CVS considers having a medical degree to be an “obstacle” to affordable medical care, which they plan to eliminate with “one-stop shopping,” having pharmacists and nurses practicing medicine by protocol. A segregated, two-tiered healthcare system will ultimately emerge as Aetna members are directed to “Minute Clinics” without access to physicians while those on other commercial insurance plans will see the physician, nurse practitioner, or physician assistant of their choice.
Confucius said, “the man who moves a mountain begins by carrying away small stones.” It is time to lay the groundwork for Kitsap residents to formally engage in meaningful dialogue with leaders of our local hospital corporation, whether operated by CHI Franciscan, Dignity Health, or a still-to-be-named corporate entity.
The idea of micro-hospitals is gaining traction because costs of construction are far lower than that of more traditional hospital facilities –costing anywhere between $7-$30 million, depending on the range of services available, according to Advisory Board statistics. Micro-hospitals can meet 90% of the community healthcare needs. They seem to flourish best in markets with critical service gaps. Ideally, micro-hospitals are located within 20 miles of a full-service hospital, facilitating the transfer of patients to larger facilities if higher-acuity needs arise. Hospital stays anticipated to be longer than 48 hours are sent to higher-acuity facilities.
There is a grassroots movement, 4500 strong, known as “Save Our Hospital” gaining notoriety in Albert Lea, Minnesota. This story is symptomatic of the fact that hospital consolidation has slowly become a national pastime. With declining revenue under the Affordable Care Act, mergers increased by 70%, leaving small communities scrambling for healthcare access. The latest casualty in the ‘hospital-consolidation-for-sport’ trend is Albert Lea, a small city located in Freeborn County, Minnesota.
In June 2016, Kitsap County emergency personnel participated in Cascadia Rising, a large-scale earthquake drill. At the time, three local hospitals planned to coordinate management of injured casualties: Navy Hospital, which would treat the “walking wounded” (least injured), or Harrison Silverdale and Harrison Bremerton, which would clear their emergency departments to receive the flood of injured patients. While those plans have changed, the grave risk to our community in the event of an earthquake should not be ignored.
How did we get here? America has struggled to balance access to hospital services with utilization, quality and price for the past 50 years. In the mid-1960’s, certificate of need laws were established to limit the supply of hospital beds and equipment, prevent overutilization of services, control costs and improve quality.
Phoebe-Putney Hospital vs. Lee County, Georgia: A Tale of Consolidation and a Little County That Could
Lee County is on their way to achieving something extraordinary; challenging the dominance of a hospital monopoly. On July 21, 2017, the CON application for Lee County was deemed complete by the Georgia Department of Community Health. A decision is anticipated by Nov. 15. If granted, the county plans to break ground on the new structure in early 2018. The CEO of Lee County Medical Center, Mr. G. Edward Alexander, stated “Our goal is to ensure that decisions for the hospital are made locally by people who live and work in Lee County.”
One Vision. One Voice. Our Choice.
The single most critical issue facing your tenure will be improving access to healthcare for the population of Bremerton. On May 1, 2017, the state Department of Health granted Catholic Health Initiatives (CHI) a long awaited Certificate of Need to transfer all of the available hospital beds outside of the city and complete a $600 million dollar hospital expansion project in Silverdale, at the expense of healthcare access.
The Pacific Northwest hospital group may be considered the “golden child” for now, but what happens if profit margins decline and further cutting costs is not feasible? The Jewish Hospital merger experience should serve as a cautionary tale for Kitsap County. Will our beloved community hospital be sold off five years from now or can we escape the same fate by devising a viable alternative for healthcare in our community?