The campaign for a little-known, unpaid job overseeing Maricopa County's public health system has become a bitter partisan battle over the five-member board that could threaten the county hospital's future.
The Pachyderm Coalition, a local conservative Republican group, recently endorsed five newcomers over two GOP incumbents and several moderate Republicans.
"This county hospital venture is one of the costliest single entities the taxpayers are saddled with and needs close oversight," coalition chairman Don Goldwater said in a statement announcing the endorsements.
Board members William Bruno of Chandler and Gerald Cuendet of Sun City West, who are running for re-election, say the group chose the slate of candidates to take over the health care district and, ultimately, close it down.
"These are people who want the power to take over the thing and do away with it, to cut the taxes so much that it doesn't exist," Bruno said.
Bruno and Cuendet were fuming this week that fellow Republicans would endorse other party members in a nonpartisan election. Both men were elected to the district's first-ever board in 2004.
"They don't know what they're talking about," Bruno said. "They have no idea that the ramifications would be just catastrophic on everybody's health care. It's just really a stupid stinking mess."
Lyle Tuttle, past chairman of the Pachyderm Coalition, said he believes Maricopa Medical Center should be closed, but that wasn't a litmus test for endorsing the candidates. Tuttle said he supports the group over the two incumbents and other Republican candidates because they are "fiscal conservatives."
"I think that hospital should be shut down," Tuttle said. "The only purpose it's serving is as a dumping ground for the other hospitals."
The coalition also asked candidates for the health care board to sign the GOP platform, avowing their allegiance on issues ranging from gun rights to prayer in schools to opposing the Kyoto protocol and supporting NATO.
"We need to have new people on the board who are independent thinkers," Tuttle said. "I want them to go in, and I want them to look for themselves, and I want them to make the decision that's right. I'm confident that if they do that, the hospital will be closed."
Voters approved the health care district in 2003 and created a property tax increase to help fund it and a nonpartisan board to administer the health care system, which was previously run by the county Board of Supervisors. The five health districts mirror the supervisorial districts.
The centerpiece of the Maricopa Integrated Health System is the 450-bed Maricopa Medical Center in Phoenix, which serves the county's poor and uninsured. It's the county's largest teaching hospital, training hundreds of doctors and nurses each year, and is among a handful of Level 1 trauma centers in the state. The safety-net system also includes outpatient clinics, behavioral health centers and the nation's second-largest burn center.
But the health board is considering replacing the 40-year-old hospital with a new facility. Funding options and location are still at issue, though health system officials have talked about moving it to downtown Phoenix.
Talk of a new hospital has conservatives like Tuttle all the more riled. If the county hospital closed, he said, other hospitals would be forced to care for more of the Valley's uninsured. Hospitals are required under federal law to provide emergency treatment to anyone who needs it, regardless of their ability to pay.
Rex Altree, a Gilbert business owner, is endorsed by the coalition in his District 1 race against Bruno. Altree said he doesn't want the hospital closed, but he wouldn't support building a new one.
"The hospital is fine. We don't need to raise more property taxes to build another one," he said. "I think it serves a wonderful purpose. I think we need to tighten up on things."
But Dr. Leonard Kirschner, former director of the Arizona Health Care Cost Containment System and president of the state AARP, said the facility has "outlived its life span." Closing the current facility, he said, would only shift the costs of care to those with insurance.
The health system's $414 million budget includes nearly $50 million in business and residential property taxes and an estimated $10 million worth of uncompensated care.
A news release from the county Republican Party, later retracted, was more strongly worded than the two-paragraph statement the coalition distributed last week. The group, it said, would support former state Rep. Colette Rosati because the other District 3 candidate, former state health director Susan Gerard, had supported Gov. Janet Napolitano, a Democrat. Gerard was an aide to Napolitano before she ran the state Department of Health Services.
Retired orthopedic surgeon Harold Stratton got the nod in District 2 over former state Rep. Greg Patterson and Rob Carey, former chief assistant attorney general, because Carey was a trial lawyer.
Incumbent Cuendet, former superintendent of the Deer Valley Unified School District, said he hopes voters understand the importance of the public health care system.
"If there's a coup, the only thing I can do is stand on my record," he said. "If people are uninformed and they want to go along with a group of people who are just kind of renegades, in my opinion, what can you do?"