Editorial: State should step in to save San Jose trauma center

Four months. That’s all the time Santa Clara County officials have to try and prevent a health care crisis in its public hospital system when Regional Medical Center shuts down its trauma center.

By August, the only remaining trauma centers in the county will be at Stanford University Medical Center and Santa Clara Valley Medical Center (VMC). VMC will see a 70% bump in trauma patients in a public hospital system that doesn’t have the staffing or bandwidth to handle the caseload. The Board of Supervisors must take action to prevent this calamity.

The culprit — who Supervisor Cindy Chavez calls a predator — is HCA Healthcare, which owns Regional in East San Jose and Good Samaritan Hospital in the West Valley.

It’s clear HCA is divesting itself from East San Jose and investing in the West Valley. At Regional, the majority of patients are either uninsured or on Medi-Cal.  Good Samaritan, which by the way is expanding its footprint by 1 million square feet, takes patients with private insurance. HCA is preying on the most vulnerable because profit margins are not there, even after raking in $65 billion in revenue last year, according to its 2023 fourth quarter report.

HCA has a history of predatory behavior, systematically shuttering facilities that serve marginalized populations like its 2004 closure of San Jose Medical Center, the city’s only downtown hospital. And shuttering Regional’s maternity ward in 2020 and Good Samaritan’s neonatal intensive care unit and acute care psychiatrist services in 2023. HCA’s rationale is the same: it’s a finance strain. That’s hard to swallow when a company reports $5.2 billion in profits that same year.

All the finger pointing and potential loss of life when it takes ambulances 20 minutes instead of five to reach a hospital is not going to matter. The county has to prove HCA’s actions are unjustified, harmful and discriminatory.

The county has to present its case to the California Department of Public Health, a regulatory body authorized to render judgement when public harm takes place. Its website confirms the mission: “The California Department of Public Health (CDPH) works to protect the public’s health in the Golden State and helps shape positive health outcomes for individuals, families and communities.”

It’s time for CDPH to walk the talk. Even if the department has never used its authority to bring down the hammer before, there is always a first time. The framework to do so is there, and the history of how HCA has crippled the county health care system is long and painful. But this time its actions have reached a tipping point.

Hospitals are built to care for people regardless of race, ethnicity or financial means. They are a foundational part of every community, and when those services are lost, there’s a ripple effect across the region and residents feel betrayed.

County officials must provide all the evidence to the state, from the history to the data to the testimonials. They need to convince the state Santa Clara County will suffer irreparable harm if Regional’s trauma center closes.

People will die. Families will suffer and East San Jose residents will be denied health care they rightly deserve. The county needs to push hard for HCA to reverse its decision, because thousands of lives are at stake.

Moryt Milo is an editor at San José Spotlight. Contact Moryt at [email protected] or follow her at @morytmilo on X, formerly known as Twitter. Catch up on her monthly editorials here.