Would everyone who is clamoring for a government-run health system please cast your gaze to North County's two public hospital districts?

The fact that private insurance companies and HMOs are cold and heartless is tough to argue. But saying that HMOs and insurance companies are greedy and inefficient is not the same as saying a government-run system would be better. Exhibits A and B: Tri-City Medical Center and Palomar Pomerado Health.

Palomar Pomerado and Tri-City are both public hospital districts, created to provide affordable hospital care in North County at a time when private hospitals weren't interested in serving the (then) small population base in our region.

And yet, despite their very reason for existence being to provide service to the communities that own them, neither is doing a stellar job of providing health care.

Palomar Pomerado pushed hard to get voters to approve a $496 million bond in 2004 to build a new hospital in Escondido and upgrade a second in Poway.

But before the new Escondido hospital is even built, or the expansion begun in Poway, administrators are now telling this newspaper that plans for the new buildings will mostly likely have to be scaled back due to cost overruns.

Yes, inflation takes its toll -- but shouldn't that have been factored into the size of the bond and how it was pitched to voters in the first place?

And I'm guessing that $2 million the district is paying to football star LaDainian Tomlinson to be its celebrity spokesman could be put to better use right about now.

Still, PPH is a model of sound management and fiscal restraint compared to what's going on over on the coast at Tri-City.

After suspending CEO Art Gonzalez in a secret meeting, the new Tri-City board of directors -- the folks elected in November to run this public hospital on our behalf -- now face the loss of liability insurance. Last week, the company holding the district's liability policy said it would cancel coverage this week unless some sort of proof is provided that the management team recently hired by the new board has more experience in running a hospital than is readily apparent.

At the same time, a series of closed meetings surrounding the management changes has the board facing complaints and possible lawsuits for violating the state's open-meeting laws.

The new four-member majority on the seven-seat board ran on a reformist platform in November's election, and had the backing of the local nurse's union.

Secret meetings, though, don't meet any definition of "reform" I'm familiar with, and the specter of ongoing litigation over the management suspensions -- announced with no investigation, and with apparently no hearings where the accused could defend themselves -- doesn't bode well for employee morale in the coming years, nor for quality patient care.

A value system based on corporate greed may not be the best way to run our nation's health-care system, but as we're seeing locally, a government-run system is no guarantee of improvement.

Contact staff writer Jim Trageser at jtrageser@nctimes.com or (760) 740-5408.