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Friday, March 30, 2007

I'm offended (update)

From: Diane C. Russell <dcrussell@gmail.com>
Date: Mar 30, 2007 5:06 AM
Subject: Re: I'm offended
To: Dereck Davis <dereck_davis@hotmail.com>

This is not as well thought out as I had hoped--other matters interfered with spending much time on it.

On 3/29/07, Dereck Davis wrote:

Ms. Russell,

Its been quite a long time.

I was out of town for a bit over nine months and had limited access to local news.

Glad to have this opportunity to dialogue once again. Since we've chatted on various subjects in the past and are well acquainted with each other's style, lets dispense with the pleasantries and get right to the source of your discontent.

First of all, as a four-term incumbent, I think I have a pretty good feel for the desires of my constituents. Sure, no one wants to pay more in taxes but the voters were very clear when I was on the campaign trail last fall; they wanted me to do what was necessary to save the Prince George's Hospital Center. Given the enormous capital debt and the lack of operating capital, how would you propose that we save the hospital?

To tell you the truth, I'm not certain. However.

This bill doesn't seem to be any less of a band-aid than the other things under discussion.

I don't think you folks have thought out what is going on and don't fully understand what the consequences will be. This "solution" may take the heat off someone for the moment, but it won't solve the problem any more. It will be about as effective in solving the hospital's problems as the appointed school board (with it's crooked CEO) was in improving school performance.

I keep hearing rhetoric about saving the hospital, but I don't know what that means.

On the one hand, I would hate to see us lose hospital beds and related services.

But on the other hand, I don't see any need to save the current hospital administration, or even the current management or ownership entities--they have failed.

One state official has been quoted as saying that "it wouldn't be pretty" if the hospital closed. I don't think ouring money down a black hole is pretty.

And "saving the hospital" at what cost? Where does "saving the hospital" (whatever that means) rank priority-wise? Although it is a catchy phrase, actually doing something effective has been a very low priority for the county.

As I said, I would hate to see the number of hospital beds and related services reduced--they should be saved somehow in some form.

But, I don't think that is the same as "saving the hospital" as it is currently organized and governed.

I don't think the political community has adequately explained to the people what might happen under various scenarios.

Would bankruptcy necessarily permanently reduce the number of hospital beds in the county?

And why is there a continuing deficit problem? How much of it is due to mis-management and how much due to non-paying (for whatever reason) patients?

To the extent that the deficit is due to mis-management, it is irresponsible and stupid to raise taxes in order to subsidize failure.

To the extent that the problem is due to non-paying patients, is raising taxes and dumping money into the hospital generally really a good solution?

If the real problem is the latter, perhaps it would be both more rational and effective if you folks dealt with the real problem--whether through some mechanism for fixing health insures, or even through a separately identified and managed fund to subsidize uninsured patients. I would be more willing to consider a short-term tax earmarked for subsidizing emergency or catastrophic medical care for the uninsured (until the state or feds resolve the real issue) than I would a permanent tax aimed at subsidizing a bleeding institution with a history of management failure.

In any case, I have about zero confidence that the county executive and county council have either the will or the ability to come up with real solutions, and almost zero confidence that the General Assembly is any better. I do have a moderate level of confidence that you folks will come up with a tax-based non-solution that makes it appear that you are doing something, and in a year or two we'll be hearing more calls to pour money down the black hole.

There isn't some giant ATM in Annapolis where we can just withdraw the funds. You should also know that the state is facing a $1.5 billion structural deficit.

Yeah, I keep reading about that, but it doesn't seem to stop non-essential spending.

If this hospital is going to survive, its going to require a significant financial contribution from both the state and the county-PERIOD! Otherwise, we need to prepare for the closure of a critical component of our health care system.

But what kind of financial contribution, to be spent how, to accomplish what end? What is the objective? To "save" the bankrupt, mis-managed hospital, or to continue the availability of the current level of medical care the hospital provides? I don't believe that the two are necessarily the same thing.

Ms. Russell, you have a luxury that I don't have. You can say don't increase taxes for this or that without having to be accountable for the fallout from that decision. I really wish activists such as yourself would run for political office and stop sitting on the sidelines second-guessing every decision. If you are blessed enough to have the opportunity to serve, you will see that it is not as easy as you make it out to be.

In some ways you make a fair point, but you office-holders also have an advantage many critics don't and that is that you usually get to frame the terms of and limit the debate so that the only options that get widely discussed are tax and spend versus the end of the world. Or in this case, raise taxes or close the hospital. Maybe we're now boxed into a corner where other options can't be on the table, but I don't think our leaders have explored (or if they have, communicated to the public) other alternatives for providing hospital care without dumping tax money into a black hole where there is no effective accountability. Much of what you may consider my unfair second-guessing is aimed at getting people to think both about other possible approached to problems and about unintended consequences of inadequately thought-out "we've gotta do something" actions.

Just so we are clear, are you telling me that if you had a choice between paying more taxes or letting Prince George's Hospital Center close, you would rather see the hospital close? I want to share your position with my civic leaders, some of whom are on your distribution list(s), to see if they share your position. If they do, the legislature can easily derail the House plan.

As I've suggested above, I don't think there are only two choices.

But if you forced me to make the choice between the tax increase provided in the current House bill or letting it close (whatever that means), I'd say let it close.

Thank you once again for this opportunity to converse on a most important issue facing our county.


Dereck E. Davis
25th District

Date: Thu, 29 Mar 2007 07:01:30 -0400
From: dcrussell@gmail.com
To: dereck_davis@hotmail.com
Subject: I'm offended

From the Post:
County Council Chairman Camille Exum (D-Seat Pleasant) said it was 'unconscionable' for the state to tax county residents. 'This council will not ever support a bill that is not in the best interest of Prince George's County,' she said, arguing that the state should take on more of the burden for the costs of the hospital, which serves patients from around the region.
Del. Derek Davis (D-Prince George's), who voted in favor of the bill, told the committee that he was offended by Exum's remarks.
He said the county House delegation 'stepped in where there was a void' and was never briefed on the county's plan for the hospital. 'We decided that the foolishness needed to stop,' Davis said. 'There are those who say they are working in the best interest of Prince George's County, like I'm not. I find that very offensive.'
And I am very much offended by delegates, like you, who choose to single out and force new taxes on Prince George's County voters despite their consistent votes against increased taxes.

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