Here’s what you need to know about Doctors Medical Center. It’s a 232-bed hospital in San Pablo, and its emergency room sees 40,000 patients every year. The people it serves are among the sickest in the Bay Area, suffering from exposure to oil refinery emissions, heavy industry, and all the obesity, asthma, and heart disease endemic to the terrible poverty of West Contra Costa County. And unless county officials can pull off a miracle, it’s going to shut down.
According to reports in the Contra Costa Times, the hospital ran a $15 million deficit in 2005, and the West Contra Costa Healthcare District, which took over operations after the private company Tenet Healthcare bailed out in 2004, filed for bankruptcy a few weeks ago. Last week, county officials pulled off a nifty trick and managed to save the hospital, at least for now. Here’s how it works: Under federal law, a county can give the state $10 million, and the state can use a different pot of $10 million in Medi-Cal money to secure matching funds from the federal government. Presto! $10 million more. But the West Contra Costa Healthcare District can’t do this, and the county doesn’t have $10 million to spare. So the healthcare district is going to “give” the county $10 million (technically, $11.5 million if you count the interest), and the county will send it to the state, whereupon it will come back at double the pot. Then the county will give it to the district in a bizarro shell game. Neat, huh?
Still, accounting tricks won’t save the hospital, which has lost almost $14 million in the first nine months of the year. The system is beset with numerous operational flaws, including a systemic failure to accurately predict how much a specific medical treatment will cost, and how much it can be reimbursed by the feds. It sounds all very complex and boring, but unless things change soon, the end result will be decidedly dramatic for the tens of thousands of poor people who depend on Doctors Medical Center to keep them alive. Stay tuned for updates.
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