One Complex Could Serve Two Hospitals

It’s time for the leaders of our health care system to come to grips with the issues that underlie disputes between the county and private hospitals, particularly Community Memorial Hospital.

In the wake of the failure of Measure O, we have an opportunity to look at these problems from a fresh perspective if both sides can muster the grace to abandon old premises and biases and the will to forge a new relationship.

All hospitals face significant challenges in today’s health care environment. Those in California are obligated to meet new standards to help assure their ability to operate after an earthquake. These standards require that the hospitals make major improvements before the end of 2008. The expense of this retrofit or new construction will be daunting.

Modern managed care, for good or ill, demands greater efficiency and economy of operation from hospitals than ever before. To achieve this, physicians must have the most current technologies and equipment medical science can make available. Technological advances have been key to increased productivity and improved efficiency and effectiveness for much of the last three decades.

Neither hospital serving the citizens of Ventura today is optimally equipped to meet these challenges, much less the earthquake retrofit. The core element required to maintain a robust hospital service capability into the foreseeable future is the development of a new state-of-the-art medical complex.

Today there are two hospitals with two quite separate missions, two organizations with two cultures, two facilities with distinctly different governance structures. Both are important. But clearly we do not need two new hospitals.

What we do need is some form of coexistence that makes sense in today’s dynamic, market-based medical economy, as flawed and capricious as it may be. What makes best sense today is to build one state-of-the-art medical arts complex to be shared by the two existing hospitals.

A new medical plaza would meet the needs of both hospitals to meet earthquake code requirements by 2008. Eliminating the need to build two hospitals would save a lot of money. It would also economize by reducing duplication of services and operating costs. It would serve the interests of physicians and other medical professionals who routinely work with both institutions.

Engaging the two facilities in a symbiotic relationship would regulate and moderate their competition without necessarily foregoing the benefits of friendly rivalry. It would, without doubt, foster mutual accommodation and collaboration.

*

This is emphatically not a proposal to merge the hospitals. Each should remain independent, just as today.

Instead, it is a proposal for symbiosis--two entities occupying the same space with mutual benefit.

The county could use government authority to raise capital through bonds or by seeking federal or state funds. Community Memorial would bring significant community presence and endowment. The collaboration would help insulate the county from spurious political challenges and might also help resolve taxpayer concerns that inevitably arise with any major capital project proposal.

A major concern would be designing the relationship so that it would withstand the scrutiny of antitrust regulators. That would require strict avoidance of anti-competitive components and a clear demonstration of how the project would serve the public interest by reducing costs and improving market performance for purchasers and patients.

To initiate a dialogue about such a worthwhile project, the public must demand it and energize it. More than just the “usual suspects” must participate in this process.

If the two facilities could agree to form a blue-ribbon citizens commission to draw up recommendations for a joint-facility concept, there are certainly people of goodwill throughout the county willing to moderate a vigorous discussion.

The creative process of those discussions must be given high visibility to provide maximum public participation.

Measure O has taught us, if we will but learn, that openness and public participation in discussions of such community significance have the greatest chance of delivering a product that works.