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The closure of Mad River Community Hospital's (MRCH) obstetrics services this fall makes me very sad ("'Loss,'" Aug. 29). MRCH is an important part of Humboldt County and many of my friends, family and neighbors gave birth there over the past 40 years.
As someone who works in healthcare, it also makes me angry. Everyone involved in providing healthcare has seen this day coming for years. The truth is that this situation was entirely avoidable and now the strained resources of our region's healthcare system are under even greater pressure.
I am not angry at Mad River hospital, nor at its CEO Doug Shaw. I am angry at our state's casual disregard for our communities' maternity care needs, at our elected officials' hollow words of support and at a health insurance industry that pursues its profit at the expense of our patients.
The crisis in maternity care has been looming for years. It is now right here in Humboldt County.
A recent independent report found nearly 50 hospitals across California have shut down maternity wards over the last 10 years, leaving "obstetric deserts" across the state. Rural communities are the hardest hit.
We have spoken out about this crisis to the health insurance industry and asked our elected officials to help. The only assistance has come from Partnership Health Plan, a not-for-profit insurance company that administers the Medi-Cal program in Humboldt.
To our Legislature and insurers, I ask: Do you want people to give birth in Humboldt County? Do you want healthy children and families in all the regions of California? Do you want economic development in the rural parts of the state?
At Open Door, we have been preparing for years for the scenario of a single hospital delivering babies so that we could ensure our pregnancy services would not be disrupted. We will keep providing pregnancy and gynecological care at our current health centers. This includes gynecological surgeries and procedures, like hysterectomies and tubal ligations at MRCH.
Open Door's model of care is for a family physician and care team to provide a patient with the full range of care they need throughout their life, including delivering babies. This opportunity to provide "full spectrum" care is what draws many people to practice medicine at Open Door, and it is an educational requirement for the Family Medicine Residency program that we partner in with Providence.
Providing high-quality pregnancy and obstetric care is complex, difficult and expensive. Sustaining it is a laudable achievement. Open Door is now the largest provider of obstetrics services in Humboldt County. We are committed to providing these services to our community. We will collaborate with Providence and our other providers of care to ensure we meet the needs of our community.
But let us be clear: Reimbursement for obstetric healthcare, by both governmental and commercial payers, does not cover the cost. Open Door runs a deficit of more than $1 million each year to offer high-quality comprehensive pregnancy services. These losses are not sustainable.
Our elected state and national officials, the Department of Health Care Services and the insurance payers, must work together to ensure adequate compensation for obstetric services. (Our state's decades-long underfunding of pregnancy services through Medi-Cal is especially egregious in light of its purported commitment to California's children.) The state's regulatory framework needs to allow for safe and cost-effective care instead of driving out services.
Mad River Community Hospital's obstetrics program is just the most recent domino to fall. Before that it was Redwood Memorial Hospital's obstetrics services and St. Joseph Hospital's acute rehab services.
We are lucky. The North Coast has collaborative-minded healthcare institutions that recognize the vital importance of working together to meet our community's needs. Providence Health has stepped in to transition our patients over to St. Joseph Hospital in Eureka.
What would happen to pregnant people in Humboldt County if Providence had not stepped in? What if Open Door had to stop providing pregnancy services or deliveries?
What will happen to Humboldt County when people cannot receive healthcare here?
We need our governmental institutions and legislators to listen and act upon our concerns.
Let's make our voices heard.
Tory Starr (he/him) is the president and executive officer of Open Door Community Health Centers.
