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Flies in the ointment

No matter how positive people feel about something, there’s almost always a naysayer, a fly in the ointment, to spoil things.

Hillsboro physician Michael Reeh apparently is this week’s fly. At a time when most of the community is celebrating the advent of a new facility for Hillsboro Community Hospital, Reeh bluntly warns caution, and it seems some folk don’t appreciate the proverbial rain on their parade.

We might be bucking for fly status, too, by writing about his concerns, but we’re accustomed to that. Decisions are better when all sides of an issue are thoughtfully considered, even the downside, and we’re often the one to reveal that. It’s our job.

So what do we make of Reeh’s dissent?

We don’t need to come up with an opinion about the civil contempt of court charge for the abrupt closer of Yadkin Valley Community Hospital; the judge already did: “ … flagrant disregard of a court order and woefully thin attempts to justify their actions.”

It’s also clear that emerging from bankruptcy wasn’t a cure for all ills. Public documents showed some HMC/CAH Consolidated hospitals continued to have trouble staying current in rent and bill payments. A weed-covered hole in the ground is all Oswego has to show for the hospital construction project initiated there more than six years ago.

But for the majority of HMC/CAH’s hospitals, there’s nary a complaint to be found, and that’s not too surprising. Each hospital operates as its own entity, and each situation and community served is different. With a dozen small rural hospitals in its portfolio, some “black eyes” are to be expected, as are apparent successes, such as Hillsboro Community Hospital.

Is HMC/CAH the best horse in the race? It doesn’t matter. It’s the one Hillsboro’s riding. You can bet it got a thorough going-over by the Bank of Hays before it agreed to a $9.7 million loan. They were on board as the major lender for HCH in 2010. They know about the company’s bankruptcy, and they know that even with a USDA loan guarantee, they could lose more than a million dollars if the hospital doesn’t make it.

It’s not unreasonable to have some uneasiness going into it, but not enough to call a halt and look for some other elusive option. The funding package is there, with Hillsboro’s help, to make a new hospital happen, the local hospital track record has been good, and we believe the potential benefits outweigh the risk. Full steam ahead.

But there’s another fly no one’s talking about, and it’s a huge one. It lives in both Washington and Topeka, and it threatens not only Hillsboro, but all small rural hospitals.

HCH is a “critical access hospital,” a small rural facility that qualifies for extra reimbursement from Medicare. Those extra funds are indeed critical to preserve both services and the bottom line.

Hospitals already took a 10-year, two-percent hit in 2013, thanks to party haggling in Washington that led to sequestration.

There could be more cuts coming. As a cost-cutting move, rulemakers want to make all critical access hospital re-apply for their status, and about two-thirds of won’t make it under the current location and distance guidelines. Marion County might have one hospital make it, but it’s possible neither would.

In Topeka, Gov. Sam Brownback wanted to send a message to Washington by refusing Medicaid expansion, but he sent a message to you, too: “Good luck, buddy. I care more about politics than I do about your health or your hospital.” Brownback rejected billions of dollars that could support rural health care providers.

As a result, Kansas has one of the highest rates of potential hospital failures in the nation.

When hospitals serve uninsured patients, they lose money, lots of it. Expanding Medicaid would have been a safety net not only for citizens, but for hospitals as well.

A new hospital gives HCH a good shot at retaining patients and remaining in business for the long haul, but they stand a better chance if critical access designations remain unchanged and Medicaid expansion happens.

Do you want a successful hospital in your community? There are two things you can do to help.

Get out a pen or fire up a computer and let your state and federal officials know that those of us in rural areas demand quality and security for our local health care options.

Next, ‘shop local’ doesn’t only apply to groceries and hardware. If ever there’s been a time to embrace the idea of ‘use it or lose it,’ it’s with our local health care providers.

— david colburn

Last modified Aug. 13, 2015

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