Future of our Hospital | Eastern North Carolina Now

    Publisher's Note: This editorial was originally printed in the Washington Daily News on Friday, December 10, 2010, I would have published it sooner for the BCN readership, who do not take the WDN, but Hood and I were having trouble hooking up until now. Anytime Hood speaks out on the BRHS debacle, and I have it in a digital format and his permission, it will be published.

    I want to commend the Washington Daily News for finally offering to print a balanced version of the hospital controversy. Unfortunately however, at this point in time that is not possible. I, nor any other county commissioner or hospital board member should be commenting in public about the merits of the proposals from outside "suitors" for taking over the hospital. This is true for two reasons.

    First, the negotiation process is in full swing at this time and it would be premature and foolish of anyone to pre-judge what those negotiations will finally produce. Until we know the details there is no way anyone can honestly say which is the best proposal. Secondly, it is not in the best interest of the people of Beaufort County for anyone to try to manipulate the negotiations to fit their preconceived notions of what is best for the future of Beaufort County. Preserving the integrity of the negotiation process is important to the people of Beaufort County in achieving the best possible deal.

    So I cannot comment on the merits or any other part of the negotiation process. And I wish the WDN, all of our county commissioners, the hospital board members (both past and present), the Committee of 100, the physicians and employees--everyone--would simply not jump to premature conclusions. Those who have done so have been irresponsible at best and damaging to the interests of the people of Beaufort County at worst. Chairman Jerry Langley said it best when he urged everyone to "let the process work itself out."

    That process involves two basic approaches, sometimes called the "dual track." That is, the idea is to immediately implement better management procedures at the hospital and the physician practices while at the same time seeking proposals for a long term approach to the hospital's future. The process included seeking comments from anyone who wished to comment. I had hoped that those comments would include ways to improve the operation of the hospital and physician practices as well as suggestions that would have helped us negotiate better proposals. Unfortunately, the process has been subverted by those who hold a pre-conceived notion of what will be best for Beaufort County years from now. Unfortunately, for some the present public and very political process is driven by self interest and greed as opposed to the best medical interest of all citizens of Beaufort County.

    I believe strongly that those who came out in favor of a specific proposal before they even knew what the proposals were have done a real disservice to the people of Beaufort County.

    My concern, all along, has been to find the best way to insure the highest quality of health care possible for our people at a competitive price. I would like to see us save as many jobs as possible in the process. I would hope we all agree on those objectives. But the issue is how to best achieve those goals. And that will be determined as much as anything else by the details of any agreements we might consider. I have only one vote, but I will never cast that vote on blind trust that any one of the suitors will just "do the right thing." I want to have it in writing and make it enforceable.

    Part of the problem we face in deciding the best way forward is that the health care industry is rapidly changing and I don't know of anyone who can tell us exactly what the environment will be even five years from now, much less twenty years down the road. That fact means we need an approach that is as flexible as possible. We need an approach that will allow us as many options as possible going forward, particularly in the ten-year-plus range.

    Our health care system in Beaufort County is one of the most important assets the people have. Make no mistake about it, those assets belong to the people of Beaufort County. Those assets exist because the people of Beaufort County have supported the hospital and their doctors. The importance of those assets is not only valuable in terms of money but they are an essential institution in Beaufort County. Our people have a fundamental right to the hospital being managed for the benefit of the citizens of Beaufort County.

    What I have learned since I became active on the hospital board last February is that the hospital has not been managed properly. When revenues declined because of a drop in the number of patients, the expenses were not reduced proportionately. Hundreds of thousands of dollars if not millions owed the hospital were not properly collected. They did not, and still do not, have an accounting/data system in place to track what parts of the system are making money and where money is being lost. We've made great progress in cleaning up this mess but we still have much to be done. Had we done those things two or three years ago we probably would not be negotiating with someone to partner with. And this fact also illustrates why I have said that we don't know, nor will we ever know, whether the hospital could remain independent until and unless it is managed appropriately.

    Having said that, I am not free to discuss the merits of the existing proposals. Whatever we do I believe strongly that the people of Beaufort County need to have a provision in any arrangement that affords them the ability to insure that the hospital and the health care system is responsive to their needs. One of those needs is quality. I believe we need some kind of performance clause based on legitimate quality standards and breadth of services that allow us to assess the degree to which the health system is meeting the people's needs and some kind of provision to enforce at least a minimum level of service and quality. And that should be the case no matter who is running the day-to-day operations or who owns the capital assets. I do not think we should turn the health care system over to anyone on blind faith that they will take care of the people's best interest.