League of Women Voters of California
Santa Clara County, CA November 7, 2000 Election
	Edward W. Bough Answers Questions Candidate for Director; El Camino Hospital District

The questions were prepared by the Los Altos - Mountain View League of Women Voters and asked of all candidates for this office.

Read the answers from all candidates.

Questions & Answers

1. If elected to the District Board, how would you approach the problem of the earthquake retrofitting required by state law?

Building a new nursing tower ($140M) would cost no more than retrofitting the original structure and would allow the existing facility to remain operational, thereby minimally disrupting ongoing patient care. New construction would also more readily allow incorporation of state-of-the-art medical and information technology. Before any construction can even be contemplated, however, it is critical that the hospital's operating budget be profitable so that the District could successfully float a bond issue to pay for it. As reimbursement for all medical care progressively declines, keeping the hospital profitable while maintaining the quality of care may be the greater challenge.

2. In view of our area's high cost of living, what do you think can be done to encourage young physicians and technical personnel to come to El Camino Hospital?

I see this as an almost intractable problem in Silicon Valley. As was noted above, if the hospital does not remain profitable in the face of declining reimbursement, there will be no money forthcoming to build a new hospital by 2013 as mandated by the state. Given these budgetary constraints, it is almost impossible to generate funds for outright housing or salary supplementation. In addition, there are numerous laws restricting financial relationships between physicians and hospitals. On-site apartments at subsidized rents would probably only be attractive or helpful to new employees with little or no extended family. Providing facilities for new physicians to practice in with partially subsidized overhead is possible when they do not directly compete with existing physicians in the community who are obviously not being subsidized. And even with such arrangements, most new physicians cannot afford housing in our community.

3. What should be the function of the district board in relation to the administration of El Camino Hospital?

The district board is the direct employer of the hospital administration and is totally responsible for its quality and performance. Furthermore, the district board is resposible for setting or accepting the goals, strategies, and policies which the administration ultimately implements. The district board cannot, and should not, micromanage hospital operations, but it is responsible for the end result: the quality of patient care and service to the community.