Editor,

WhidbeyHealth is an extremely valuable resource for island residents that must be preserved and especially nurtured.

It is a rural, critical access health system, similar to other critical access systems that are closing around the country.

I reemphasize closing even when those communities never believed it would happen. Medicare and, in Washington state, Medicaid, recognize the extreme difficulties such systems have in remaining viable in the face of volume, economic, regulatory and demographic issues.

Compounding these are hurdles in recruitment, motivation and retention of great people at the bedside. Operating costs accelerate, facilities must be replaced and debt incurred.

While, in general, the hospital services are paid at cost regardless of volume for Medicaid and Medicare, insurers like Kaiser, formerly Group Health, must pay their fair share to cover shortfalls.

While the hospital is addressing physician models, generally payments are less than cost, especially for high quality specialists.

A barrier exists that without adequate volume of patients, specialists might see their skills erode at the same time their partner and family may need support.

This results in the need for tax revenue that goes beyond funding needed debt and facility costs.

In planning for the future, I urge that discussion occur with the community about reasonable additional tax support every few years for nurturing operations as well as critical access shortfalls, understanding management is accountable for justifying all dollars spent and appropriate management of insurance contracts and critical access reimbursement.

Quality, safety and service come first. I, for one, would pay more to help.

Frank Hemeon

Langley

• Editor’s note: Frank Hemeon is a former interim WhidbeyHealth CFO and controller for Whidbey General, as well CFO of Kaiser Permanente Northwest and other hospitals large and small around the country.