Just How Messed up IS this Push for a Somervell County Hospital District? Somervell County Salon-Glen Rose, Rainbow, Nemo, Glass....Texas

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Just How Messed up IS this Push for a Somervell County Hospital District?

1 March 2013 at 5:49:00 PM

I want to talk about a number of things that are goofy about THIS go-round about trying to get Somervell County citizens suckered into voting for a large amount of taxes by passing a hospital district. In case you forgot, the LAST time GRMC tried to pass this it was defeated by a 2-1 margin. A lot of the same elements are here this time, including trying to frighten people about their jobs or losing the hospital and other claptrap. The difference this time is that there is going to be a money PAC to pour out PR to get people to agree to pay higher taxes, so as Commissioner James Barnard points out, we are paying for an election that a PAC pushed.


What is also different this time is the arrogance from the Hospital Authority board in not even ATTEMPTING to look at other alternatives. Who do they represent??? Somervell County appoints these people, so the people on this board are NOT elected, cannot raise taxes and their obligation is to make recommendations to the county. They have come, hat in hand, to ask for more money to run the hospital, to pay the doctors more salary, but, again, they are an advisory board that operates semi-autonomously. What they WANT to do is be a hospital district that no longer has to come to the county but can raise their own taxes, in the same way the school district and water district do.


That means at that point that Somervell County commissioners court will wash their hands of them and the new district would have the ability to set the tax rate they think they need to run the Monument to Gary Marks. How much tax? Well, no one will really say...


Let's look at this last audio exchange a little more closely. According to an audit of what it costs to run the hospital, the cost is 3 1/2 cents to run the hospital plus another 3 cents for the indebtness (that would be part of the 14.4 million plus interest that Mike Ford saw fit to ram through without a legal hearing on the merits of money going from a PUBLIC entity to a private one.) Does that come close to 17 cents? I'm not a math whiz but I would say no. So where WOULD all this extra money go, especially when the hospital can't seem to run itself efficiently now? You don't think if we pass that district that the now- autonomous entity would soak up every last dime on..... something?

(Update: Ooops. My Bad. The tax rate that the District wants is not 17 cents. It's actually 17 AND A HALF CENTS.)

Another huge question about this whole boondoggle is why Larry Shaw and other Hospital Authority board members have not actively looked for other solutions that do not soak the taxpayers but, say, allow another private entity to LEASE the facilities, thus bringing in revenue and not costing the people who live here extra money, particularly when it appears the entites managing it currently have mismanaged it. As appointees who could certainly be thrown OFF the board for mismanagement, how is it that they have not been pursuing all opportunities to succesfully run the hospital? Why should a PAC be running the show instead of really attempting to find out what the people of Somervell, the second smallest county in Texas, wants? (As they did NOT want a hospital district the last time GRMC tried to shove it down people's throats.)

Community Health Services and Lake Granbury Medical Center have certainly made noises about LEASING GRMC. In fact, they put in a non-disclosure agreement request with Mike Ford on the 7th of February. This was to get the process STARTED so that they could start making a proposal. What did Mike Ford do? Did he immediately turn it over to the APPOINTED Hospital Authority board to deal with it? No. He sat on it while interjecting himself into the middle of it, or, at the very least, if he DID pass this on, didn't tell either CHS OR he commissioners about it until the meeting of the 21st. n fact he SAYS he was doing some kind of conversations with Orcutt of Lake Granbury at some time previously.  Then, when called on it, on February 21, he tried to excuse his actions by saying that CHS ought to have gone to the appointed board to talk about it. Well, why didn't HE make sure to pass it on or tell them on the 7th or 8th instead of 2 weeks later that they were going to the wrong entity?He cannot have it both ways; if he sticks himsefl in the middle of it, then he can't then say Oh, you shouldn't be talking to the county but to the authority.  But what you have to hear is Larry Shaw's response to this. Oh, he doesn't want to *muck up the water* or supposedly entertain a proposal for a lease from Lake Granbury until AFTER a district is formed. Clearly the APPOINTED board does not give a hoot about anything about trying to get their SEVENTEEN (and a half) CENTSof tax rate from all of us here so they basically refuse to entertain any other viable suggestion except for a district.


Note as you listen to that that CHS is NOT planning to close the hospital. The CHS guy even says they are NOT closing down the hospitals they run but are growing. (therefore putting the lie to anyone that says that going to CHS would be closing the hospital.

Note that Mike Ford says that the authority does not have to go out for proposals. So they can be appointed DESPOTS (except of course that they can be dumped by the ELECTED commissioners court)

P.S. Update on the PR part of this. Have seen multiple letters to the editor pushing passing the hospital district, undoubtedly part of this effort to not only make the issue seem like "IF YOU DON'T PASS THIS THE HOSPITAL WILL CLOSE" scare-mongering. Don't be fooled.

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1 - humanbeing   5 Mar 2013 @ 9:44:42 PM 

I don't know what the best solution is for GRMC at this point in time. I voted for the district the first time. I'm not sure how I will vote in the next election, not because I think there has been gross mismanagement nor because of any suspiscion or resentment toward Mr. Marks, the current management and board or the County Court but because I know that things are changing in this tricky world. It's complicated.

Even though I know something about the problems health care providers are facing these days, all over the country, not just here, I also know that this decision needs to be based upon knowledge that most of us just don't have, including myself. Deciding what's best for GRMC, as a voter and a taxpayer, will not be easy. 

I've worked at both facilities over the years, GRMC and Lake Granbury. Neither was perfect, from an employee's point of view. But, in my opinion, the more 'corporate' any business becomes these days, the less connection it often has to its employees and clients.

Do I want my taxes to go up? No. If they do because of the formation of a hospital district, would I consider it worth it? Maybe. Stay tuned. This is an important decision for our community. We don't want to lose GRMC. It's important for our health care needs and our economy, whatever the best solution might be.

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2 - salon   6 Mar 2013 @ 10:31:58 AM 

One of the main problems I have with the way this particular hospital district push is being done is that the appointed hospital advisory board has refused to consider other alternatives other than this. This despite the fact that there is at least one other alternative that would keep the hospital here but have it leased to another entity. Who knows if there are even other possible solutions that might come out had this been more of a process that asked local citizens what they thought rather than having, again, an ADVISORY board that has a particular end they want running the show?

Let's say that the election does not pass. It's entirely possible that, even being run by the county, some services would have to be cut back. Remember that when GRMC, then a private entity, attempted to get government grants, they were turned down because of the number of other hospitals in the area within a short distance radius. For true trauma situations, people will not be going to GRMC anyway, and for elective surgeries, there are other hospitals not far away, including Harris Methodist in Ft Worth or Scott in Waco.

If you listen to what Commissioner James Barnard said in one of those most recent meetings, the amount that the appointed hospital authority board wants is 17 and a half cents and yet it only costs about 6 1/2 cents to run the thing. Ford could not answer whether the district would actually use all of that, but heck, the way the costs have been run up, why would anyone think if they ask for it, that's not what it would be?

I personally want GRMC to stay here but as a more leanly run emergency and limited services clinic, As one of the commissioners told me,otherwise it's like building a Super Walmart in Walnut Springs.

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3 - humanbeing   6 Mar 2013 @ 7:54:46 PM 

I agree with you, Salon, that other options do need to be publicly considered but I do not agree that we as citizens or even the commissioners are necessarily qualified enough in our understanding of the complex reality of what it takes to successfully run a health care facility from a financial point of view to make the best decision at the voting box. No one wants to pay more money, Right?

Because our healthcare coverage in this country is provided by a few, for-profit corporations who are not required by our government to be competitive or efficient, many of us cannot even afford coverage. This is the real problem GRMC, along with many other institutions, is facing. I believe that GRMC's problems are much larger than any local issue. Costs are skyrocketing all over the country. America has the most expensive, least efficient system of any advanced democracy on the planet. Why? Because we have a hangup about socialized medicine and we don't want to pay for it like all the other, better-served countries do.

Got an emergency? Better hope your triage 'clinic' has all the personnel and the qualifications, 24/7, to stablilize you or your spouse or child before being careflighted. The idea of a lean emergency room is naive. Most of us would not accept anything less than the ability to save a life, if needed. That's complicated. Full time physicians, nurses, laboratory, radiology, house keeping...and better have enough units of your blood type on hand, just in case you're bleeding to death...nothing simple about this reality or our vote on this issue.

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4 - salon   6 Mar 2013 @ 8:18:12 PM 

Except that GRMC is not a full trauma center right now. I heard of a fairly recent example where somoene was severely injured and coudl not be taken to the existing GRMC.

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5 - humanbeing   8 Mar 2013 @ 7:10:07 PM 

I think GRMC is a level four trauma but of course they can't handle everything. They are, however, equipped to deal with some pretty horrible situations when they have to, 24/7. Emergencies don't only happen between 9 and 5.

The real problem is our system that requires, for example, a woman without health insurance to go to the ER at 2am on a Sunday morning to treat a painful urinary tract infection that she's had for three days because she doesn't have a primary care physician or the money to pay one or access to a clinic like Planned Parenthood to help her, and she just can't stand it anymore. Maybe she's not even educated enough about her own body or too young and inexperienced to understand what the problem is.

When she walks in the door, she will be attended by a nurse, a physician, and laboratory staff, all getting shift differential pay in addition to hourly because it's 2am on a weekend. If her abdominal pain is bad enough, they may order full lab, including cardiac enzymes, plus a radiological workup, just so they won't be held liable in case something more serious is going on and because ruling out problems, step by step, just takes too much time. Afterall, we expect instant gratification, don't we? And sometimes, unnecessary testing is ordered before the physician even examines the patient. I'm not saying this goes on at GRMC but I know that it does in many other facilities that I've worked for. In fact, it's become the new standard.

Will that ER get reimbursed? Maybe, but that will require the time and expense of several other employees in the business office to figure it out on Monday. Then, of course, housekeeping has to step in and clean things up for the next non-emergency and just in case there's a real one coming.

This is a perfect example of how to use a tank to shoot an insect and one of the many reasons our health care system is crashing. It's an outrageously wasteful way to deal with a relatively simple problem and is just not an intelligent use of resources. Why does this continue? Because the Corporations that supply these facilities are making so much money. They own Congress through their lobbying and they get to make the rules.

I believe that as long as health care in our country is defined as a business, first and foremost, rather than a necessity, it will continue to go down. Other advanced countries understand that having a segment of their population unhealthy makes their country unhealthy. Why don't we? It's a matter of values and priorities. Here in America, investors are our priorities, not our citizens.

Does this answer the question about our vote for a Hospital District? No.

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6 - salon   8 Mar 2013 @ 8:24:16 PM 

I completely agree with you about health care. Every time I start to wrap my mind around why it is so dang expensive and inefficient, I have to stop. You hit the nail on the head about health care in this country being a business and not a necessity. I am for universal health care. It's absurd that we have such bad statistics compared to the rest of the world http://www.theatlantic.com/international/archive/2012/06/heres-a-map-of-the-countries-that-provide-universal-health-care-americas-still-not-on-it/259153/ -

IF this was the argument with regard to Somervell District, we'd be having an entirely different conversation. You wrote the other day, in another context about a better plan than *endless growth*. The way that this whole hospital situation has been handled for the last 5 years or so has been an example of endless growth that went around the bush and under the covers to get done and ended up an expensive boondoggle. I don't think anyone really wants to necesarily get rid of the hospital itself. I like the idea of having emergency services here but see no reason, if currently it's 6 1/2 cents to run and pay back the debt that was taken on, for a voted in district to get 17 1/2 cents.

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7 - humanbeing   10 Mar 2013 @ 8:08:18 PM 

I think that because health care has become a business, first and foremost, every facility is pressured to keep up with more and more technology and services. I remember reading something months ago in The Reporter about a new vision for GRMC to offer greatly expanded service over what it currently has, like obstetrics and pediatrics. I think it was Dr. Davis who was quoted. I did not agree with his statement. I think GRMC will have to draw a line.

The main problem is that the entire economy in this country, including our health care, is based on an old paradigm that doesn't work anymore. No one really knows what to do right now as we travel this transitional period that is leading us into something else. Not the voters, not business, not GRMC.

I assume the 17 1/2 cents is to cover future increases but this uncertainty is not reassuring in these tricky times. The management needs to make their case much more convincingly if they want the voters to get on board. 

I, too, support a universal health care system because I truly believe this will be the only and best way forward.  

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8 - salon   14 Mar 2013 @ 4:39:27 PM 


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9 - humanbeing   22 Mar 2013 @ 9:21:51 PM 

Yes, salon, this is exactly the point. Financing and executing health care should not be a for-profit venture. This may have worked in the '50's and 60's but it doesn't serve the people anymore. I believe that a Universal, one-payer system is the only solution to this part of the problem.

Another part of the problem is that our wonderful technological advances have created the illusion that the sky is the limit and everyone can have any extravagant, exotic, costly procedure available at all times, regardless. This isn't rational, reasonable nor is it necessarily good management for the patient. We have a health system that won't even allow people to die when they are ready to because we don't want to acknowledge death and we don't want to talk about it. How crazy is that?

There are many problems in our health care that we need to address and there won't be any quick, easy solutions. We just have to hash these things out, pure and simple, and find a more realistic, more humane understanding.

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