This community opinion was contributed by San Benito County resident, George Fendler. The opinions expressed do not necessarily represent BenitoLink or other affiliated contributors. Lea este artículo en español aquí.
Hazel Hawkins Memorial Hospital (HHMH) has been a mainstay of our county for about 115 years. Every community needs a hospital. HHMH is our only hospital. The loss of this hospital would be more catastrophic than the loss of a hospital in a community with multiple hospitals.
I believe that we need to step back and reevaluate our current operational structure. One thing that jumps out at me is that the selection of our board members is not based on medical management criteria; it’s essentially a popularity contest. For most of these special district elections (water, health, fire, etc.) the person who gets the seat is the person who puts out the most yard signs. That’s not a very good way to staff a board.
A successful company generally is governed by a board of directors who is responsible for setting the overall direction, making high-level decisions and ensuring the company’s financial health and compliance with regulations. The composition of our board doesn’t
contain the skills necessary to accomplish most of those objectives.
Realistically, I don’t see how an elected, volunteer board could possibly achieve that kind of a team. Because of the limitations that our board structure has, it would be a good idea to have some sort of an advisory board between the elected board and the corporate officers.
The advisory board would be free to brainstorm and discuss strategic and logistic processes without being bound to the Brown Act or any specific parliamentary process to achieve its goals. It would make presentations to the elected board who would then vote yea or nay on their recommendations. The advisory board would be composed of salaried professionals with education and experience in healthcare management. Once this structure is in place, proper governance can begin.
The next thing I would consider is that our board is actually the county’s healthcare board—not just a hospital board. With that in mind, there are medical specialties that can exist more efficiently outside of a licensed hospital structure. Specialties like dialysis,
cosmetic surgery, ophthalmology, dermatology and radiation treatments can operate as stand-alone practices and share administrative staff and other expenses. Some of these stand-alone clinics can be quite profitable. The advisory board would be able to evaluate and make recommendations concerning these practices.
One very important skill someone on the advisory board should have is experience in obtaining grants, low-interest loans and other sources of revenue.
Another skill would be to explore and manage partnerships with other institutions in an effort to achieve better economies of scale. There are over eleven hundred medical delivery networks in the U.S. Our healthcare district should explore partnerships with one or more of them. This would improve our ability to accept insurance from more insurers and give us better buying power when purchasing or leasing expensive medical equipment.
The political climate in our country is changing. The current administration is attempting to stabilize the economic structure of the nation. Unfortunately, the approach that they have taken is having just the opposite effect. This misstep is coming at a really bad time for our
community’s healthcare system.
One of the few things I learned in high school Latin class was “est vel non est.” Many years later, that morphed into Boolean algebra when I studied computer science. A thing either is or it isn’t.
Is our federal government going to help us with the financial aspects of running our healthcare system? Est vel non est? That’s one or zero? The answer is a resounding zero—no reliable or consistent help. So, what are we to do?
The answer to that question could be zero (sell it to someone who may or may not be able to finance it) or one (Figure out how to run a financially viable healthcare system). My vote is for “one.” Let’s forget about getting help from our government to run our hospital and figure out how to make it work on our own. Any additional funding that we get from the federal or state will help. But we are learning that we can’t count on it. Interestingly, if the board takes the insane, irreversible step to sell it to Insight, then Insight won’t be able to count on it either!
George Fendler.
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