The biggest thing standing in the way of saving West Contra Costa's busiest emergency department is politics. State health Secretary Diana Dooley must push past that and clear the way for transitioning the financially failing Doctors Medical Center into a satellite emergency facility.
Nurses and physicians, more concerned with protecting unsustainable jobs than ensuring adequate emergency service, continue demanding that Doctors remain a full-service hospital.
Unfortunately, that's not realistic. The district lacks the revenues. Civil rights attorney Pamela Price's misguided attempt to use the courts to block service reductions won't produce more income, as the judge in the case understands.
Assemblywoman Nancy Skinner's pending legislation seeking higher federal reimbursement rates is a long shot that, even if it succeeds, won't close the funding gap. With or without that additional money, the numbers don't work.
We saw that as the district borrowed to keep Doctors running the past few years. All that has done is bury West County taxpayers deeper in debt that will take decades to pay off.
We see that again in a new financial analysis prepared for an advisory group trying to find a solution. A streamlined full-service hospital would lose $18 million to $22 million a year.
Nurses and physicians keep calling for a county bailout. Their protests and marches grab media attention, but ignore reality. The county, reeling from budget cutbacks and huge pension and retiree health costs, struggles to adequately fund its existing programs, including health services and understaffed sheriff and district attorney offices.
It's time to get real. Neighboring hospitals have agreed to consider financial assistance, but only for a sustainable model. The only scenario that comes close is a freestanding emergency department operating under the license of the county's Martinez hospital.
That would still lose about $9 million annually, but the other hospitals have incentive to help close that gap to avoid patient diversions that overburden their emergency rooms.
Of course, doctors and nurses have been working in Sacramento to block this option. They argue that anything less than a full-service hospital would be unsafe for patients. That's untrue. Hundreds of satellite ERs operate in other states.
There's an open legal question whether California law allows the state Department of Public Health to license a satellite emergency department. Attempts to change the law would likely fail because of the California Nurses Association's tight grip on the Legislature.
But local leaders have made a strong legal argument that the state could issue the license under current law. We hope Dooley moves quickly so that a smooth transition can begin before the hospital runs out of cash.