General Hospital, episode 303

Perhaps the most intriguing bit of news this week in the Advocate involves the case of a transient who apparently drove his car into the Emergency Room. Well, in strict truth, he drove his vehicle at the Emergency Room, apparently damaging the glass wind barrier at the entrance.

This instance of wanton destruction was apparently prompted by “frustration” with the hospital staff, and it is related to another local issue—that of the hospital itself. It is the largest health care within miles, and is accredited with the state—it has actually won awards in the past for quality of care, although in recent years the standard has gone down. A certain amount of thoughtlessness and recklessness goes on at the hospital, especially, it is noted, with Medical and Medicaid patients. While it is not able to deal with major life threatening conditions, the hospital does have OB/GYN services, and acute care facility, and a fair number of beds. For major medical mishaps, patients are airlifted out. For most surgical procedures, patients go out of town. But the hospital serves a function. It has a 24 hour ER. It’s there when you need it. (And bills ferociously for it later.)

However, Mendocino Coast District Hospital is going under. Rapidly. Most of the community has sensed this coming for some time, and a series of increasing desperate articles in the Advocate testify to it. The hospital has repeatedly had troubles renewing the Blue Shield and Blue Cross contracts. It has also repeatedly been accused of mismanagement and gross misuse of funds.

Almost no one in the community disputes that the hospital wastes money, overpaying administrators and underpaying health care professionals. I know numerous nurses and doctors who formerly worked with the hospital, and now do not, because of the difficulties in the administration there. A recent letter to the editor written by Herb Ruhs laid out the myriad problems with the hospital from the perspective of a former doctor, and encouraged the community to do something about it.

In the November election, a bond act to raise funds for the hospital was voted down by a substantial margin. The message was clear—we as a community are tired of the histrionics of the hospital. It is time for a major change. The hospital claims that it will be cutting vital services, including the ambulance, for lack of funds. Yet, plans go on for the annual hospital fund raiser, Winesong. (In which, ironically, masses of the coast’s elite get together to drink wine in the hot sun and then merrily drive home. Perhaps there is a certain pragmatism here, inasmuch as the accident rate skyrockets during Winesong weekend.)

The question the community is faced with is this: do we allow the hospital to go under, or sell out to a conglomerate, potentially threatening the already questionable quality of care available? Or do we strive to save it, and at what cost? How much are we willing to do to save a clearly lame duck from what seems like an inevitable fate?

The problem with the hospital speaks to a larger problem in Californian, and American, health care. The fact is, a large portion of the nation can’t even afford to go to hospitals for care. Those who can choose to go to places like Stanford and UCSF. Except for a thinning group of middle class locals and confused tourists, it is unclear who the hospital is really serving, and if it’s entirely fair to demand that people who can’t afford to go to the hospital pay for it. Especially when the hospital is engaged in a multi million dollar renovation. It is clear that major changes are needed in the health care system—one wonders how many people will have to suffer before they happen.

[Fort Bragg]