Re: Hospital Consolidation

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

For me, the question still remains - will the cost of surgery at the
proposed facility be higher than it would be if done currently at Gritman
or at Pullman?  Is that a valid concern?  Lori


At 09:58 AM 12/17/1999 -0800, you wrote:
>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
>> >>
>> >
>> >
>>
>
>