Why I voted NO | Eastern North Carolina Now

     Publisher's Note: We do very much appreciate this fine article on the BRHS debacle from Hood Richardson, originally published in the Beaufort Observer.

    At the 1-18-11 Hospital Board meeting Hood Richardson was one of two who voted against the motion to recommend University Health Systems to the County Commissioners based on a revised UHS offer. We asked Mr. Richardson to explain why he voted "no" and here is his response:

    Let me explain the entire Hospital situation up until this point and conclude with why I voted "no" when the Hospital board voted to accept the UHS offer. However, for those who will not read the full explanation, let me give you the quick, short version: I voted no because there are still too many unanswered questions about the details of the deal that need to be answered before I can vote for it. And let me say clearly, that position does not have anything to do with whether I believe UHS will offer fine health care. That is a given. The issue is whether we have the best deal both UHS and Beaufort County can agree upon. I do not think anybody can say that at this point.

    The Hospital got into bad financial shape due to poor management and weak oversight. The previous administration and board simply did not "take care of business" the way it should have been done. Then when the red ink started to flow the former CEO, board chair and County Commissioner representative on the board decided to just give the Hospital to UHS. Fortunately, we had enough votes to block that and advertise for bids. The bidding process entailed negotiations after the initial bids were received.

    When the bids came in, UHS did not offer the best bid. So we entered into negotiations with four bidders, including UHS. We negotiated in good faith and clearly Community Health Systems had the best offer. While we were still negotiating, a group of people started a campaign against CHS (and LHP) and drove both of them away. UHS then improved their offer and I am indeed very glad they did. I think the reason they did is because they knew we still had alternatives, as we still do today (1-19-11).

    And I will say that I believe we would have already closed a much better deal had all of the public outcry not happened. Whether that deal would have been with CHS or UHS, I don't think anybody could say, but I am convinced it would have been better than the latest UHS offer. The public involvement did not serve us well in getting the best deal for the people of Beaufort County.

    Here is what is still wrong with the UHS proposal.

    1. The "unilateral option" at the end of the lease allows UHS to decide the fate of our health care system without any local control of, or participation in, that decision. The worst case scenario in my opinion is that they would build a new hospital and dump the existing facility back on the County, and the County would have no practical use of the facility, and even an expensive demolition liability. Clearly, we need the ability to protect the County's interest at the end of the lease, either by mutual agreement or at least the Right of First Refusal by UHS.

    2. The current proposal leaves unanswered the issue related to the Certificate of Need. The CON is like a franchise to do business and is essential if you're going to operate a health care system. Whether the CON could be transferred out of Beaufort County, either literally or in effect, is not clearly addressed at this point.

3. We have no representation on the UHS decision-making board. Having "advisory input" is not sufficient. Beaufort County either needs representation on the UHS board or we need a very detailed agreement that looks after Beaufort County's interest in the years ahead. It would not be wise to allow UHS to do with the Aurora Clinic what they have done with the Hatteras Clinic. But that is but an example of the problem of lack of representation in the UHS decision-making system. Without representation this is not a partnership. The health care system in Beaufort County should be a partnership, for legal reasons if none other, but the best health care will come not from an autocratic bureaucracy but from a true partnership.

4. I also voted "no" last night because we have not yet seen the details of "the numbers." I do not think it meets my fiduciary duty to the people to vote on a deal without knowing the numbers.

    These are not insignificant issues that the Hospital Board simply ignored. I trust the Commissioners will not do likewise.

    While I am delighted at CHS improving their offer by $16 million, the current offer is still woefully inadequate from a financial standpoint. It could very well be that this offer gives away more than $100 million of the taxpayer's assets for essentially nothing in return.

    My complaint is not against UHS as a health care provider. I would welcome them looking after Beaufort's health care needs. But I believe the business arrangement should be that of a partnership. A partnership, at its heart, involves mutual agreement with neither party taking advantage of the other. A partnership involves all parties being involved in major decisions. A partnership provides for legal accountability for all parties.

    And I would conclude by saying, as I said last night, that I applaud those who played a constructive role in the negotiations thus far. I hope they will continue to do so. But I believe those who worked outside of, and even against, the negotiation process did not serve the people of this county and our grandchildren very well. While we were in the negotiating process everyone should have supported that process until the details were worked out. Once we had the final numbers then people could have campaigned for or against any particular bidder. But chasing off your bidders to leave us to negotiate with only one was simply foolish.

    And it still remains foolish.

    The Board of Commissioners should, in my judgment, seek a mutually agreeable deal with UHS. If the issues mentioned above can be satisfactorily addressed, so be it. That would be great in my opinion. If not then the Commissioners should consider all the alternatives available to us and do what is in the best interest of the People of Beaufort County, both those living here today and those who will be living here thirty years from now.