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  Find the money

UC SAN FRANCISCO is planning to shut down the outpatient dialysis clinic it runs at San Francisco General Hospital – and turn over the patients to a for-profit company. This is a terrible plan – one the city must help the university avoid.

The clinic serves some of the city's sickest residents, all of whom have life-threatening kidney diseases. As Tali Woodward reports on page 16, the hospital staff is ironing out plans to transfer the clinic's patients to stand-alone dialysis centers run by a company called DaVita, which is headquartered in Torrance and runs almost 500 dialysis centers nationwide.

Because DaVita is mainly out to make a profit, it has fewer doctors (sometimes none) and nurses on-site and tends to boot patients who prove difficult in any way.

Health care professionals – even the ones who've had a say in this decision – admit it's a bad one. But they argue that they do not have the money to keep the unit running, given current state and federal funding. And they warn that this is only the opening shot in what promises to be a terrible battle for public health during this year's budget process.

Mayor Willie Brown has instructed city departments to submit flat budgets – which do not even allow for the cost-of-living increases promised to most city workers – since he took office. Years of rising drug and equipment costs, combined with low funding from all levels of government, have left the city's public health system hanging by a thread.

If the impending closure of the renal clinic is any indication of what the health system is facing in this tight budget year, public officials need to take immediate, decisive action. We already know plenty of places where city dollars are being squandered – think of the mayor's platoons of special assistants and the millions wasted on the city's contract with Bechtel. The Board of Supervisors needs to put the budget under the microscope and track down the dollars needed to provide essential medical care to the people who live and work in San Francisco.