Published in the Medford Mail Tribune and Ashland Daily Tidings, September 25, 2012
Guest Opinion By Matt Witt
Why should we care whether the huge Dignity Health hospital chain takes over Ashland Community Hospital? Because any outside takeover can have a severe impact on jobs, the quality of care, and the rights of patients and doctors. That doesn’t mean no takeover should ever be considered. But it does mean that any possible acquisition must be done carefully, which requires
1. Meaningful community input with enough time to identify and resolve important issues before a deal is all but done.
2. Community consideration of alternatives, including proposals from other health systems like Asante, rather than just one preselected proposal.
3. Leadership with no potential conflict of interest and that represents the full range of patients’ concerns.
4. Preservation of individual choice and control over our own care.
We’ve seen outside takeovers before in which employees and customers were promised that they would thrive with wealthier owners. At Harry & David, jobs were lost, pensions were cut, and small contractors weren’t paid for work they had done. At Musician’s Friend, the new owners took what they wanted and then eliminated 200 good local jobs.
Our current hospital management says it can’t balance the budget but that Dignity, the fifth largest hospital chain in the nation with more than 40 facilities in three other states, will fix that by massive new spending. Maybe this will happen, or maybe not. Or maybe it will only happen at first.
If we relinquish community control, what happens when out-of-state executives, having established their first foothold in Oregon, decide to cut back or close our hospital so they can expand into larger markets in the state? What happens when numbers-crunchers who have no stake in our community decide to increase fees or cut jobs, benefits, or patient services?
Are these just hypothetical concerns? Hardly. Dignity is already imposing its own agenda on our community. While what used to be Catholic Healthcare West has changed its name to Dignity, its rules based on the chain’s Catholic tenets remain the same. A spokesperson admitted earlier this month that our hospital and doctors at its clinics will be required to abide by the chain’s longstanding “Statement of Common Values.”
She said that, under these rules, a terminally ill patient will no longer be allowed to request end-of-life care from a willing physician at the hospital’s Center for Family Medicine, as permitted by Oregon’s Death with Dignity law that has twice been ratified by the state’s voters. (No patient or doctor is required by law to participate in such care, but terminally ill patients have a legal right to request it and doctors have a legal right to provide it if they so choose.)
When Mayor [John] Stromberg asked whether this statement’s rules could be eliminated for ACH, Dignity’s spokesperson said, “As far as loosening it, don’t hold out hope. We have our feet in Catholic mud, there is no denying it.” When a doctor affiliated with the hospital courageously wrote to the City Council that the Dignity takeover does not protect his patients’ choices under Oregon law, the hospital’s CEO, Mark Marchetti, wrote that the doctor “will have to decide if he wishes to continue to be part of our clinic.”
For months, Marchetti denied publicly that Dignity would take away our legal right to choose end-of-life care or would limit women’s reproductive rights. Indeed, he wrote in his Aug. 7, 2012 blog that nothing would change and that “I do not believe that our board of directors would have chosen to align with Dignity had it remained a faith-based organization.”
The CEO himself might fare differently under the various takeover proposals the hospital received. To avoid any potential conflict of interest, the job of evaluating and negotiating alternatives for the hospital and keeping the community involved should be turned over to a more broad-based team that represents the full range of patients’ concerns.
Most area residents want the hospital to remain open, and most believe that terminally ill patients like my 96-year-old father must remain free to make their own choices as provided by law, even if those might not be the choices we would make for ourselves. We need to let our elected representatives know that we want all alternatives on the table, not just the Dignity proposal. We want full and informed community participation in the decision. We want to be represented by people who have no conflict of interest. And we want an outcome that preserves patient control over our own health care choices.
Matt Witt is a writer and photographer who lives in Talent.
READ – Dignity/ACH deal gets political, editorial from Ashland Daily Tidings, September 22
READ – Letters to the Editor of the Daily Tidings, September 20
READ – Dignity Health offers a hand up to ACH, guest opinion by Tracy Caldwell, a registered nurse who works at Ashland Community Hospital, September 26
LISTEN – Hospital affiliation discussed on Jefferson Public Radio, Ashland Community hospital’s CEO Mark Marchetti and Janet Troy, Vice President of Development were guests on Jefferson Public Radio’s ‘Jefferson Exchange’ talk show. They discussed the hospital’s financial health, place in the community, and upcoming affiliation with Dignity Health. Mark explained how the affiliation process worked and why Dignity Health was chosen. To hear the entire interview, click here.