New hospital is crucial to the local community

As most know, the Hospital District has placed a bond issue on the ballot for this fall. For voters to make a sound decision, they need a lot of information, much of which is apparently not as widely known as it should be. For the moment, though, let’s focus on the threshold issue: does this community need a hospital at all?

That might seem too obvious to need discussion, but claims that it does not have been heard in public, so let’s look. First off, the crucial aspect is neither hospital rooms nor a clinic: it is the Emergency Room.

The fact that really serious cases are shipped out, by ambulance or MedStar helicopter, must not confuse anyone; before the ambulance or helicopter arrives, the care the patient receives in the Emergency Room can, and often does, make the difference between permanent injury and safe recovery, or literally between life and death.

The Emergency Room is a “Level V Trauma-Care” facility; its job is to “stabilize” patients with serious injuries before passing them on to higher-level trauma-care facilities. Without the rapid and highly skilled medical attention that only a true Emergency Room can provide patients, many area residents, as well as auto travelers on the busy highways around us, would be much worse off today than they are – possibly dead.

At any moment, that could be one or more of your loved ones, or even you yourself.

Such emergency care is not something a standard medical clinic can provide. Even a clinic set up for “urgent care” will not have all the capabilities that a true Emergency Room does. And there is another point, less elegant but equally important: finances.

The District is accredited as a “Critical Access Hospital.” That means, among other things, that governmental insurance (Medicare and Medicaid) reimburse it on a “cost-plus” basis, which is not how most hospitals or any clinics are paid. Without that “Critical Access Hospital” designation – which, obviously, requires that there be an actual hospital – neither the Emergency Room nor the hospital proper nor the associated medical clinic would be financially workable. And that is exactly why the “Critical Access” designation was created: to make it possible for small communities remote from major medical facilities to have the “critical” access to medical care that would otherwise be impossible.

But that is far from the whole story on what this hospital means to the District. The District employs dozens of people, and almost all the jobs are the sorts that communities want and need. If the day came that there was no longer a hospital here, the immediate economic impact on the community would be staggering from the loss of so many good jobs, with no alternative medical facility in the area to pick up the slack.

And that would be only the immediate effect: in the middle to long term, it is near certain that many families, especially those with elderly family members, would choose to relocate to somewhere that does have an Emergency Room close at hand. Many other families who might have chosen to move here as the area develops would elect to stay away. It is quite obvious that between the unemployment and then the loss of population (and probably businesses), the long-term effect of losing the hospital would be a virtual deathblow to the community.

Again: ambulances and helicopters are little use if seriously injured or ill patients cannot receive immediate stabilizing treatment. For stroke victims, for example, to quote The New York Times, “In the real world, the difference between recovery and disability or death is measured in hours.”

And that is from the stroke itself, not from when the patient arrives at the Emergency Room. Likewise, crash victims may lose limbs or die if they do not receive skilled care within a very short time.

To imagine that this community can do without a real, full-time hospital Emergency Room is totally, stupendously wrong.

Eric Walker, Ritzville