Improving Local Hospitals and Healthcare

By Ken Yeager

Maintaining essential healthcare services is not an easy issue with simple solutions, but our community cannot afford to lose the services Santa Clara Valley Medical Center provides.

Santa Clara Valley Medical Center is the busiest hospital in the valley. It is the only hospital with an open door policy, guaranteeing residents of Santa Clara County access to medical care, regardless of their ability to pay. Overall, the majority of SCVMC patients are uninsured or underinsured and the hospital provides over half of the Medi-Cal inpatient days in our community. But funding for safety net hospitals has become less secure. The federal and state governments continue to cut funds for mandated programs and services including Medi-Cal and Medicaid.

While funds diminish, the need for Santa Clara Valley Medical Center's services grows. In 2004, there were nearly 47,000 more people with Medi-Cal or no insurance seen at SCVMC. That is a 47% increase from 1999. As other area hospitals have terminated their Medi-Cal contracts or cut back on the number of Medi-Cal and uninsured patients they are willing to care for, SCVMC will continue to see more of these patients. Last year, Santa Clara Valley Medical Center delivered 80% of the charity healthcare in this county, at a cost of more than $100 million.

As the key component of our safety net, this public hospital does more than care for the uninsured or underinsured. Santa Clara Valley Medical Center plays a major role in responding to medical emergencies. On a daily basis, residents of this valley are taken to its Emergency Department or Trauma Center for life-saving treatments. In addition, the hospital is responsible for planning a medical response to man-made and natural disasters. Whether it's an earthquake, pandemic flu or a bioterrorist attack, Santa Clara Valley Medical Center has a central function in our County's emergency response.

Santa Clara Valley Medical Center's trauma services, emergency services, burn unit, spinal cord and brain injury centers are just some of the essential services needed to ensure the health of this community. The hospital provides this wide-range of services to a very large and diverse population. In 2004 over 195,000 people + or 1 in 10 county residents + received care at Santa Clara Valley Medical Center. In today's healthcare marketplace, profit usually comes first and if this hospital cannot provide these services, they are not likely to be replaced in today's economic environment.

And while the need for SCVMC services increases, there have been significant, uncontrollable rise in expenses. The state has mandated nursing ratios, and while this has certain advantages for patient care, SCVMC expenses have increase $20 million as a result of adding positions to meet the mandate. Other expenses that continue to increase include salary and benefit costs for full-time employees and the cost of pharmaceuticals.

The challenge of maintaining the critical services provided by Santa Clara Valley Medical Center is left to County Government. As you may remember, a lack of profit was the reason for the closure of San Jose Medical Center, a private hospital with an emergency department and trauma center. Maintaining essential healthcare services is not an easy issue with simple solutions, but our community cannot afford to lose the services Santa Clara Valley Medical Center provides.

Part of the solution to the growing healthcare crisis sits with the federal and state governments. For example, SCVMC receives little in terms of payment for taking care of uninsured patients and incurs substantial costs of providing this care + over a $100 million last year. The Medi-Cal program pays less than 50% of the cost of providing hospital services. Better reimbursements are needed, from both the state and federal government.

And government may not have all the answers to these issues. Private business, organized labor and many others must play an active role in looking for solutions to these problems. But while we work on solutions, we can't sit around and wait. Locally, we need to do all we can to make sure Santa Clara Valley Medical Center stays open.