PPH should get out of Hospital business

Published in North County Times 2/26/08

The Palomar Pomerado Hospital facilities' master plan is in shambles. When Proposition BB was passed, voters thought it would result in major improvements to existing facilities and the construction of an additional new medical center and other facilities.

Most of the promises are no longer on the table. Instead, the only remaining part of the plan that is still firm is to build merely one new hospital, and even that on a much smaller scale than they originally promised. This determination to build in the Escondido Regional Technology Center comes from angst. Palomar Pomerado fears that if they do not build it, Kaiser Permanente will build its own hospital, providing unwelcome competition nearby.

Surely, there are better ways to spend limited taxpayer funds.

For example, why not design the new hospital that is planned for the ERTC site in Escondido in such a way that it can be turned over completely to Kaiser? That way, Kaiser will get what they need and the money saved or generated could go to the other pressing needs that are being shelved.

The obvious result of such a change would be that PPH would need to attract more of its own patients. For example, the large Penn-Elm Medical Group recently dropped its affiliation with PPH so that its patients now use other hospitals. As it stands, Kaiser is providing about a third of the Escondido hospital's patients. PPH cannot stand alone based on its own clientele.

This begs the obvious question: If customers are voting with their feet to go somewhere else, might it not be better if someone else took PPH's place?

The covert, disruptive agreement with Kaiser shows that PPH will go to great lengths to reduce competition. This despite abundant evidence that increased competition is better, not worse. Communities like northern Riverside County and the Las Vegas area are much better served because there are numerous hospitals competing for patients and doctors.

A good case can be made that PPH, with its withering amount of goodwill, should get out of the business of operating hospitals entirely. The Grossmont Hospital District came to this conclusion years ago and instead contracted with Sharp. Voters in that district overwhelmingly voted for an improvement bond and are well on their way to meeting their facility goals, without controversy.

A fresh new player stepping into the downtown Escondido facility would attract the many local patients who presently travel south to secure the quality that they demand.This would also free the feeble PPH board from dealing with its intractable operational problems. Like other publicly elected boards, it is ill-suited to compete successfully in the brutal business of health care.