Hospital Consolidation

["John and Laurie Danahy" <JDANAHY@turbonet.com>]

Based on what I have read and heard, it seems to me that there are two
issues to be debated.

First is should the two communities consolidate the regional medical
facilities into one in the corridor at a cost of $34 million dollars.
Certainly Pullman needs to replace its failing facility.  Unfortunately,
local voters turned down bonds that would have provided relief from their
current situation.  Moscow does not need to replace its current facility,
however, expansion seems to be severely limited unless Gritman can purchase
more of the downtown area.
How to finance a proposed merged medical facility in the corridor has not
been fully explained.  Gritman is a non profit private enterprise, as such
it has, I believe, no taxing authority.  Any part of the $34 million it had
to pay would have to come from somewhere.  Pullman apparently does have some
taxing authority and can ask for financial help from its voters.  The two
states have very different tax based structures and I do not see how we can
create a merged financial package that is fair to all.  Also a merged
facility in the corridor presents transportation concerns to all.  From my
perspective, the city of Moscow would soon see bypass roads developed so
patients could get to the merged facility without having to traverse
downtown Moscow.  This creates secondary negative impacts to the downtown
community.
The idea that the two communities merge into Gritman seems to have merit up
front.  Pullman however, does not want to transport across the corridor and
really does not want to lose some of its identity.  Clarkston is a separate
city, but often seems a suburb of Lewiston.  Pullman does not want to end up
the same.  Again too, Gritman would need to expand its facility, something
that at present it is unable to do, unless it creates a satellite facility
in another location, but then we are back to the $34 million dollar
question.

The second issue that has surfaced is the questions of a group of local
doctors building a private out patient surgical facility in the corridor.
This facility would offer lower cost out patient surgeries, be run as a for
profit private enterprise, and give the medical professionals some freedoms
in their practice.  This would operate by taking the "cream" of local out
patient surgeries from the local hospitals, offering them at a "lower cost"
since they would not have to subsidize higher cost surgeries, leaving the
hospitals with no choice but to raise charges for what is left.
At first glance, this seems to be a neat idea.  It would create competition,
and lower medical costs to consumers, but I remind everyone of Robert
Heinlein's TANSTAAFL  There ain't no such thing as a free lunch.  Lower
costs for some out patient surgeries just means higher costs for others.  I
would also wonder how the medical insurance industry would view this.
Having some experience crossing state lines with insurance companies, it
does seem to severely complicate an already complicated system.

Just some thoughts

John

John and Laurie Danahy
jdanahy@turbonet.com
>