As members of the debt reduction "super committee" wrestle to slice $400 billion from Medicare over 10 years, I wonder what they might say about the $430 million proton beam center war now being waged a few miles from my home in San Diego.
This nearly a half billion dollar investment in proton therapy is a big part of what's wrong—in a microcosm—with the healthcare system.
Leaders of two healthcare powerhouses here—Scripps Health and UC San Diego Medical Center—each want their system's name on their own cyclotron building. So each hospital is proceeding with massive construction projects five miles apart.
Scripps, which broke ground on its $225 million Scripps Proton Therapy Center in October of 2010, has the lead and will start treating 2,500 patients a year in 2013. UCSD, announced the same month that it will build its own $205 million UC San Diego Proton Therapy and Research Center in La Jolla, to treat 1,500 patients a year.
Both organizations intend to conduct research on the effectiveness of proton beam therapy treatments, which arguably has not yet been decisively shown. There are only nine cancer proton centers in the nation, and four were built only in the last few years.
As one might imagine, Chris Van Gorder, president and CEO of Scripps Health, is furious, saying he "can't believe" the state-funded hospital now plans a project of this magnitude right next to his.
"The story here is a government (UCSD) using community and taxpayer resources to build unnecessary facilities and capacity," Van Gorder says. "They are using the advantages of being a government to compete – arguably unfairly – against private facilities (and their) Proton (center) is a perfect example. There is absolutely no justification to build two in the same community when there are only (nine) in the entire United States."
Proton therapy, he explains, has high fixed costs and needs enough volume just to cover that and generate enough margin. "If a community has too many beds or therapy centers, it becomes difficult, if not impossible to cover fixed costs, much less variable ones. And then all fail."