Five private and community medical systems in the New Orleans area operated at a loss in 2008, with some losing even more than they had expected at the start of the year. The Metropolitan Hospital Council of New Orleans said that the combined operating deficits for West Jefferson Medical Center, East Jefferson General Hospital, Ochsner Health System, Touro Infirmary, and Tulane Medical Center will eclipse $120 million, and perhaps go higher once the medical facilities close the books on the year that ended Dec. 31.