SAN JOSE: New Valley Medical Center Faces ‘Tough Road’ Ahead

      Administrators for San Jose's Valley Medical Center "face the tough task" of competing "in a tough marketplace while continuing to provide free medical care to the poor." The four-year, $197 million renovation project for the facility was "the most expensive building project in county history, costing taxpayers at least $12 million over the next 20 years." While county supervisors approved the project in 1994, VMC soon became "the subject of a heated debate that boiled down to whether medical care was a commodity to be bought and sold or a public right," the AP/Sacramento Bee reports. While supporters have "praised the medical center as a symbol of the county's commitment to provide first-rate medical care for its poor," opponents say "the county could have saved money by paying other hospitals to treat the poor -- as many other counties do -- and still have met its obligation to care for those who cannot pay."

Last Resort
      As a "provider of last resort," the facility must "deliver a large volume of uncompensated care and run unprofitable round- the-clock services like trauma centers and neonatal intensive care." The AP/Bee reports that if the hospital is to survive financially it "must attract those with private insurance," but only "15% of the hospital's current clientele fit that bill." But perhaps the "greatest threat" to VMC is "the rapid growth of Medicaid managed care," which often signs up the healthiest and therefore least expensive Medi-Cal enrollees. This leaves "public hospitals with the expensive burden of caring for the uninsured and chronically ill." According to health care experts, the VMC will have "to adopt practices used by private- sector hospitals, including streamlined operations, state-of-the- art technologies, affiliating with managed care plans and becoming more customer-friendly." Bob Sillen, director of the county's Health and Hospital System, said, "It's a risk. But it's also an opportunity. It's a risk we had to take because without it, we have nothing" (10/17).