anguishing of his eight-year presidency.
"There is no decision
that I have taken in my eight years as president I have
anguished more about than this one," he told
senators Oct. 28. "I knew at the beginning of the
merger that it was bold and therefore risky. I knew it
would face many obstacles. I'm still not sure that asking
for dissolution was the right thing. I only know that I
had no alternative than to do so."
Much of the meeting at the
Law School -- a tense one because of the presence outside
of loudly chanting unionized workers of UCSF Stanford
Health Care -- was devoted to Casper's explanation of his
decision.
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While the first year of
the merger was "relatively placid," Casper
said, when times grow tougher "it is very much
harder to get people to focus on the joint endeavor
rather than on all the sacrifices that seem to be
coming."
Indeed, he said, a
successful merger requires identification with a new
culture -- a UCSF Stanford Health Care culture. "And
that has really not occurred," he said.
If Stanford and the
University of California were to have tried to recruit
new leadership for UCSF Stanford Health Care, Casper
added, that "would have meant that those who
participated, such as myself, would [have had to] have
been able to say that actually the new leadership at UCSF
Stanford Health Care would have strong support within our
medical centers for the activities."
But, as he wrote to UC
President Richard Atkinson: "We have failed to
achieve a new common UCSF Stanford Health Care culture
that would provide the wholehearted support needed."
Several faculty members
praised Casper for being willing to take the risks that
were incumbent with the merger effort.
"I realize how
distressing this has been to so many people," said
John Brauman, chemistry. "Academic institutions are
rarely willing to take this kind of risk. And I have to
say that I admire immensely your willingness to have
really tried to solve this problem in a very different
way. . . . And I'd just like to thank you for that."
Brauman's comment drew a
round of applause for Casper. In addition, Judith Swain,
medicine, called his decision courageous.
As Casper detailed other
factors that sealed the fate of the merger -- including
severe cutbacks in federal funding as well as much higher
than expected merger-related transaction costs and Y2K
compliance expenses -- Phyllis Gardner, senior associate
dean of the Medical School, praised him for recognizing
that there is a nationwide problem in the funding of
academic medical centers. She mentioned difficulties
facing the University of Pennsylvania and Cornell
University as examples.
Gardner said it has come
to the point where "academic institutions, as a
whole, are in jeopardy. This should be a wake-up call to
everybody in this room, because each person in this room
has benefited from the rich amount of innovation that's
come from here."
Brad Efron, statistics,
asked Casper what the costs of the breakup would be and
if Stanford's health care services could be viable as an
independent entity.
Casper said he had no
estimates of how much the breakup would cost. But, he
added, "Stanford will make it alone because we have
to make it alone," and noted that he had heard in
recent weeks from medical school faculty that it might be
easier to confront issues alone "if we were fully
responsible for our own destiny, as it were." As
part of UCSF Stanford Health Care, he said, "people
did not have a direct enough sense that their efforts
would actually benefit their institution, their part of
the institution," Casper said.
He also emphasized that
"neither the costs of the merger nor the costs of
the demerger are costs that will have to be borne by
Stanford University," but by the hospitals' separate
corporation.
The first hour of the
senate meeting was punctuated by loud chanting outdoors
by hospital workers who are members of Local 715 of the
Service Employees International Union. The union, which
is in contract talks with UCSF Stanford Health Care, has
been targeting Casper at public events and is asking now
that the university honor its negotiations to date with
UCSF Stanford Health Care.
Casper said the talks are
the responsibility of UCSF Stanford Health Care, a
private nonprofit corporation still separate from the
university, and that while he sits on that entity's board
of directors, he is not on the executive committee.
"It is quite clear
that in addition to everything else, I can't run the
labor relations of UCSF Stanford Health Care," he
said. UCSF Stanford Health Care has successfully
negotiated contracts with each of its four other unions.
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