Bad Medicine

A nurses' union joins antidevelopment forces to prevent a new hospital from being built.

As Americans' wages, job security, and access to health care vanish, I'd ordinarily be first in line to praise my favorite labor union, the California Nurses Association (CNA). Unlike its famously authoritarian competitor, the Service Employees International Union, the CNA is democratically run. And the nurses' union is known to advocate causes that benefit not just nurses, but also the rest of us. It has lobbied to pass laws that increase the required ratio of hospital staff to patients, and to establish universal health care.

That's why it troubled me to learn about a recent union gambit to obtain better wages and job conditions for its members now, by sacrificing thousands of potential jobs for construction, health care, and service industry workers in the future.

SF Weekly has learned that California Pacific Medical Center (CPMC), the local four-hospital affiliate of the nonprofit conglomerate Sutter Health, quietly submitted revised plans to the Planning Department on Jan. 26 for a proposed 555-bed, 15-story, $1.7 billion hospital in the Cathedral Hill area. The new hospital, slated to be built on the current site of the Cathedral Hill Hotel, would be linked via tunnel to a proposed medical office building on the east side of Van Ness. The project is part of $2.3 billion in infrastructure spending CPMC plans to use to expand its San Francisco operations, a possible bright spot in the city's darkening employment picture.

CPMC spokesman Kevin McCormack said the Cathedral Hill facility "would be the best stroke care center in the West. We would be the referring center for California and Nevada for strokes, liver transplants, cardiac care, and all the major areas of health care."

"From a land use perspective, it's the right project," said Gabriel Metcalf, executive director of the smart-growth think tank San Francisco Planning and Urban Research (SPUR). "Health care is very much part of the economic base of this city, and of most central cities in America today, and its one of the major reasons that people from the surrounding region come into San Francisco."

But for the CNA, the hospital seems to be a mere disposable bargaining chip.

In December, CNA organizer Nato Green distributed a flyer announcing the creation of a Coalition for Health Planning, made up of groups such as the CNA, the SEIU United Healthcare Workers–West, and the Cathedral Hill Neighbors Association, a group formed in 2006 expressly to halt the proposed Van Ness Avenue hospital.

Green's flyer urged people to write to members of San Francisco's Board of Supervisors, demanding they reject any CPMC plans that didn't evenly distribute hospital facilities throughout the city, and didn't respect workers' "right to union representation."

Besides, Green said in an interview, the proposed "mega-hospital" is not "appropriate" for the neighborhood.


There's something to be said for exploiting the process of issuing building permits for squeezing public amenities like parks from companies. But in San Francisco, participants in these sorts of tactics sometimes lose sight of all that's at stake. The David-versus-Goliath fulfillment of beating back a large corporation can confuse activists into thinking that victory comes when Goliath either dies or leaves town — even though exiting giants may take with them things the city badly needs.

By using opposition to the proposed hospital as a cudgel, Green is trying to pressure CPMC to expand St. Luke's Hospital in the Mission District beyond what the health care firm and city leaders agreed to after exhaustive negotiations last year. I also suspect he's trying to extract a better labor contract for nurses from CPMC, too. These tactics are self-serving and shortsighted because if CNA's new NIMBY coalition ends up killing the proposed Cathedral Hill hospital, it will eliminate the thousands of jobs that facility would create.

When I recently interviewed Green, he interspersed worthy concerns about whether the new St. Luke's will be too small — and thus not able to sustain nursing and other jobs there — with NIMBY nonsense about how CPMC's proposed Cathedral Hill hospital is too big even for the high-rise neighborhood along Van Ness. Granted, Green may be exaggerating to win concessions for workers.

But the neighborhood allies he's recruited are in it for keeps. Already, opposition to the Cathedral Hill project from labor and the neighborhood group has helped set the project back four years. Green's formal NIMBY-labor alliance threatens to postpone the project and all its public benefits further still.


Charles and Susan Michel, a couple living in the affluent Peninsula bedroom community of Los Altos, are among the misguided neighborhood opponents of the proposed hospital at Cathedral Hill. Like NIMBY complainers throughout time, they seem willing to sacrifice the needs of the community at large to preserve their supposed "right" to ample parking, stunning views, and uninterrupted downtown sunshine from dawn to dusk. Ordinarily, such concerns aren't a top priority for workers who could never afford such luxuries.

Around three years ago, the Michels became worried about their daughter's stumbling efforts to make a home in San Francisco. After graduating from college in 1999 she'd had one change-of-ownership eviction, one bad roommate, and one apartment that seemed to be in a dangerous neighborhood.

"We love our daughter, and we wanted a safe place for her," said Susan Michel.

So the Michels bought a condominium at One Daniel Burnham Court, a pair of nine-story and 16-story towers joined by a guarded glass atrium near the corner of Post and Van Ness.

Not long afterward, however, the Michels' daughter's housing situation again seemed to darken. Susan Michel learned of a proposal to turn the site of Cathedral Hill Hotel across the street into the grounds of a hospital.

"We will no longer be able to have any view of San Francisco Bay because the hospital will take that away," the Michels wrote in a 2006 letter of protest to the Planning Department.

"The hospital building would take a lot of the daylight from her apartment," Susan Michel added during an interview last week.

It's almost tempting to empathize with the Michels' wish to guarantee their daughter a sunlight-bathed, bay-view–endowed condominium future. And Nato Green's strategy of joining their neighborhood's protests would be compelling if one union's tactics were the only thing that mattered to San Francisco workers.

But holding up nearly $1.7 billion in shovel-ready infrastructure spending that would create thousands of jobs — just as America's economic free-fall threatens to throw millions of workers into poverty — is a cause unbecoming of my favorite labor union.

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