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 Author: rearnheart
PostPosted: Mon Apr 30, 2018 8:19 pm 
I sent a copy of this letter to all our County Commissioners after a presentation last Thursday, 26. I post it here to share what I learned and what I thought might be some options regarding the continuing funding, profit vs non -profit, of the hospital.


Thank you for the informative discussion Thursday night. As a county resident, I feel that you were balanced (not biased) in sharing the current status of the discussion concerning the GRMC.

There is no one in Grant, Catron, Hidalgo, or Luna County that, at one time or another, had some dealings with GRMC. My hope is that they were all medically successful. But cataloging medical experiences is not my purpose here. I have two issues that I would like to inject into this discussion that may or may not have already been covered in your deliberations.

Number One:

I do not believe that the polarizing ‘profit/non profit’ conflict is at the heart of the issues at GRMC. Ultimately the goal of both public and private are the same; to deliver quality health care to the community. The challenges to the non-proft side of the equation are that federal reimbursements are being slashed under the current federal budget in the name of ‘entitlement reform’ and ‘balanced budgets’, both explanations, however, being incredulous. This was mentioned in the presentation informing those present that the lion’s share of funding for the GRMC is federal (Medicare and Medicaid) and because of low reimbursement schedules, pay outs are low and slow from the government, stressing providers and the hospital alike.

We can’t change that part of the equation; if the GRMC stays afloat, it does so on an ocean of federal money.

And per your presentation, potential GRMC ‘profit’ suitors go unrequited because the profit just isn’t sufficient from federal reimbursements to pay returns to investors so...no money, no honey.

OK. I get that part.

But I believe, perhaps wrongly, that a hybrid form of these two platforms must exist but on a smaller scale. We have within a 2 hour drive, three hospitals, four counting us. While the hospitals themselves are both profit and non-profit and their sustenance from different sources, they could, with some effort, share some benefits. Independent providers from multiple medical specialties could contract with GRMC and others, to provide their specialty services on a regular basis through individual agreements with the hospitals. The hospitals in turn would provide space and assistance, the specialists pay the hospital for same. This program is already functioning here in Silver with heart/pacemaker care and there are probably more that I am not aware of.

Mountain View Hospital in Las Cruces does not have a brain surgeon on staff but has as an agreement with a surgeon in El Paso to use surgical theaters in both El Paso and Las Cruces. Both cities benefit from his services. GRMC could do the same with (for example) the two new neurologists and dermatologists in Las Cruces, since we have neither.

As I said at the outset, this is probably old news to those who have been discussing this for a while. But it does bear repeating.

And speaking of bears…



Number Two:

All Commissioners are aware of the proposed plan by the Air Force out of Holloman to do 10,000 sorties a year over the Silver City area and the adjacent Gila Wilderness. There are other areas of operation that already exist near and around Mogollon and Reserve. As you know, the reviews of the proposals for the expansion in our area can be found here: http://www.hollomanafbairspaceeis.com/Default.aspx

It is my opinion that the flyovers would be the death knell for our community.

Sissy McAndrew had an interview on KURU about the economic impact of these flyovers after attending a regional meeting of the Association of Realtors in Alamogordo. Agents there were gleeful that the planes would be flying over Silver rather than their business area. NIMBY was in full display. On KURU, Sissy explored the broader impact on the economy here in Silver, the same economy that provides for the continued survival of the GRMC.

Sissy relayed in her interview that the impact of the flyovers would destroy one of our major selling points to new home buyers. Some buyers have already abandoned their intent to move here because of the flyovers. Word will get out and suddenly we will be faced with a tax shortfall that would surely compromise the survival of the hospital should it remain under its non-profit status. Sonic booms don’t make for good neighbors; the natural peace and quiet, the community life style and the immediate access to Nature that the Gila affords would be devastated...and so would sales and taxes.

But the real estate market is not the only business affected by the sorties. Flying at 500 feet overhead it is not hard to imagine that trail hiking, back packing, camping, hunting, guides, gear sellers, on and on would be stopped entirely should the flyovers happen. A minimum of 27 flights a day could happen with the flight altitudes as low as 500 ft. Go to the end of your street and pace out 500 feet. Now imagine an air liner taking off right over your head. Now let that happen once an hour and think about buying real estate here. Or anything else, for that matter.

We don’t have a fall back economy. We aren’t flush with retail jobs or car repair jobs or construction jobs. It wouldn’t take much to send the Silver City economy into a tail spin. I’ve seen plywood over all the windows lining Bullard. It’s a sign of depression and defeat, all brought to you by The United States Air Force, whose very reason for being is to protect the people of the USA, not destroying the natural world and our lively hoods while waging a war on squirrels.

Now, for the bears. I researched some studies on the effect of constant or repetitive extreme sounds on mammals ie. cougars, mountain lions, bear, skunk, coatimundi, fox, ferrets, squirrels, chipmunks, and on and on. It isn’t hard to figure out. Sonic booms disturb cougars sleep and hunting patterns, as a result, starvation. Hormonal systems are so affected by the intensity and frequency that procreation promotes infertility in females and lower sperm counts in males. Hibernation could not occur. Constant flyovers would affect bird migrations. In short, it would only take two, maybe three generations before all mammalian wildlife would disappear in the Gila...and all the peace and all the economic resources and all that we share with the natural world and, ultimately, us.

I can live with whatever decision the Commission makes regarding the GRMC, I believe there are good things in all of the proposals.

I said I wasn’t going to get into anecdotes, but I lied. I’ll get into one; my own.

On January 1, at 2:30 a.m., New Year’s Day, I had a number of first’s: I had my first gran mal (tonic clonic) seizure, my first IV, my first hospital ride in an ambulance, my first time in an ER, and my first helicopter ride. It was also the first time that I found out I had a ‘significant’ brain tumor the size of an orange. After I had surgery at Mountain View, I had a number of second’s: multiple, uncontrollable seizures, hospitalizations, therapies, drug titrations, multiple medications combos and, finally, 4 years of trying to put my life back together. Many, many times the GRMC played an important role in my search for wellness.

I have all my parts again but they are arranged different than before. Not to hurt anyone’s feelings, but I never want to see the insides of the GRMC again; but I’m extremely glad to know that its there.

Sincerely,

Richard Earnheart

PS: Now that I have thought about it more, the flyovers must be the priority in keeping the hospital functioning in the community. If we allow them, there will be no need for a hospital.


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 Author: digitalwiz
PostPosted: Tue May 01, 2018 7:09 pm 
Thank you Richard for your usual articulate, well-reasoned essay. I will only quibble with one sentence. "Ultimately the goal of both public and private are the same; to deliver quality health care to the community." Really?!? The purpose of private health care is to generate profit. If it happens to actually deliver real health care that's a side benefit.


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 Author: rearnheart
PostPosted: Wed May 02, 2018 8:37 am 
I stand corrected, my friend.
r


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 Author: bobstockdale
PostPosted: Thu May 03, 2018 4:06 am 
While the United States has one of the world's best medical systems for the wealthy, there are dozens of countries with better medical care for the general public at half the cost.
The basic problems associated with health care in the U.S. are not enough good doctors and way too many parasites within the health care system.
The money already spent fighting over and then launching the Affordable Care Act would have put enough doctors through medical school to solve the problem of not enough doctors. With plenty of doctors, competition would quickly drive the price down, weed out the bad ones, and provide for more proactive health care. Many of today's doctors went to medical school with money as the goal instead of compassion or innate talent.
The insurance industry provides no health care at all. The purpose of insurance is to provide a common money pool to cushion the fall for individual people. The United Stated Government already has its own money pool. If everyone is to have health care, the government can dispense the money to doctors directly. There's no reason at all for middlemen to make a profit. Other than some necessary bookkeeping and oversight, the massive bureaucracy and profit taking of the insurance industry's involvement in universal health care is 100% parasitic.
The Affordable Care Act looks good on paper, but it does almost nothing to reduce the parasitic bureaucracy of the insurance industry that they can't sidestep, and is likely to actually reduce the number of doctors.
It's a shame that the new health care system will turn out to be a failure compared to what it could have been. Most of the blame lies squarely on the Republicans, because their alternative was even worse and their obstructionist agenda severely compromised constructive discussion. It was the Republicans who protected the parasitic insurance industry. Their blind faith in capitalism is founded in ignorance, fear, and greed, and is failing us badly.
For all its shortcomings, the affordable care act is a foot in the door, and hopefully we can begin to evolve it into something that works.

Many years ago in the Sierra Nevadas, I was standing in a saddle at about 11,000 feet looking out over the Nevada desert when I saw two little specs low on the horizon. A few seconds later they went directly over me at about 400 feet and close to twice the speed of sound. All the grass on the meadow was knocked almost flat and the pressure wave actually rocked me back on my heels just a bit.


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 Author: mimbresgranny
PostPosted: Thu May 03, 2018 11:55 am 
It is all true. Obama's compromise (and his original stance) was to keep insurance companies.
A footnote: there is one of the Nixon tapes where there is a discussion about creating the HMO model for health care and at the end of the discussion the person talking to Nixon says "We will all be rich." There is no doubt they knew and currently know the purpose of insurance companies had been hijacked.

The ACA did attempt to create more Doctors.
A footnote: the reason there aren't more doctors is because the AMA and Medical Schools have limited the number of doctors they will graduate. They might say it is because of the limits of their classes but there is no attempt to increase those classes availability to meet the number of applicants. It would seem they are very aware that an increase in the number of practitioners would likely drive down the potential incomes.
lp


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