After West Contra Costa voters said they didn't want to pay more to keep Doctors Medical Center afloat, the hospital district board and county supervisors last week extracted some extra money from property owners anyway.

The latest financing scheme should stave off closure at least through September. It was a necessary, one-time stopgap move. The question remains whether labor leaders and executives from other hospitals will make good use of limited time to devise a sustainable plan for preserving critical care.

Fortunately, executives from nearby hospitals have finally seriously engaged. Sadly, physicians and nurses at Doctors remain in denial, unwilling to acknowledge the county cannot afford to rescue the hospital from insolvency.

Doctors Medical Center is seen in San Pablo, Calif. on Wednesday, May 7, 2014. (Kristopher Skinner/Bay Area News Group)
Doctors Medical Center is seen in San Pablo, Calif. on Wednesday, May 7, 2014. (Kristopher Skinner/Bay Area News Group)

Doctors houses West County's busiest emergency room, and the only one other than Kaiser's. Keeping the Doctors ER running should be the first priority. The rest of the operation remains financially unsustainable despite three years of cost-trimming.

No one should be surprised we've reached this point. The crisis has been building for years. In 2004, voters approved a $52 annual parcel tax to help keep the hospital open. In 2011, they increased it to $99. This year, the district sought to triple that, to $309, but could muster support of only 52 percent of voters for a measure that required two-thirds approval.

Meanwhile, the district spends more than it takes in. To cover its current bills, it borrows against future tax revenues. It's now $71 million in debt to the county and bondholders, a liability that won't be retired until 2042.


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Even if the hospital closes, West County taxpayers must repay the loans. And to keep the current operation running, the health care district must borrow more. Which is exactly what happened last week when county supervisors agreed to loan another $6 million to sustain Doctors on life support for another three months.

Supervisor John Gioia of Richmond, whose district includes the hospital, insists there will be no more county advances. "This is the last time," he said flatly.

That means changes must be made. Sutter, John Muir and Kaiser hospital executives have an interest in the outcome. If the Doctors emergency room closes, its costly patients, mostly uninsured or on Medi-Cal, will end up at their facilities. And the longer travel time will often delay critically needed care.

While John Muir and Kaiser have contributed about $19 million since 2008 to help keep Doctors afloat, they won't consider giving more until the district implements "a politically viable and financially sustainable long-term" plan.

Rather than sit on the sidelines as they have previously, the executives of the three hospital systems are helping fund, and actively participating in, an analysis of alternatives. The leading options involve reducing the size of hospital operations, or converting Doctors to solely an emergency room facility.

The latter alternative, while probably most financially realistic, is fraught with political and possible legal obstacles, exacerbated by the opposition of the hospital nurses and doctors.

They want to preserve the status quo. "We don't want to make any further cuts to the services we provide the community," says emergency room nurse Maria Sahagun. For the doctors, it's all or nothing. "The voice of the medical staff of DMC is clear: Save it, or Close it!" wrote Dr. Richard Stern last week in an email to Gioia.

The nurses and doctors insist the county should take over the hospital and raise the sales tax in Contra Costa to help pay for it. Clearly, the county doesn't have the money to take over the hospital. As for the discussed tax, which is politically questionable, it wouldn't provide enough to close the financial gap.

Stern and Dr. Sharon Drager, in an opinion piece last Sunday, said employees had expressed willingness to take a 10 percent pay cut; but Sahagun says most nurses are not.

The clock is ticking. Officials from the county and the nearby hospitals are carefully crunching numbers and studying options, but the nurses and doctors continue to dig in their heels.

It's time for them to get real, to work on solutions rather than roadblocks.

Daniel Borenstein is a staff columnist and editorial writer. Reach him at 925-943-8248 or dborenstein@bayareanewsgroup.com. Follow him at Twitter.com/borensteindan.