In just a few seconds, Contra Costa's emergency medical services director, Pat Frost, explained this week what the expected closure of Doctors Medical Center San Pablo will mean to West County. She said the hospital handles 62 percent of the region's EMS ambulance traffic, 120 emergency room visits per day and 550 cardiac cases per year.
"These patients are going to have to be cared for in different ways," she said, in a moment of chilling understatement.
You could sense the concern -- in some cases, the anger -- among the more than 200 people who attended the Board of Supervisors meeting Tuesday where a report on the likely fate of the facility was unhappily dissected.
The bottom line, the only line that matters, is that Doctors Medical Center is operating at an $18 million annual deficit, even after parcel tax bailouts in 2004 and 2011, infusions of state funds, cost-cutting and considerable hand-wringing.
When a last, desperate life raft -- a mail-in parcel tax that would have generated $20 million in yearly revenues -- failed to get two-thirds support last week, it signaled the beginning of the end. The mourners in the audience seemed to know that but they came looking for signs of life, anyway.
Couldn't the county float DMC the money it needed?
From where, Supervisor John Gioia asked: "Do you take it from our foster care system? Do you take it from law enforcement?"
Couldn't the county absorb DMC into its system? Hardly, said Health Services Director Dr. William Walker, whose operation confronts a $20 million shortfall of its own.
The sad fact is no one's rushing to solve this problem. Nor is any one entity to blame. The cloud cast over Doctors Medical is largely a product of a deeply flawed health care system.
Eighty percent of DMC's patients -- many of them seniors or indigents -- rely on Medi-Cal or Medicare coverage, which pays far less than the true cost of treatment. Another 10 percent of patients are uninsured. "When you're losing money on 90 percent of your patients," said Gioia, "you're never going to make money on the 10 percent."
West County Healthcare Director Eric Zell lamented a sad reality: "The fact that we can't figure out as a society how to provide services to this segment of the community when there's so much money in the health care system is pretty tragic."
The Affordable Care Act, designed to address this problem, actually makes things worse, Zell said. Medicare cuts that help fund ACA have resulted in lower reimbursement rates, costing DMC about $2.5 million a year.
The center also suffers from being a rare stand-alone hospital, lacking the bargaining power of a chain in negotiations with commercial insurers and the economies of scale that come with a larger client base.
"This hospital used to serve the entire economic strata of West County, from the richest to the poorest," Zell said. "The development of the Kaiser system pulled many employed residents away and left our hospital for those who had no other options."
No decision on closure is expected until May 28. Meanwhile, Zell and Gioia dare to dream that large, profitable operations -- John Muir Health, Sutter Health, Kaiser, corporate donors or a combination thereof -- might partner with DMC to avoid a catastrophe in the making. It hardly seems an unreasonable request.
Allowing the hospital to fail won't make the needs it served go away.
Contact Tom Barnidge at email@example.com.