Re: Hospital Consolidation

[Lori Keenan <lkeenan@norby.latah.lib.id.us>]

John,

Thank you for summarizing so well the very complicated issue hospital and
new surgery unit issues.  

I have a question (one of many) about the proposed surgery unit in the
corridor - how can it promise to offer surgery at a lower cost if it needs
to recoup the expense of building a new facility?  Am I missing something
important here?

Lori Keenan


At 09:23 AM 12/17/1999 -0800, you wrote:
>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
>>
>
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