And, as paradoxical as it may seem, a federal designation as a Health Professional Shortage Area, or HPSA, will improve access for a number of patients in the area. The designation is common in the Valley and gives those areas more opportunities for grants and loan repayments to attract new doctors, John Alexander, executive director of the Merced County Health Care Consortium, said.
"It is an exciting time to live in Merced. Sure it is depressing to see the health care problems and the foreclosed homes and the stories about crime, but on the other hand, there are enough of us here that see the diamond in the rough," Alexander said. "The people here have heart."
Money problems prompt Plan Bs as fallback
The drama playing out in Merced in many ways reflects tensions unfolding on public and private campuses nationwide as public funds and endowments dry up. Projects that seemed doable in richer times only a year or so ago now are threatened with delays or even oblivion.
In the case of California campuses, the drama pits research faculty against those favoring primary care medicine; better endowed campuses versus cash-starved start-ups, local legislators against those 500 miles away with their own favored education projects.
Some in the UC system and state government are already sketching out potential "Plan Bs" to reduce costs while attempting to improve health care in the Valley:
Focusing the Merced medical school more on educating doctors than expensive research, an approach favored by Lt. Gov. John Garamendi, a UC regent.
Moving medical studies 54 miles to the Fresno campus of UC San Francisco, with its brand-new medical education building.
Expanding the Valley-based medical residencies of existing UC medical schools in San Francisco, Davis and Irvine to attempt to meet rural needs.
Yet many in the Valley say they're not ready to be shunted aside again, especially in favor of what they view as long-favored UC campuses in more flush metropolitan areas.
Regional support for a Merced medical school runs so deep that it crosses political and economic lines and includes virtually every interest group: business, government, health care advocates, farmworkers and farmers. "It will be the pulse of new technology, new techniques, new teaching methods. Our residents will be the recipients of that knowledge; they will become healthier. Everyone in our community will become healthier," said Deidre Kelsey, a member of the five-seat Merced County Board of Supervisors.
Jerry Callister, local attorney and chairman of the board at County Bank, is another staunch supporter of the school. He's familiar with the UC Davis Medical School in Sacramento because his son is finishing his final year there, and he remains confident that a medical school will still rise in Merced. "I can see what medical schools have done in communities like Davis and Irvine. It would help our community too -- medically and economically," Callister said.
Budget battles fray nerves on many campuses
So a battle looms in coming weeks, possibly playing off Valley leaders against Sacramento budget slashers and rival UC campuses. In May 2008, the UC Board of Regents gave the campus authority to continue planning efforts for the medical school. While the board would make the ultimate decision whether to move ahead, it probably would look to the UC Office of the President in Oakland for guidance.
Others look to the campus of UCSF Fresno as a model for why UC Merced is needed.