County Hospital Denying Care to the Poor, Rival Says

Ventura County’s public hospital is denying care to the poor in favor of treating more paying patients to help reduce costs and balance its budget, an attorney for a rival hospital argued Wednesday.

The county hospital not only is violating its mandate to serve the poor but its operating practices discriminate against needy patients, John McDermott, an attorney for Community Memorial Hospital, argued before the 2nd District Court of Appeal in Ventura.

In addition, by providing discounted health care to some patients--such as government employees--the county is using taxpayer money to unfairly compete with private hospitals, McDermott told the three-justice panel.

“The issue is whether the county is constitutionally authorized to treat paying patients who can be treated equally well by private hospitals,” he said.

Community Memorial is challenging a 1995 lower court ruling that interpreted state law to permit the county to provide health care to paying patients. The hospital contends that the county is hurting its business by actively seeking out privately insured patients.

Peter Ackerman, a lawyer representing Ventura County Medical Center, argued Wednesday that the intent of state law is to give people the freedom to choose between hospitals.

“The purpose of this [law] is to allow everyone, rich and poor, to get medical care wherever they want,” Ackerman told the court. “[Community Memorial] is arguing that the public does not have freedom of choice, that hospitals should be segregated.”

Ackerman also denied that the county is neglecting its responsibility to care for the poor by treating more paying patients. He said as many as 90% of the medical center’s patients are considered needy.

During the one-hour hearing, Justice Arthur Gilbert questioned Community Memorial’s argument that the county is serving more paying patients to reduce its overhead costs and balance its books.

“Couldn’t the argument also be made that the county is taking paying patients to make more revenues to enable it to treat more poor patients?” he asked.

Justice Kenneth Yegan also commented that he understood Community Memorial’s argument to say that unless a person is indigent, that individual should go to a private hospital for care.

“If I personally prefer to go to the county hospital because it employs a doctor that I like, and I can’t go there, that doesn’t seem right to me,” Yegan said.

But McDermott countered that the county contracts with physicians who require their patients to go to the county hospital, in effect denying them freedom of choice.

Community Memorial believes that the county does have the right in some limited circumstances to serve paying patients, such as in cases of emergency or when no other hospital is available, McDermott said.

To use taxpayer money, however, to effectively create a “private economic enterprise” is not legal, he said.

Assistant County Counsel Noel Klebaum said the key issue to be decided is whether the county has the legal right to serve paying patients. He argued that counties around the state have been doing that for more than 30 years, so a ruling against Ventura County could set a new precedent.

The justices are expected to render a decision within 90 days.

Regardless of the outcome, McDermott told the court Wednesday that Community Memorial intends to file a new lawsuit against the county over its alleged failure to properly treat the poor.

In its initial lawsuit against the county, CMH alleged that VCMC turned away indigent patients being transferred from other hospitals.