A REAL HEALTH
CARE PLAN FOR
Making the Case for Two Upcounty Hospitals
The fight to decide who gets to build a new hospital in upper Montgomery County may be distracting us from the larger needs of not only the county's residents, but of residents in the counties that share our border.
Both Holy Cross and Adventist HealthCare have submitted excellent, if modest, proposals for the community to consider. These hospitals would be in Germantown and Clarksburg, respectively. Both have their individual supporters among government officials.
However, I believe that our county and state must commit the resources necessary to build both projects, and make further investments over time to expand those facilities, if we are to face the health and public safety challenges the near future poses.
The need for more hospital beds could not be more clear. Each proposal touches on that issue. However, even together, the total number of beds would be simply a good step forward.
Here's an example of our problem: On January 2, 2007, you might have felt like it was a rather ordinary - if cold - day in Montgomery County. If that was the case, you probably were not seeking emergency treatment in area Emergency Departments. At midday, ambulances were being turned away from Sibley Memorial Hospital in NW Washington, Suburban Hospital, and Shady Grove Hospital EDs. There was no terror attack, no smallpox outbreak, and no natural disaster. Just quite a number of sick people with the flu and norovirus. And yet, EDs in the southwest sector of the county were overwhelmed.
Imagine what the situation will be if a terror attack, disease outbreak, or natural disaster does occur. That's not even getting into the fact that the population is completely unprepared for evacuation. The everyday diversion of ambulances is probably the most critical argument in favor of one or more new hospitals.
Holy Cross plans to add 101 beds (some have argued that some of those beds are being shifted from Holy Cross in Silver Spring, but that has not been clarified yet for me to state as fact). Adventist's hospital would add 86 beds.
That's probably a good start, but not enough to handle a catastrophic event unless we build both.
A second compelling reason to build both is the increasing need for care among those without health insurance. Not only would both hospitals be required to provide charity care under state regulations, but both companies are actually eager to do so. These services would enhance those already being provided at their current facilities.
This is not only good from a moral standpoint, but from a fiscal one as well. Our county's elected officials have run Montgomery's finances into the ground over the last 8 years. With almost 40% of the county's rich having moved to Northern Virginia, a loss of billions in revenue is colliding with a long-term structural deficit in a most imperfect storm.
We simply cannot go on like this, and programs such as Montgomery Cares and other taxpayer-funded health plans will have to be scaled back. The County Council just bragged about having kept the funding for Montgomery Cares in the budget. It may be a feel-good statement for some special interests, but the reality is that once the stimulus money dries up, the county will literally be bankrupt if we continue spending at this rate. Whistling past the graveyard is a favorite pastime of this council, but wealthy citizens will continue to flee, and Wall Street will yank the AAA bond rating. "Feeling good" doesn't pay off debts, and debts get collected on, and governments do go bankrupt.
It's time to wake up.
And time to build two hospitals.
We can have two more EDs serving the health needs of the most vulnerable. Every human being has the right to health care, in the sense that emergency health needs should be met for every person, regardless of ability to pay. These hospitals can help us provide that, while reducing the burden on the budget and the taxpayer. Cadillac health plans for the uninsured are no longer realistic, and we need to get real before it's too late.
A third issue is the critical need for more mental health services in the county. The Holy Cross plan calls for 6 psychiatric beds. We need more than that, and we should ensure that both hospitals will help us meet the mental health challenges ahead. Right now, we not only lack facilities for mental health patients, but our county police are burdened with having to be the mental health envoys of the community. More facilities, providing more patients with treatment, will not only help our police focus on the serious crime issues, but also help us address our homeless population - which is embarrassingly large for such a wealthy jurisdiction.
A fourth need is jobs. Holy Cross plans to offer 600 jobs; Adventist will offer 1000. These exclude the construction jobs that would also be created. 1600 sure sounds better than either figure by itself, especially during these bad economic times. We have the highest unemployment in decades in Montgomery County, and our council is promoting the same mixed-use development that has failed to create jobs over the last 8 years. These hospitals would offer real jobs, not McJobs.
Fifth, I believe that the Clarksburg hospital should eventually include a trauma center. Anecdotally, I hear often about victims of traffic accidents in the Upcounty being sent everywhere from Baltimore to Washington County to the Washington Hospital Center. While those are all excellent facilities, Upcounty residents - as well as residents of lower Frederick and Carroll counties - deserve a shorter helicopter flight for emergency treatment.
Clarksburg is ideally located in the center of that region. Yes, I realize that trauma centers are very expensive. But the state of Maryland should help us make that investment, as well as the Federal government.
In 2006, when I ran for the House of Delegates, I spoke often about the need to press the Federal government for more funds. We need transportation funds, because not only do Federal workers use our roads and transit systems to get to work, but because we are on the outskirts of a major terror target, the nation's capital.
Likewise, as a terror target, we have a need for more hospital beds than a Midwestern city. It is a public safety issue, and a national security issue.
A new trauma center is badly needed for our Upcounty residents, and for residents elsewhere in the state.
This need, and the possibility of receiving Federal funds, is very real.
In the Baltimore Sun, Edward Gunts wrote that the University of Maryland's Shock Trauma Center is receiving $2.4 million in Federal funds for an addition. This is because the UMSTC offers training to military surgeons, doctors and nurses. Of course we have the Naval Hospital - soon to add Walter Reed's programs - here already; this would provide an opportunity for those personnel to work with one or both Upcounty hospitals. Then we could qualify for Federal funds.
Overall, $13 million in Federal funds will be going to the Baltimore facility, which is overcrowded right now. $50 million is coming from the state, and $35 million will be raised by the UMSTC.
Of course, Adventist's hospital is scheduled to cost $177 million (I don't have a figure for Holy Cross's proposal). These are going to be expensive.
Aside from protecting Clarksburg's already damaged streams, I would advise that these lofty but foolish goals of "green" buildings and LEED certification be put aside. We cannot afford to waste funds on "global warming" not caused by human activity. (Did you hear about the climate change recently discovered on Mars? All those darn Hummers on the Red Planet must have been responsible, right?).
Contain costs, and get government spending under control so that we can start focusing on the core responsibilities of county and state government. That's what our elected officials need to do, starting today.
Finally, Holy Cross will be joining with Montgomery College's nursing program to address the shortage of nurses in area hospitals. (Don't get me started, though, as some hospitals are not hiring, despite a high ratio of patients-to-nurses!)
In conclusion, the strengths of each project would make building both worthwhile. Adding some of the expanded features I've proposed would make an even greater payoff on the investment.
Can we afford it? That's a question we must ask about virtually every budget item and wishlist today. But I would at least like to add to the debate and discussion, in the hopes that we won't shortchange an opportunity to make a serious improvement in the health and safety of the Upcounty and our neighboring counties.