There have been times in the life of this community – mill closures, fires, a recession that was really a depression – when it faced a tipping point, when the whole thing could have gone this way or that, regaining equilibrium or sliding on down the hill.
The vote on whether the community should take over ownership of its hospital feels like one of those times. Running Grays Harbor Community Hospital as a private, non-profit company doesn’t work anymore. Because of the local economy, 78 percent of the people who come to the hospital for care have Medicaid or Medicare insurance or no insurance at all, which means the hospital runs in the red.
The state Legislature, recognizing that rural hospitals in situations such as ours need more help, passed a law saying the state — which administers the Medicaid program — will pay Community Hospital at a higher rate than normal. But there’s a catch. The Legislature said it will kick in only if the local community forms a public hospital district to run things, with a board elected by voters.
It sets up two likely scenarios. One, pass the measure before voters now and form a hospital district, triggering the extra money from the state and giving the district authority to charge property taxes if the elected board sees the need. That would put the hospital back in the black and able to offer its current level of services.
The other scenario is that voters say no and the hospital has to cut way back on the services it provides. The current hospital board and management could choose what to cut, or the hospital’s creditors will step in and make the choices. Either way, there doesn’t seem to be a scenario in which the hospital goes about its business as is.
It’s not clear what a diminished hospital would look like. It would probably lose its status as a Level 3 trauma center and along with that the ability to do emergency surgeries. Heart attack in the middle of the night? Badly broken bone? You’re likely riding to Olympia in an ambulance or to Seattle in a helicopter.
Whether it’s a scare tactic or not, hospital management points to the maternity ward as one of the biggest money losers, so there’s the real possibility that no more babies would be born here.
Simply put, this is too big an area not to have a strong hospital. The state Legislature recognizes it. It concedes that a straight, market-based health care system doesn’t work everywhere and there is a strong public interest in subsidizing it here. The Legislature does the same thing with schools. The state gives areas like ours “levy equalization” money so that our schools can compete with schools in more prosperous areas. But again, there’s a catch. We have to pony up and pass a general M&O levy. It’s not unlike the catch built in to the extra Medicaid reimbursement.
One of the biggest objections from opponents of forming a district is the potential for a property tax increase. Hospital officials have estimated a new district would need to set a levy rate of about 50 cents per thousand of assessed value. Fifty dollars on property worth $100,000. That will be a decision for the new board that voters will elect.
The board could decide not to use its power to levy, although that might again trigger intercession from the creditors. State Sen. Jim Hargrove, on this page two days ago, says a property tax levy cap would top out at 42 cents per thousand and that the extra reimbursement rate should be enough to keep the hospital in the black.
Regardless, it’s not far-fetched to think a new district would charge as much as it could under the cap and there’s nothing good about that. Except one thing: We’d have a strong hospital, the value of which is incalculable.
It’s truly ironic that some people are considering voting no because they don’t like the way the hospital has been run. Since it’s a private hospital, most of the management decisions happen out of sight of the public. Forming a hospital district would mean that for the first time, the public could see how the decisions get made. If they don’t like what board members do, they can vote to replace them. Don’t like the management? Complain to the people you elected.
It’s hard to imagine this community with a greatly diminished hospital. But try this: Picture the ambulance ride from Ocean Shores to Olympia for this procedure or that, or the surgeries that won’t be performed here because the surgeons couldn’t make a living when they could no longer do emergency surgeries. Picture the people who’ll lose their jobs and leave the community and the people and businesses who won’t come to a community that can’t support a full service hospital.
Picture the conversation between the expectant young couple deciding whether to come here for a job, when they find out they’d be driving an hour away for the delivery of their baby.
There are tipping points in the lives of communities. This feels like one of them.
A yes vote to form a public hospital district will ensure that the communities served by Grays Harbor Community Hospital will continue to have access to quality health care and that the citizens of the hospital district will have a new level of input in the leadership of the hospital through their elected commissioners.
The Daily World’s editorial board consists of Publisher Sean McDonald, Editor Doug Barker, City Editor Dan Jackson and Sports Editor Rick Anderson.