California Road Trip, Day 18, Stockton

Philip Kauffman, our road manager picnicking in Visalia, taking a break from herding butterflys.

Our organizers in Stockton have demonstrated spectacular hospitality, including providing us hotel rooms, where we found baskets with a cornucopia of gifts, mostly food, but also wine and a cork screw.  It was over the top but much appreciated.

Shortly after our arrival, I spoke briefly with the former Director of the “county hospital” San Joaquin General (SJGH), from which we were banned.  See yesterday’s post for details.   Once upon a time, SJGH was a vibrant, healthy hospital that required little subsidies from the county.  They offered a panoply of services including a neonatal intensive care unit which was quite profitable, subsidizing the care of those without resources.   We call that “cost shifting”.  Over time, other facilities, with deeper pockets, have invested in and offered redundant services focusing on those that are most profitable.   The cream is gone but SJGH’s mission remains… leaving it with a 10-20 million shortfall, subsidized by county taxpayers.  A local task force is being developed to investigate the situation.   Who’s on committee?  I am sure those whose livelihood depend on the “profitability” of the competing hospitals lust for a chair at the table.  Their agenda?  Continue to keep SJGH alive with a continued infusion of millions of dollars so that their facilities won’t have to care for many of those who are unable to pay their bills.

At the risk of getting wonky, again, remember how insurance companies thrive by avoiding “adverse selection?”   Competing hospitals thrive by avoiding “adverse market share.”   That’s what we are talking about!

Before heading up the road to Davis, I will interview the prior Director of San Joaquin General at greater length this morning.  More juicy details tomorrow.  I can hardly wait.

–paul hochfeld

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