Which Hospital(s) Can Fill Needs Best?

I find much of what William Fulton says in his article “Time for a Truce in Ventura” (Nov. 2) has merit but he has ignored one very important factor. The 1996-97 Ventura County Grand Jury tried to make the point and apparently failed.

The Ventura County Medical Center receives significant state and federal subsidies because of its status as a disproportionate share facility. That is to say that a disproportionate share of its patient load is the indigent and uninsured. Those subsidies and some associated cost savings amount to $12 million to $14 million per year.

It is difficult, if not impossible, to envision a significant change in the delivery of medical services to the indigent and uninsured in Ventura County that would not disqualify the County Medical Center as a disproportionate share institution. Because of the size of Community Hospital it could not qualify even if it assumed all of the services offered by the County Medical Center. The taxpayers of the county would have to make up for the lost subsidies.

One can argue whether subsidies are the appropriate way to meet the medical needs of the poor. But at this time they are a fact of life. There is no indication that will change. Ventura County cannot meet its obligation to provide medical care for the poor without those subsidies.

The management of the Ventura County Medical Center should be applauded for its efforts to minimize the costs of medical care for those it has a mandated obligation to serve. The development of the outpatient clinic system is perhaps the most outstanding example. It serves people where they live and keeps them out of high-cost emergency room treatment. The development of that network of clinics seems to be particularly onerous to the county’s medical establishment and Community Hospital.

Is it possible that they are the ones who are out of step with the trends in delivering medical services?

JOHN S. MURRAY, Simi Valley

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The article “Time for a Truce in Ventura” (Nov. 2) by William Fulton cannot go unanswered. I am sure he is a newcomer to our county and does not understand the modern way of dealing out health care these days.

As all but about a dozen counties in California have discovered, county hospitals are no longer cost-effective. Santa Barbara found out years ago, San Luis Obispo found out years ago, Los Angeles is trying to rid itself of its facility. They are now a huge drain on tax dollars that are in short supply.

We no longer can keep our facility open to satisfy Pierre Durand and our county employees. We have enough private hospitals in the county now to take care of all the patients available and still have beds left over even with the close of the county facility.

Why is this so difficult a concept for our supervisors to understand? This is not just about the relative importance of hospitals; it is about improper expenditure of taxpayer dollars on a dinosaur we can no longer afford to feed.

ROBERT D. WILLIS

Ventura