American Commitment: “Work Hard”

An ad from American Commitment blames Arizona Senate candidate Richard Carmona for the debts an Arizona health care system and community hospital incurred under Carmona’s leadership. But the ad neglects to mention that the health care system was already $36 million in debt when Carmona was appointed, due largely to a health care market plagued by high numbers of uninsured and underinsured people seeking uncompensated services at the hospital’s emergency room.

Health System Was Plagued By Budgetary Problems Before Carmona Came On Board

Carmona Became CEO Of Kino Community Hospital In 1995. From the Arizona Daily Star: “In 1994, he was appointed by the Pima County Board of Supervisors to chair a commission reviewing the county’s financially troubled Kino Community Hospital. The following year, the board decided Carmona himself was the best solution to the hospital’s problems and named him CEO and medical director.” [Arizona Daily Star via Nexis, 6/16/02]

  • Hospital’s Operating Deficit Was Already $4 Million When Carmona Was Hired. From the Arizona Daily Star: “The hospital’s operating deficit, which actually stood closer to $4 million when Carmona was hired, was indeed eliminated during his two years as CEO. But those numbers masked serious financial problems, including a mounting balance of uncollectible accounts that made it seem Kino had more money than it actually did, financial reports show.” [Arizona Daily Star via Nexis, 6/16/02]

Carmona Was Appointed Interim Head Of Entire Pima County Health System In 1997 And Confirmed As Permanent Chief After A Year. From the Associated Press: “The interim head of Pima County’s health care system is the top choice of 100 applicants in a national search and is expected to get the post permanently. The Board of Supervisors will decide Tuesday whether to follow a Pima Health Care Commission recommendation to name Richard Carmona chief of the system. Board members on Friday indicated that Carmona is likely to get the votes he needs for the job. Since July 1997, the 48-year-old doctor has been the interim head of the $ 230 million health care system, which includes Kino Community Hospital, home health care and long-term indigent care.” [Associated Press via Nexis, 9/13/98]

  • Department Was Already $36 Million In Debt At Time Of Carmona’s Appointment In 1997. From the Arizona Republic: “At the time of Carmona’s appointment in 1997, the department was about $36 million in debt, based on reports from the Associated Press.” [, 10/16/12]

Pima County Health Care System Had Been Running Deficits Since 1982, With Vast Majority Due To Community Hospital. From the Tucson Citizen: “The budgets: The $180 million health-care system accounts for one-third of the county budget. Kino Community Hospital’s budget is $55 million. Red ink: The system, which is supposed to pay its own way through contracts and fees, has been running annual deficits that total $46.2 million since 1982. Of that deficit, $40 million is at Kino.” [Tucson Citizen, 1/5/00]

Most Kino Hospital Debt Incurred Providing Services To Uninsured Or Underinsured Patients. From the Tucson Citizen: “The past nine years, Kino has cost almost $70 million to run, with debt anticipated to be about $13 million to $15 million this fiscal year. Most of the debt over the years has been accrued from providing uncompensated services, mainly to uninsured and underinsured patients, and undocumented immigrants.” [Tucson Citizen via Nexis, 10/21/02]

Tucson’s Health Care Market Is Particularly Strapped. From an Arizona Daily Star article about underfunded trauma centers:

Most of the blame for that is placed on what many see as Tucson’s severely squeezed health care market – now considered one of the worst in the country – with these factors most often cited:

  • The domination of managed care HMOs, which have significantly lowered reimbursements to doctors and hospitals, and have forced people to crowd emergency rooms when they can’t get in to see their doctors.
  • Our proximity to the Mexican border, with illegal immigrants who oftenup [sic] as unpaid-for trauma cases.
  • Federal laws mandating that no patient be refused emergency care, regardless of nationality or ability to pay.
  • One of the highest uninsured populations in the nation, at more than 25 percent. [Arizona Daily Star via Nexis, 5/27/01]

Carmona Resigned Position In 1999. From the Arizona Daily Star: “A year later, though, the board accepted Carmona’s resignation after Kino’s debts continued to mount. ‘I think in some ways I’ve been treated unfairly,’ Carmona said in 1999 about being pressured to leave. ‘I’ve exposed problems, and now I’m being held responsible for those problems.’” [Arizona Daily Star via Nexis, 6/16/02]

  • Hospital Board Chairman: Carmona “Did A Good Job…Problems  Existed Before He Entered The System.” From the Los Angeles Times: “Carmona quit at a time when Tucson’s Kino Community Hospital was facing mounting financial difficulties. At the time, Carmona was criticized for not keeping officials apprised of the hospital’s problems, while Carmona’s defenders say not all the difficulties can be laid at his feet. ‘I think those who look at it critically would say he did a good job,’ said Mike Rollins, former chairman of the hospital board. ‘The problems existed before he entered the system.’” [Los Angeles Times, 3/29/02]
  • Hospital Chief Of Staff: Budgetary Problems Were Inevitable Because It Served Poor And Uninsured Patients. From the Arizona Daily Star: “A year later, though, the board accepted Carmona’s resignation after Kino’s debts continued to mount. ‘I think in some ways I’ve been treated unfairly,’ Carmona said in 1999 about being pressured to leave. ‘I’ve exposed problems, and now I’m being held responsible for those problems.’” Dr. Lenn Ditmanson, Kino’s former chief of staff, said the hospital’s problems were inevitable given its mission of treating poor and uninsured patients.” [Arizona Daily Star via Nexis, 6/16/02]
  • Pima Supervisor: Carmona Held System Together In “Tough, Unstable Times.” From the Arizona Daily Star: “The year after Carmona assumed interim control of Pima County’s entire health care system, Kino’s operating deficit rose to $4.5 million. But that didn’t dissuade supervisors from making Carmona’s promotion permanent in September 1998. ‘I think he’s held a system together (in) pretty tough, unstable times,’ then-Supervisor Raul Grijalva said at the time. ‘Now it’s time to take that system and (Kino Community Hospital) to a whole new level.’” [Arizona Daily Star via Nexis, 6/16/02]

[NARRATOR:] Hardworking families can’t afford more wasteful Washington spending, and Richard Carmona has a proven record of reckless spending. As head of the Pima County Health System, Carmona ran up a $14 million deficit in just two years. Then, he was forced out as CEO of a Tucson hospital and left it $40 million in debt. Taxpayers bailed out Carmona’s mess. More debt. Higher taxes. Sound familiar? Arizona can’t afford Richard Carmona. American Commitment is responsible for the content of this advertising. [American Commitment via, 10/25/12]