Publisher's Note: We've been a bit short of staff this week, so we here at BCN do very much appreciate this excellent submission from the staff of the Beaufort Observer.
The good news is that Community Health Systems (CHS) has agreed to re-enter the negotiations on proposals to take over the Beaufort Health System. The bad news is that we still have the problem that created their withdrawal in the first place.
to read a more detailed report from Brandia Deatherage of our partner publication Beaufort County Now.
What makes CHS's return so important to the taxpayers of Beaufort County is that it means the negotiations will be competitive. Without CHS it is highly likely that University Health Systems (UHS) would simply take, more or less, a "take it or leave it" position in its attempt to take over the System.
And takeover is the correct term. Anyone who has reviewed the actual proposal from UHS can see clearly that they would control the decisions related to what is done with the doctors' practices and the hospital. There is no effective method of local input into their decision-making apparatus. Hopefully that will be addressed in the negotiations. CHS offers a symbol of local governance in their original proposal, but it is not clear how effective that would be. That too is a significant point to clear up in the negotiations.
But the biggest difference between the two proposals is that the UHS proposal would mean that they would completely take over the hospital and all of its assets, including the Certificate of Need. It is a "forever deal." CHS on the other hand would return the assets at the end of the lease unless the lease is extended. That in and of itself gives Beaufort County some control of what happens to the Health System.
But we think that is insufficient. We think there should be an ejection button in the deal so that Beaufort County can bail out of any takeover if it is not working out. We don't know the details of how such a release valve should work but we think that whoever runs the hospital must be accountable to the people of Beaufort County.
The third factor that must be weighed heavily is whether the best interests of the citizens of Beaufort County are served by a monopolistic health care delivery system as opposed to one that has UHS competing daily with another entity. We think patients having a choice of provider is extremely important.
Again, we don't know the details of how that would work, but we do think as a general rule that the best accountability system is one based on free enterprise competition.
A competitive system works to the advantage of holding down costs for the patients and even their insurance companies, insuring quality of service and for the employees. If there is only one employer in the region then employees must take whatever UHS offers. That is not in the best interest of the employees.
But those are the details. The negotiations will determine the utility of any change that is made in the health care delivery system in the county.
We're just glad CHS is willing to negotiate and we hope they and UHS will do so in good faith to produce a mutually beneficial deal. That deal must then be compared to the possibility of continuing to operate the Health System independently. But we suspect that even if the system remains independent in ownership we suspect that an outside management system will have to be brought in to run it correctly.
We don't know which is the best approach. We don't think anyone knows at this point because we don't know the details and we can assume that we don't know anybody's best deal.
And that is what distresses us most about this entire situation. All of these people who have already decided that UHS is the best alternative have severely damaged the best interests of Beaufort County citizens, patients and taxpayers. That includes the doctors and employees, some members and former members of the Hospital board, the Washington Daily News, the Chamber of Commerce, Committee of 100, the local Realtors' group, commissioner candidates Evans and Arnhols and sitting Commissioner Al Klemm. All of these "leaders" have come out in favor of UHS before they know what the details of the options available to us are. The process should not only be unbiased, but it should have the appearance of being unbiased. Those who hung their hats on UHS before now, for whatever reason, have disqualified themselves from being afforded a presumption of unbiased participation at this point.
But while various community leaders have, we feel, done a gross disservice to the citizens of Beaufort County, that is especially true of Hospital board members and former board members. These people have a fiduciary duty to maintain an unbiased process in which each and every potential proposer would be given fair consideration. But in some instances these people decided on UHS before they even knew what the proposals were. That is a gross violation of their public trust.
The effect of this exhibition of bias by the champions of UHS was to nearly drive CHS away and who knows how many more might have submitted bids had they not sensed a charade. If these people honestly believed UHS was so superior to anyone else they would have been confident enough to allow that to come out in the process. They did not do that, choosing instead to short-circuit the process at the expense of the best interests of the people of Beaufort County.
We don't usually subscribe to most conspiracy theories, but in this instance the bias is so obvious that it raises serious questions in our mind about what the motivation was. These people are not that stupid. Some of them apparently had ulterior motives. They had to have or else why would they not have been willing to let the process run its course? And they should disclose these biases if they remain involved in this process. Perhaps Dr. Penders (who had an undisclosed vested interest) was not as irrational as we first thought. Maybe his suspicion was justified, but just misplaced when he alleged, without any substantiation, that the decision was being driven by political contributions. We hope the rumors we've heard are not true.
We are not suggesting that the biased UHS supporters should remove themselves from the process but rather that their bias be disclosed. We trust the decision-makers to take that into account.
But having said that, it leaves a major problem for Commissioner Al Klemm.
The Board of Commissioners will be the decision-maker in this matter. And that is how it should be, unless the decision is given to the voters. The Commissioners are the elected representatives of the people. That is what a republican form of government means. The people elect the decision-makers. And whatever decision the Commissioners make should have as much credibility as possible. It cannot be credible if bias is the driving force. That presents Mr. Klemm with a real character test.
Commissioners, unlike the rest of us, have THE vote on this matter. And one of the prime requisites for an honest system is that votes be cast in an unbiased manner. The simplicity of the situation Mr. Klemm has created is this: He has a vote and he has already announced what it will be before he sees the facts. "He cast his vote before he read the bill." He should recuse himself.
And speaking of unbiased participation, we should serve notice that we will not be video recording or reporting on the details of the negotiations. We don't think there is any doubt that any committee appointed by the Hospital board is subject to the Open Meetings and Public Records laws but we do not think the detailed negotiations should be reported publically. That is not in the public's best interest in this particular situation. The results thereof should be fully disclosed, but the process should proceed in a confidential setting until such time as the comparative deals are fixed.
We are very glad the negotiations will be done in a competitive environment and we wish the negotiating team well.
No Poll Exists with that Id!