Wednesday, Aug. 20, 2008

A bold plan for a new hospital

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Some of the best health care in America exists in Montgomery County.

While it has not always been the case, these days all of the county's major hospitals seem to be well managed, well resourced, and investing in the medical needs of our community.

But, there are challenges:

īThe population not only continues to grow, but it continues to age.

State planners project the growth rate for age 65 years and over between now and 2015 to be five times as fast as 65 years and under. Inpatient days at hospitals are six times greater for the over-65 group, which is a contributing factor in a state projection that 220 more hospital beds will be needed in the county during this growth period.

īThe needs of those without health insurance continue to go largely unmet.

An estimated 80,000 to 100,000 people in the county are uninsured. A county program, Montgomery Cares, provides some assistance to 15,000 uninsured patients through hospitals and clinics. That is far short of its targeted 40,000 people in fiscal 2008 where budgeted dollars for the program were returned to the county coffers because there was not enough capacity to serve this population.

īThere will be an even greater shortage of health care professionals in the future.

Historically, it has been difficult to fill the need for health care professionals, especially nurses. It is projected that between 2000 and 2020, demand for these jobs will increase by 40 percent due to growth and attrition while the supply will increase only 6 percent.

Holy Cross Hospital announced last week its intent to pursue a bold idea that speaks to all three of these challenges — a new 100-bed hospital in Germantown on the campus of Montgomery College.

The plan also calls for a reinvestment at its Silver Spring hospital, converting to all private rooms and enhancing emergency and surgical services all within the "footprint" of its existing facility. Further, Holy Cross, which has done the heavy lifting in the county in delivering health services to the uninsured at its hospital is planning a health center in Gaithersburg this year and another clinic in Wheaton/Aspen Hill next year. Each clinic can require a subsidy of up to $1 million a year.

Delivering affordable health care for all in need and making the economics work between public and private forces is a complex undertaking. Sorting out the issues of turf and compatibility among county hospitals is equally difficult.

But, a good idea is a good idea. And this one deserves careful consideration by the state's health-care regulators who must grant needed approvals.

Holy Cross has mastered the economic mix of providing care for patients regardless of whether they have insurance or not. It has access to capital through its alignment with the Trinity Health Care System.

A Germantown hospital would bring services to one of the most densely populated areas of the county, where the senior population is reportedly growing at 6.2 percent a year, plus provide access to hundreds of uninsured people in that area who now find their way to Silver Spring. Locating the hospital on the campus of Montgomery College marries two reputable institutions with promising synergy, notably shared faculty and mentoring and a concept of "teaching sabbaticals" that could extend the service of professional health care staff.

If the plan withstands objective analysis and moves forward, it could very well be that a very good health system in our county will get even better.