Recently, the City Council-appointed citizens commission recommended that Memorial Health System be re-established as a nonprofit organization. Although I am confident the commission's intent was sincere, I find it disturbing that Memorial CEO Dr. Larry McEvoy publicly advocated for this same option while deliberations were ongoing. His advocacy should have been considered a self-serving conflict of interest and no factor in the decision.
Quite often these public input/assessment processes are designed to feign an objective assessment with the true intent of pursuing preconceived intentions.
The following arguments, as submitted for changing the ownership structure, are weak at best:
The health care industry is in the midst of a dramatic transition. Using the changing health care environment as a reason for changing the ownership structure and throwing out concepts like bundled services, fee for service, etc., is an attempt to obfuscate the issue. Change is constant and these concepts are nothing new. Assuming analysts are correct and health care changes are more dramatic than at any other time in history, this is not the time to lose control of one of our most important assets.
City Council members do not have the experience to manage a health care system and are subject to political winds of change.Experience is not necessary in that Council's job is not to manage operations, but establish policies and approve the budget. A nonprofit board's experience in health care shall be limited as well. Its job will be the same, but with the added responsibility of fundraising.
The biggest difference is that Council is directly selected through an actual election, while a nonprofit board is typically recommended by the CEO and appointed by fellow board members. All councils, boards, commissions, etc., are subject to "political winds of change," nonprofits included.
A nonprofit is not motivated by profits, but by charitable intent. All organizations, to include nonprofits, are motivated by financial return on investment. The use of those returns is what makes the difference between the public, private and nonprofit sectors.
Better but less-publicized arguments for ownership change are as follows: A public hospital does not attract the mix of patients that would enhance the organization's long-term financial viability; poor quality and medical errors are more likely in financially distressed public health care organizations; and public-owned organizations are less nimble.
Although more reasonable, these points are not compelling enough to change Memorial's ownership structure. I propose the following solution:
1. Establish a partnership among the public, private and nonprofit sectors.
• The public sector's role will be to maintain ownership and ensure accountability to citizens. Memorial's role shall be to operationalize City Council-approved strategies, policies and budget.
• The private sector will provide funding or access to funding, and will guide Memorial on how to be more efficient and less costly, thus using its monies on facility and equipment modernization and staff salaries/training.
• The nonprofits will bring "the moral compass," ensuring our system is mission-focused and our most vulnerable citizens are being treated.
2. The partnership must be formalized. A meaningful mission statement and bylaws must be established that can withstand executive and political leadership changes. They might even become statutory. We need to view our health care system as something sacrosanct.
3. Hospital executives need authority to make decisions and establish partnerships within their Council-approved policy and budgetary guidelines. Operational interference from City Council should be a violation of the city charter.
4. Our newly established partnership must be marketed to potential funders and businesses interested in this area. These organizations want to know that we are working together as a community.
Instead of focusing on how our public health care system can become a stand-alone organization, we need to identify ways the three sectors can effectively work together. This concept is not new; it just requires strong leadership, commitment and people who can work through "turf issues." The end result will be an efficient, effective, flexible and relevant Memorial Health System.
Ken Barela, local business consultant and former mayor of Fountain, is a former senior vice president of Pikes Peak Behavioral Health Group.
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