While I fully support improving patient access to emergency care and agree with the need to establish a free standing emergency department (FSED) in the south part of the (public) hospital district (No. 1), this has been a severely flawed process with no public input. It is being prematurely rushed to a final vote for no apparent reason. Indeed, a group from Kent has asked for an opportunity to make their case for why it should be located in Kent – and we should at least listen to them before voting.
The hospital commission requested that staff undertake an options analysis to rationally assess the need for and appropriate location of a future FSED – and the resulting report, which was presented tonight (March 15), is woefully insufficient. The report is highly opinionated, hasn’t collected basic facts and provides almost no basis for comparing and analyzing different options. Covington might indeed be the best site for this facility – but we’ll never know as a professional, unbiased comparison wasn’t done.
Our resulting decision is an illustration of some of the worst aspects of American health care.
We are choosing to go forward with a major investment in the most expensive type of health care and doing so in potentially the wrong location and without a good public process.
What is clear is that from the hospital administration’s standpoint (which received majority support from the hospital commission) the overriding reason for locating in Covington is fighting for market share with other hospitals. Much of this “market” is well beyond the boundaries of the hospital district. As a public hospital district it seems our overriding reason for making any investment of public resources should rather be maximizing the public good and providing the best health care to the greatest number of citizens within the boundaries of our district.
It became clear in the minimal analysis that was done that an area of greater need that is in our district – Kent – is being bypassed to locate in a more affluent area that will almost certainly soon have an oversupply of the services this emergency center will offer. It is hard, with a straight face, to really say that there will be a shortage of emergency care in Covington when this project opens. We are the third of three organizations to announce our intent to locate a FSED in greater Covington and ours will be the smallest of the three projects. We’ll also be locating just one mile from the largest of the three projects and about five miles from Swedish Medical Center’s project in Maple Valley. Three FSEDs in this area is a waste of health care resources. As we are spending public dollars we have a duty not to pile onto this waste.
Meanwhile, the largest city in our district (Kent) has no emergency care within its boundaries and longer driving times to reach emergency care. Our publically owned hospital staff actually downgraded locating in Kent because its population was poorer than that of greater Covington. In a rational world, emergency care centers would be spread apart geographically and public institutions using their public subsidy should not purposely cluster redundant services in affluent areas.
The path we’ve chosen to take is unfortunately contradictory to why Public Hospital Districts were established in the first place.
This is at least a $25 million project, yet the first time the commission received anything in writing about it was on Thursday night. Now, on Monday afternoon, we were asked to take a final vote on it. There has been no public hearing on this major investment that our taxpayers will be responsible for paying the bonds on for many years. Public projects should seek public input, including input from the city of Kent on what they might be able to offer Valley Medical Center. To have not had a serious discussion with the largest city in our district about this potential project shows a shocking lack of due diligence. This is especially so when the district’s goals for 2010 were expanded to not just be looking at Covington for a potential FSED, but to include other areas in the southeast part of our district – which by definition would include Kent.
The options analysis presented as reasoning for establishing this facility is riddled with errors (six factual mistakes in the first sentence alone). The scores put together in the report seem skewed and highly biased – not the neutral analysis that most policy-making bodies would expect, at a minimum, from their staff. The quality of this analysis should be unacceptable – it clearly does not provide a solid basis for making a major decision to be paid for by all our district’s taxpayers.
This vote is premature. We have been requested to delay and hear from a group of Kent citizens and we should at least agree to listen to these constituents. For all of these reasons I voted no on this hasty decision.
Anthony Hemstad,
Hospital Commissioner
