By George Fritz HahnAs the town council's representative on the [Holy Cross] hospital's Health Study Committee and chair of the Taos Health Systems Board Nominating Committee, I thought it …
By George Fritz Hahn
As the town council's representative on the [Holy Cross] hospital's Health Study Committee and chair of the Taos Health Systems Board Nominating Committee, I thought it appropriate to respond Dr. Del Endres' My Turn column in the Taos News, "When it comes to our hospital, choose facts over fear" (Feb. 13).
I attended the meeting that you referenced below and heard Mr. Bellis' comment. As you stated the number of closures is far less, but that does not preclude the fact that rural hospital closures have been increasing at an augmented rate. I didn't take Mr. Bellis' comments as "scare techniques" rather that closure trends are alarmingly increasing.
For example, "Currently, 46 percent of rural hospitals operate at a loss, compared to 44 percent in 2018 and 40 percent in 2017. Due to financial strains, nearly 700 rural hospitals are financially vulnerable and at high risk of closure" (ruralhealthweb.org and from your own Becker reference noted below). The challenges rural hospitals are facing will likely persist next year, and more hospitals will close. Across the U.S., more than 600 rural hospitals are vulnerable to closure, according to an estimate from iVantage Health Analytics, a firm that compiles a hospital strength index based on data about financial stability, patients and quality indicators.
A reality check is how I interpreted Mr. Bellis' comment - not a scare tactic. Mr. Bellis' chief concern was to establish consistent, long-term support for the hospital.
You state that "Medicaid expansion protects rural hospitals and all hospitals in those states that accept it" and yet "The National Rural Hospital Association points to cuts in Medicare reimbursement rates - not refusing Medicaid expansion - as a primary reason for flailing rural hospital bottom lines." How are we to bridge that gap unless our community supports its hospital?
You state that "six hospitals in New Mexico have a gross receipt tax for supporting their hospital." And that "only about half of New Mexico hospitals have a tax support for their hospital. ... So the obligatory tax to support hospitals is not really obligatory." I feel that your statewide (macro) perspective excludes individual community's contextual factors.
For example, hospitals in the southern part of the state are positively impacted by the oil industry; Los Alamos as the wealthiest county in the state and has no need to support its hospital through tax revenue due to its more traditional payer mix. It is also a fact that all hospitals under 25 beds receive community support in the form of property or GRT tax revenue. I'd posit that a more fair comparison would be to Española's hospital, which that community supports with a 4.25 mill for the privately owned "Presbyterian" hospital.
You suggest, "We need to look at ways to support Holy Cross Medical Center but we should also look outside the box. ... Charging a higher mill levy to those with second and third homes or more expensive new homes has been done elsewhere." Where has this been done "elsewhere"? The Health Study committee has researched this possibility and found that New Mexico statutes will not allow it. I believe that ski valley's "surcharge" would run into discriminatory adjudication and not withstand scrutiny. The state legislative process, though laudable, will not address the problem in a timely fashion.
You list numerous personnel and billing complaints. It is my opinion that the THS Board and their independently contracted administrators [Bill Patten and Steve Rozenboom] have addressed and continue to address these issues and great progress has been made. Are you suggesting that we "throw the baby out with the bathwater"?
Oversight and transparency are provided in four primary ways: 1. the independent, regionally selected THS Board; 2. the Hospital Health Study Committee; 3. mill spending accountability and oversight provided by our Taos County Commission; and 4. the presence and influence of 1199.
Finally, your statement that one-third of our property tax bills are delinquent is not quite accurate. Paula Santistevan, deputy treasurer, [notes regarding] delinquent property taxes in Taos County: "If you exclude the uncollectable accounts listed above, our delinquent properties are around 10,000." The 23,000 reported by Dr. Endres, though technically correct, failed to mention that over half of those reported 23,000 in delinquency were actually the result of two aged bankruptcies in the Tres Piedras area.
George Fritz Hahn is a Taos town councilor.
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