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Editorials from around Pennsylvania

December 26, 2018

Editorials from around Pennsylvania:

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CLOSURE OF UPMC PINNACLE LANCASTER HIGHLIGHTS THE TOUGH REALITIES OF RUNNING HOSPITALS LIKE BUSINESSES, Dec. 23

We’re among the many Lancaster County residents distressed by UPMC Pinnacle’s decision to close its College Avenue hospital.

The decision hit many of us in a personal way, as the former St. Joe’s was the repository of many of our most significant life moments: the deaths of parents and other loved ones, the births of children and grandchildren. The 135-year-old hospital was a Lancaster city mainstay and, though we knew it was underutilized in recent years, we still hoped it would be there forever.

So we understand the sadness and even anger of some city residents. We worry, too, for the hospital employees who won’t be retained by UPMC Pinnacle. It’s never easy to lose a job, but this is a particularly rough time of the year for it to happen.

We also understand city residents’ concern that the very busy Lancaster General Hospital will be, come the spring, the only hospital within the city’s limits.

But we’re not sure why so much anger was directed last week at Lancaster Mayor Danene Sorace and the Lancaster City Council.

We agree that it wasn’t helpful when Randy Patterson, the city’s director of economic development and neighborhood revitalization, said he hoped the hospital would be razed to create a “blank canvas” for development.

The hospital complex covers a full city block — a significant piece of real estate in a city that is desperate to expand its tax base. So we understand what Patterson was thinking, but he probably should have curbed his enthusiasm for demolition, given the circumstances.

Patterson’s comment drew the wrath of activist Tammy Rojas, coordinator of the Lancaster Healthcare Rights Committee of the advocacy organization Put People First! As LNP’s Tim Stuhldreher reported, Rojas demanded at a city council meeting Tuesday evening that city officials work to keep the hospital open.

And at that meeting, Pastor Kevin Brown of Kingdom Life International Assembly said, “Taking this hospital out of the city is an outrage.”

We’re not sure what the city can do about it. The hospital is owned by the UPMC Pinnacle system, which operates a chain of hospitals in Lancaster, Dauphin, Cumberland and York counties. The system says it has a charitable mission, but it still has to heed its bottom line.

In modern American health care, a hospital stays open only if it makes financial sense to keep it open. Efficiency and market share may not have been the foremost concerns of hospital administrators in the past, but they are pressing concerns now.

And a hospital system — they’re mostly all systems now, as smaller hospitals are acquired by larger ones and health care entities consolidate — is run like a business, even if it’s a nonprofit.

This may sadden us, but it’s the reality. That we accept it doesn’t diminish our concerns about the health care needs of county residents.

What we don’t know, however, are the precise reasons UPMC Pinnacle is closing this hospital.

Its website addressed frequently asked questions, but didn’t really deliver on this particular one. The answer to why it was closing was mostly a word salad describing a vague “three-part plan to ensure the continued availability of the high-quality clinical care expected of UPMC for Lancaster-area communities.” We read and reread it, trying to discern the meaning, to no avail.

We share the concerns of members of the health care community who told LNP’s Stauffer that so much depends now on how Lancaster General Hospital — which Stauffer described as “the dominant force in Lancaster County health care” — responds in the wake of the closure of UPMC Pinnacle Lancaster.

“It’s kind of going to be laid in their lap to figure out how they’re going to handle the extra volume, to a system that’s already pretty stressed,” said Michael Fitzgibbons, president and CEO of Susquehanna Valley EMS.

Fitzgibbons said that without an emergency department at UPMC Pinnacle Lancaster, his agency’s calls will take longer, “which then has a domino effect on the whole system.”

Bob May, executive director of Lancaster EMS, said in an email to Stauffer that his agency has had an ambulance station at the former St. Joseph Hospital since the early 1970s.

“Busiest unit in the county,” he wrote, noting that the agency is evaluating its options. “It’s vital to have a base of operations in or near the west part of the city.”

As Stauffer noted, UPMC Pinnacle Lancaster had 136 beds set up and staffed, with 3,513 admissions and 23,360 emergency department visits, according to state records from 2017.

Lancaster General Hospital had 533 beds; 31,941 admissions; and 115,990 emergency department visits.

The math makes clear the pressure that will be on LGH.

Penn Medicine Lancaster General Health has proven to be a fine system and we have faith that it will continue to serve this county well.

But there is real trepidation in the community.

“We are in need of more services, not less, if we wish to have healthy lives,” Rojas said in a news release. “Lancaster can’t afford to lose the jobs or the access to care that local hospitals provide.”

Alas, this is the state of play in American health care today. Smaller hospitals with close ties to their immediate locales just don’t have the patient volume to survive in an era when consolidation and financial calculation reign.

We think there ought to be more important considerations than a health system’s bottom line. Obviously, it needs to be solvent to operate, but its solvency should be the means to its central end — serving the community — and not the end itself.

It’s not asking too much to have some choice in where one gets one’s health care. But increasingly, we are being left with fewer choices — and no way of changing that reality.

The resulting helplessness might be mitigated if health systems communicated in more straightforward ways with the community they serve. We wish UPMC Pinnacle had done this.

Now, we’d urge LG Health officials to address, in a more detailed way than it has so far, people’s concerns over the closure of the only other city hospital.

Time isn’t the only thing that heals. Communication does, too.

__LNP

Online: https://bit.ly/2QOyVTE

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PA LIQUOR LAW CHANGES WORK FOR SHOPPERS, Dec. 21

The ongoing entry of the homegrown Country Fair convenience store chain into the business of selling beer and wine punctuates how much the experience of shopping for those products in Pennsylvania has changed.

As reporter Madeleine O’Neill detailed this week, six Country Fair locations have started selling beer in the past year, and all but one of those stores sells bottles of wine. Wine sales will be coming to the sixth store as well.

Country Fair officials said another nine stores are preparing to enter that market. The stores require changes to their buildings to meet the requirements of state liquor laws.

The payoff for consumers as beer and wine are sold in more places? Ask Deon Person.

“It’s just convenient,” Person told O’Neill as he picked up a six-pack at the Country Fair store at West 18th and Sassafras streets. “I’m literally a couple of blocks away from home.”

Country Fair is joining a growing number of outlets for beer and wine sales. Expansion of consumer choice and convenience started in earnest in 2010 with a Pennsylvania Supreme Court ruling that rejected a challenge by the Malt Beverage Distributors Association of Pennsylvania — a trade group representing beer distributors — to grocery stores’ right to use their restaurant liquor licenses to sell two six-packs of beer for takeout.

Two additional changes signed into law by Gov. Tom Wolf in 2016 further expanded shoppers’ options. The first allowed grocery and convenience stores selling beer to also sell up to four 750-milliliter bottles of wine to go. Previously wine could be purchased only at state-run liquor stores or wineries.

Elizabeth Brassell, spokeswoman for the Pennsylvania Liquor Control Board, said that was a “market-changer” that made more retailers interested in adding alcoholic beverages to their stock. Country Fair is among them.

The second change helped level the playing field for beer distributors by allowing them to sell beer in any quantity, including six-packs, quarts and growlers. Distributors previously had been limited to sales by the case or keg.

We’ve long advocated for liquor law reforms that focus more on those doing the buying instead of those doing the selling, and bring Pennsylvania more in line with other states. And we still believe the state shouldn’t be in the liquor business except for roles in regulation and law enforcement.

But the changes in beer and wine sales have gone a long way toward improving access, choice and convenience for consumers. In addition, the LCB expanded hours and improved customer service at the state liquor stores.

It took far too long, but now Pennsylvania consumers have more options to buy what they want in the quantities they want and where they want. Imagine that.

__Erie Times

Online: https://bit.ly/2GGTTzo

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ENDING THE BLOODSHED: POLITICAL GAMES PROLONG US INVOLVEMNT IN YEMEN, Dec. 26

The 56-41 vote by the United States Senate to end U.S. military support for Saudi Arabia’s deadly war in Yemen is remarkable for several reasons.

First, and quite amazingly, it marked the first time that the Senate has utilized the powers granted to it under the 1973 War Powers Act, which gives Congress the authority to end military actions.

Second, the bipartisan vote was a complete 180 from just this past March, when a similar bill to end the U.S. involvement in Yemen only received 44 votes. Political junkies will tell you that a 12-vote swing is an awful lot.

Of course, there is a reason for that vote swing and it was not because 12 senators suddenly developed a conscience. Rather, the brutal murder of Washington Post columnist Jamal Khashoggi, allegedly at the order of Saudi Crown Prince Mohammed bin Salman, resulted in an enormous outcry. The country wanted Congress to rebuke the Saudis and removing support for the war in Yemen, which has come mostly in the form of arms and fuel for bombers, was the clearest way to do so.

But getting out of the conflict in Yemen is good for the U.S. and good for the world. Foreign policy experts agree that without U.S. assistance, the bloodshed is likely to come to an end. This would be great news because some analysts have estimated that more than 50,000 people already have been killed in the conflict and that nearly 20 million Yemeni are in urgent need of humanitarian assistance.

Sadly, getting the Senate vote is not a straight shot for removing U.S. support for the war. House Republicans, with the critical help of five House Democrats, slipped a provision into the recently passed “farm bill,” a legislative package focused on agricultural subsidies, which blocks a vote on the Yemen resolution during this congressional term. The thought is that the Senate, which will be even more GOP-heavy come 2019, will not pass the Yemen war resolution again.

The Senate must show its backbone in 2019 and vote the Yemen resolution through again, with the support of the House. Ending U.S. support for the war in Yemen should not be a red vs. blue game. It should be a bipartisan consensus, fueled by a desire to stand apart from the Saudis and reclaim our morality.

__Pittsburgh Post-Gazette

Online: https://bit.ly/2Sm3Tzr

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BEVERAGE TAX FIGHT STILL RAGES. WHY?

The long arm of government should not be reaching into people’s refrigerators and pantry cupboards to dictate what they consume -- even for low income people who rely on government help. That doesn’t stop debates that periodically break out suggesting that certain foods should be prohibited from being paid for with food stamps - like steak or sweets or snacks.

Still, the government can and does wield influence; they can control or curb consumption through taxation, often on the basis of health concerns. Hence, the phrase “sin tax.”

Sugary beverages have become the latest sin to get taxed. After contentious battles and debates, the city imposed a 1.5 cent tax on sweetened beverages starting in 2017. Though the proceeds are designed to increase pre-K education, as well as fund Community Schools and the city’s Rebuild program, the opponents fought back with a lawsuit.

A year later, the courts upheld the city’s ability to impose the tax. The beverage and grocery coalition opposing the tax, though, hasn’t relented. Just last week, Councilmember Allan Domb filed a resolution in Council to hold even more hearings on the matter. And the issue is likely to figure in the upcoming mayor’s race. Why?

Opponents insist their criticism of the tax is out of concern for poor people, since the burden of the tax falls on them disproportionately. Recently, some members of the city’s black clergy used the same argument to disavow their support of the tax.

Given the health problems arising from high consumption of sugar, and the already disturbing reports that life expectancy for low income people is far lower than for more privileged groups, you’d think church and civic leaders would be more angry about how their communities are deprived of early education opportunities, not the 18 extra cents for a can of Coke.

It should come as good news that recent research from the National Bureau of Economic Research found the Philadelphia tax reduced adults’ frequency of regular soda consumption by 10.4 times per month, and says there is evidence that overall sugar consumption has been reduced slightly.

If the tax were done solely as a health measure, it would be one thing. But the early childhood education that the tax funds has a far more positive long term impact than a drink.

The clergy have also followed the playbook in faulting the bill for an erosion of jobs and an increase in struggling stores who are losing sales of sodas. But recently, the Food Trust looked at wage tax receipts from the sector in the economy most affected by the tax and found a slight increase, so the doomsday complaints from the beverage industry that this is a job killer just aren’t verifiable.

The soda tax has so far generated $137 million. According to a recent controller’s report, only $31.7 million has been used to fund pre-K, but the city plans to increase enrollment from 2,000 seats to 6,500 in 2020. Philadelphia has 100,000 children under the age of five, so that’s still not enough, but it’s more than a drop in the bucket. It’s time to stop arguing about it.

__Philadelphia Inquirer

Online: https://bit.ly/2GIZvZQ

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