Re: Hospital Consolidation

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

I believe there are two answers to your question.
First costs are averaged.  That is the charge for outpatient surgery, such
as arthroscopic knee surgery, is higher to help offset the cost of quadruple
bypass surgery.
Second, Those who can pay, or have insurance that pays, pay higher charges
to cover the costs of those less fortunate.  By only taking those patients
who can pay, or who have insurance that can pay, charges can be lowered.

John

John and Laurie Danahy
jdanahy@turbonet.com
----- Original Message -----
From: Lori Keenan <lkeenan@norby.latah.lib.id.us>
To: John and Laurie Danahy <JDANAHY@turbonet.com>; <vision2020@moscow.com>
Sent: Friday, December 17, 1999 9:50 AM
Subject: Re: Hospital Consolidation


> 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
> >>
> >
> >
>