Health Care on the Central Coast is limited, by urban standards. From Santa Barbara north to Salinas, there are 4 hospitals over 100 beds, and 3 licensed for less. If you are a "high risk" OB patient, your only choice is Sierra Vista Regional Med Center in San Luis, no other Neonatal ICU unit on the coast. If your children need pediatric hospital services, the choices are Sierra Vista or Cottage, in Santa Barbara. (Or transfer off the coast to San Francisco or LA). For more typical geriatric issues, only Cottage in SB, French Hospital in SLO, or Sierra Vista do cardiovascular surgery, and if you need high risk surgery, you'll end up in San Francisco or LA. For orthopedic surgeries, hips and total joints, Sierra Vista and Cottage in SB do a lot of elective ortho surgeries. The real problem is after hours, weekends, and holidays. The specialists, including cardiovascular, neurosurgery and orthopedic surgeries generally only have one MD "on call" for the whole county, and the patients get moved to wherever he/she is, not the other way around. In general, that's San Luis, so if you fall and break your hip in Paso Robles, you'll get transferred to San Luis, and then get put on the "to follow" operating room list, and the surgeon will get to you when he/she gets to you. (Of course, falling in San Luis is the same routine, just minus the 30 or 40 mile transfer.)
The other issue is Medicare reimbursement. The feds consider SLO county "rural" despite the high cost of living, so the reimbursement rate is about 20% - 40% lower than for the same services performed in LA or Orange county. (The government says 20%, the doctors say 40%.) So, many physicians have closed their practices to new Medicare patients. There are no psychiatrists in SLO county that will see Medicare patients. (There are also no psych inpatient services, patients have to go to Santa Barbara for services.)