The vote by Tuolumne County supervisors Tuesday to ultimately close Tuolumne General Hospital and get the county out of the health care business was both historic and sad.
It marks the end of a 150-year medical institution where many thousands have received top-notch health care.
It means that 111 TGH employees will be in the job market as of July 1.
The gut-wrenching vote years in the making was also the right thing to do. It was the only thing to do.
Consider what the board, county administrators, hospital leaders and hired consultants have been through in the last decade: scores of tense meetings, emotional public hearings, numbers crunching sessions and repeated attempts to force TGH's ever-deepening debt to reverse or at least slow down.
The times that supervisors heard and agreed to new fix-it plans, all comparable to doctors promising a futile cure for a terminal illness, were many: TGH administrators were switched, even fired in one case, their varying proposals of surefire financial fixes were trusted, as were their assurances that yet another program would, this time, guarantee that bills would be accurately tallied and swiftly mailed out.
But the patient TGH only got worse.
By July 1, when TGH acute care services will end and the clinics will go into the hands of a private operator, Tuolumne County will have since the 1997-98 fiscal year spent a staggering $40 million-plus on the hospital.
To be certain, Tuolumne General, which has always served patients regardless of their ability to pay, was never expected to pay for itself.
But to allow the hospital to continue as is would have been to force virtually every other county department to eliminate critical services or close altogether. County roads, already in abysmal shape, would have gotten worse, the now-marginal sheriff deputy patrols would have been reduced to bare bones, libraries would have closed, recreation programs eliminated.
Respected Supervisor Dick Pland boiled down the dilemma in another realistic way: There is another hospital alternative in the county Sonora Regional Medical Center that has promised to provide the indigent medical services the county must have available. But there is no law enforcement option if the sheriff's office were to close. Likewise, there is no backup agency to process building permits, no service ready to take over clearing snow from public roads, no business offering to loan books for free.
No doubt, Pland and his fellow board members know that their one vote raises serious concerns about the state of Tuolumne County health care in coming months and years.
Will Sonora Regional be able to rise to the huge challenge the county has just handed it?
Will the county find a competent private company to take over TGH's outpatient clinics by July 1?
What will become of TGH's psychiatric and long-term care units, which the board has allowed to remain open for at least three years?
In the case of these two TGH services, the board was as wise to give them more time, albeit a finite time, as it was to close the other hospital departments quickly. The families of many of the long-term care patients live in this area and will need time to find other facilities for their loved ones. And the psychiatric unit actually draws patients from other parts of the state and, with more marketing, may come close to paying for itself.
Many TGH employees are understandably angry that they weren't given a longer grace period before closure. Again, finances forced the board's hand. But the board and County Administrator Craig Pedro are hardly dismissing these members of the work force as casualties.
Local work fairs planned specifically for these people are already scheduled. And between Sonora Regional and the medical provider that will take over the TGH clinics, at least 74 health care positions must be filled. Pedro also says many of the TGH employees will be encouraged to take vacant county positions in other departments.
Rarely, if ever, has one board vote affected so many people or set into motion so many changes to come. Pland was also on target when he called the vote the toughest decision he and fellow board members have wrestled with "maybe ever."
Given the hospital's turbulent and sad recent history, it also stands as the wisest business decision Tuolumne County leaders have made "maybe ever."
Union Democrat editorial positions are formed through regular meetings of the newspaper's editorial board Publisher Geoff White, Managing Editor Patty Fuller, City Editor Craig Cassidy and senior reporter-columnist Chris Bateman.