San Antonio Express-News (Sunday)
Hospital closure fosters medical access inequities
TIthe imminent closing of one 327-bed hospital in San Antonio shouldn’t set off panic about the availability of health care.
shouldn’t trigger back and forth arguments about the moral and financial obligations of institutions.
And it shouldn’t be needed as a reminder that the ghosts of inequities created in this city, generations ago, continue to haunt this generation.
Yet, that’s what’s sprung from the staggering announcement that Texas Vista Medical Center, the Southwest Side hospital that has been serving low-income residents for more than 40 years, will close May 1.
Dallas-based Steward Health Care System bought Southwest General Hospital in 2017 before renaming it Texas Vista in 2021. In his announcement of the closure, Texas Vista’s president, Jon Turton, said, “TVMC does not want to close, and the consequences of our closure will cause an immediate public health crisis for the city’s most vulnerable patients.”
With Texas Vista being one of only two major hospitals in the southernmost part of the city, that’s a statement with which everyone concurs. Especially troubling is the impact the closure will have on mental health services.
Steward wants Bexar County and county-owned University Health to come to its rescue — but it isn’t going to happen.
Nor should it.
When county staff met with Texas Vista last month, its leaders asked the county for a $5 million to $10 million bailout. On Feb. 24, University Health received from Steward a proposal for takeover with a deadline of three business days, on March 1. Of course, there was no deal. Three days to make a decision about an investment of millions into a deteriorating facility is absurd.
A company that calls itself the “the largest private tax-paying hospital operator in the country” shouldn’t require a government entity and a government-operated health care system to clean up its financial mismanagement.
Steward has publicly attempted to guilt or shame University Health into buying its hospital, saying it has been, “choked out by the well-heeled ‘public’ hospital competitor across town.”
But Steward is to blame. We agree with University Health President and CEO George Hernandez who said during a meeting with this Editorial Board:
“We have an obligation to seriously look at all options in terms of providing care to the community and we throw a wide net. But we also have an obligation to use due diligence when we look at those options to make sure that we’re not buying something that is going to be short-lived.”
University Health has a $500 million deal with Texas A&M UniversitySan Antonio, TAMUSA, to build a 256-bed hospital near the campus. Suggestions that the new hospital be built where Texas Vista sits are impractical for reasons of congested land space, ownership of the surrounding property, and flipping old infrastructure into new infrastructure.
If anything, building the new hospital at that site will delay its opening, which is now scheduled for 2026 or 2027 at the TAMUSA site. There have been delays because the infrastructure on the South Side has been neglected for so long.
Bexar County Commissioner Rebeca ClayFlores told this Editorial Board the neglect of that infrastructure and the impact of the planned closure of one hospital on the community as an example of the consequences of historic inequities.
Last year, in a series titled, “Access Denied,” the Express-News explored the shameful imbalance of access to health care and medical facilities in San Antonio. Health care is least available to those most in need because of where they live. For every eight emergency rooms in wealthy North Side, there’s one for the South Side.
Because racially based government policies in the 20th century pushed Mexican Americans and African Americans to parts of San Antonio with poor infrastructure and little investment, those areas still suffer the consequences in the 21st century.
Soon, there will be only one hospital on the South Side, until the new one is built.
Now, University Health is working with other area hospitals and organizations to take in Texas Vista’s patients while Texas Vista’s more than 800 employees are being offered jobs elsewhere.
But in the seventh-largest city in the nation, the crisis of access to medical care determined by ZIP code, of where you live deciding the quality of your life or expediting your death, remains critical.
For every eight North Side emergency rooms, there’s one for the South Side