A Healthy Approach

It took an earthquake--or at least the fear of one--to start some movement toward repairing one of the deepest rifts in Ventura County’s civic landscape: its notorious Hospital War.

The prospect of having to spend tens of millions of dollars to make their buildings safe during earthquakes jostled the directors of Community Memorial Hospital into requesting discussions with the Board of Supervisors about how to end a long-festering feud between CMH and Ventura County Medical Center.

Whatever the motivation, it is high time for a truce between the county’s public and private health care providers. We encourage both sides to work in good faith toward a sustainable partnership while avoiding the pitfalls of the past.

For decades the two hospitals, located just two blocks apart on Loma Vista Road, cooperated to give Ventura high-quality medical care. But over the past five years, as policy changes put them in greater competition for paying patients and those insured by Medi-Cal, the institutions have been in an all-out war--fought in meeting rooms, in courtrooms and at the ballot box.

At the heart of the dispute are the shift to managed care and profit-driven health services and the questions of who will serve the very poor and who will pay for it.

Previous efforts to work together have fallen flat. Merger talks in 1996 failed in part because Community Memorial wanted to convert Ventura County Medical Center into an outpatient center and in part because of lingering bitterness from the private hospital’s successful campaign to block construction of a $56-million wing at the county hospital.

Now the situation has changed.

A state law inspired by the 1994 Northridge earthquake requires that by 2008 all California hospitals must meet strict standards to prevent their buildings from collapsing during quakes. Retrofitting hospitals built before 1973 is expected to be so expensive that in many cases it will be cheaper to rebuild them entirely. Large portions of both Community Memorial and VCMC are older than that.

Working together could allow both hospitals to streamline services and save money--while taking advantage of the county’s ability to issue bonds or win state funding to pay for the work.

“We need to form a more regional approach,” says Supervisor John K. Flynn. “If merging is a good idea we ought to do it, and not just for earthquake reasons.”

A combined public-private medical partnership would be in line with a statewide trend that has pushed California’s counties to scale down or close medical facilities in favor of contracting for services with private medical providers.

San Diego, Santa Barbara and Orange counties have all closed their county hospitals because it is cheaper to pay private ones to care for the poor.

Previous efforts to craft a partnership in Ventura County have been hindered by the uncompromising advocacy of the strong-willed directors of the two institutions. This time around, says Flynn, “We certainly need their technical help but for policy-making we need the board members together. There are some hospital warriors out there; what we need are hospital diplomats.”

And so, from the ramparts to the negotiating table. It’s ironic that it took the threat of a huge reconstruction bill to make the two sides look beyond their differences and see the merits of working together. But if the result is a more efficient and cost-effective way of providing hospital care, the returns could be healthy indeed.