I have written a lot about the collapse of Los Angeles' Martin Luther King, Jr-Harbor Hospital, a hospital almost totally dependent on government funding and under government control.

Now, it looks like the same tragic story may be spooling out in San Diego County, where Sharp Grossmont Hospital is at risk of losing federal payments because of its failure to avoid preventable deaths, according to the San Diego Union-Tribune.

But losing government payments is not really the "root cause" of the problem - receiving them is.  Tellingly, Sharp Grossmont earns over half its revenues from Medicare and Medi-Cal (Medicaid).  Furthermore, Sharp operates the hospital under a long-term lease with the Grossmont Healthcare District - a public agency.  Notice the pattern?  A muddle of government control results in poor patient care - just like at MLK-Harbor.

To be blunt, a hospital cannot be accountable to its community if it is dependent on government bureaucrats in Sacramento (Medi-Cal) and Baltimore (Centers for Medicare & Medicaid Services) instead of patients. If government intervention is neccessary at all, it should be solely at the local level - to ensure community oversight and participation in decision-making.