By ROBERT MELTON and JOHN C. MORRISON, Guest Commentary, Monterey Herald
April 2, 2012 -- Directors of the Salinas Valley Memorial Hospital Health System are engaged in making a historic decision—whether to transfer the hospital and its resources to one of several large national hospital corporations, or whether to merge with Natividad Medical Center and form a locally managed health care organization.
We believe the best solution for the residents of the Salinas Valley is to retain ownership of their valuable hospital, join with county-owned Natividad, build a common management system, and continue to operate under local governance. This will keep health care dollars and decisions within the community.
Throughout California, communities are actively involved in strengthening their health care delivery systems, integrating outpatient and hospital services, and improving the efficiency and quality of care. While business leaders, health insurance companies and families struggle with the cost of health care, the consensus is that we cannot continue business as usual. For example, there is a need for better coordination of primary care and specialty care, for the integration of preventive services into medical care, and for the modernization of health information systems.
Financial incentives are already in place to encourage these developments. Now is the time for communities to take the initiative and make sure that the improved systems are appropriate for local residents. There are many examples of counties around us taking this kind of initiative, including the formation of provider foundations, health improvement coalitions, as well as mergers and affiliations between hospitals and health organizations.
Whatever the outcome of the Supreme Court decision on the Affordable Care Act, the health care world is already changing and will continue to change rapidly over the next decade. Can the two Salinas hospitals continue as they are? Probably not, considering the size of the population, since duplication of administration, support services and clinical services is costly. It is also unlikely that competition between these two local hospitals will result in care that is accessible, affordable and of high quality over the long run.
If the SVMS board transfers ownership and control to a national hospital chain, major decisions affecting the hospital's future will be made in board rooms that are thousands of miles from Salinas, and where shareholder profits may come ahead of issues of quality and accessiblity of care. Many health care dollars would leave the community and flow to shareholders rather than being invested locally.
If SVMS chooses instead to pursue the vision of a new, merged hospital organization for Salinas, the unique resources of Salinas Valley Memorial Hospital and Natividad have the potential to be forged into a modern, flexible, locally accountable organization. This is a once-in-a-lifetime opportunity to build on the outstanding and advanced programs for heart disease and cancer at SVM
S and the strong primary care, clinical and resident training program at Natividad. The two hospitals' affiliations with major universities could be preserved. This new organization could also be the core for a system that integrates other health programs in the community, such as those offering health screening, preventive care, rehabilitation services and health promotion.
The merger of our two hospitals under local management will require the kind of effort that goes with any major community change. It is a complex task. However, with local expertise, commitment and vision, the leaders of our hospitals and community can and should create a hospital and health care system that will serve all for decades to come.
Robert Melton, a physician, retired as health officer for Monterey County. John Morrison, also a physician, is a hospital and health care consultant.
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