The daunting complexities of the U.S. health care/health insurance landscape are on full display in San Mateo County these days.
Look no farther than the current effort to preserve Seton Medical Center in Daly City (and its Coastside branch in Moss Beach) as a prime example.
Seton, a private enterprise, is owned by Verity Health System (it also owns hospitals in San Jose and Gilroy). That business has filed for bankruptcy protection. If a buyer for Seton cannot be found, its assets could be shut down, leaving patients without important services in the North County.
San Mateo County authorities, along with counterparts in adjacent San Francisco to the north, are scrambling to head off such a grim scenario. It’s a tough challenge.
Seton’s customers are generally low-income folks who lack private insurance. Eighty-seven percent of them pay reduced rates via Medicaid or MediCal, according to available data. That greatly impacts Seton’s bottom line.
San Mateo County Supervisor David Canepa, who represents the North County, has indicated that Seton lost $30 million last year. He said he doubts that a buyer for Seton can be found.
The 367-bed Seton Medical Center (originally, Mary’s Help Hospital, which opened in 1965) is Daly City’s largest employer with about 700 workers, most of them unionized. Union officials are among the most concerned about the fate of the hospital.
A task force designed to come up with solutions has been formed. At a press conference recently in South San Francisco, Canepa stressed that the Seton case illustrates the county’s stark gulf between rich and poor.
He noted that the southern part of the county has been seeing new medical facilities open on a regular basis. But those cater primarily to customers with private insurance, which reimburses medical providers at higher rates.
He termed Seton’s uncertain future as a looming “health care crisis” for low-income residents in the North County.
He was asked if one or both of the county’s special health care districts, Sequoia and/or Peninsula, would be interested in assisting with the move to save Seton.
He said officials of the Peninsula Health Care District have not expressed interest in expanding its reach beyond its present borders (San Mateo/Foster City to San Bruno).
Further, creating a new health care district for the North County would be difficult, he noted. It would require several steps, culminating in an election in that service area.
Winning such an election in cities where the Kaiser system has a significant presence would be problematic, according to a number of people with knowledge of the situation. Kaiser consumers would have no compelling reason to vote to tax themselves for a hospital they would not utilize.
Cheryl Fama, CEO of the Peninsula Health Care District (and a former Seton nurse), said any discussions about Seton’s fate have been purely informal, with no decisions or recommendations broached.
She said all participants in the Seton matter should proceed with caution in a rapidly-changing health care landscape. A key question, she said, is “what should be saved.”
The Sequoia and Peninsula hospital districts were created after World War II to address the county’s growing population and the need for acute care medical services.
Sequoia Hospital in Redwood City and Peninsula Hospital in Burlingame were built via district tax dollars. Both hospitals are now operated privately but the districts continue to generate taxes. Those monies are used to finance other health-related programs.
To ease Seton’s budget woes, San Mateo County supervisors have allocated $40 million in recent years. Of that total, $15 million has gone toward a program to upgrade Seton’s seismic safety requirements, Canepa said.
Those seismic retrofit needs are another negative fiscal factor (a red flag for any potential buyer) looming over those facilities.
The county, which is the medical provider of last resort for the poor on the Peninsula and is facing ever-higher health care costs of its own, has a vested interest in seeing Seton’s services preserved.
How that can occur with a minimum amount of disruption for all concerned remains to be seen.
John Horgan’s column appears weekly in the Mercury News. You can contact him by email at email@example.com and by regular mail at P.O. Box 117083, Burlingame, CA 94011.
Horgan: Seton situation shines a light on health care complexities